March 22, 2023
Words & Photos by Jens Odegaard 

For nearly a decade, Dr. Katja Duesterdieck-Zellmer felt alone in being stressed about her job. She’s a board-certified associate professor of large animal surgery at the Carlson College of Veterinary Medicine. 

Her job is to perform highly complex procedures on patients who cannot communicate for themselves at the college’s Lois Bates Acheson Veterinary Teaching Hospital. Duesterdieck-Zellmer has to evaluate the animal’s condition with her surgical team and then work with the animal’s owner to determine a course of action that’s best for the animal, but also takes all the owner’s considerations into account. 

She then strives to perform a perfect surgery, while leading her surgical team, that will give her patient the best quality of life in the future. As with all surgeries, serious complications are always a risk, and Duesterdieck-Zellmer has to carry that weight.

In addition to performing these surgeries, she is teaching surgery residents (veterinarians completing post-doctoral specialty training), clinical fellows (veterinarians working toward becoming residents) and veterinary students who are seeking their DVMs. On top of that, she also has a research appointment. 

Then you have all the regular workplace stressors we all face: interpersonal relationships, competing priorities, budgets, fatigue, you know the drill. 
“I always thought it's just me, and I'm not tough enough, and I just have to deal with it,” Duesterdieck-Zellmer said. 

(Photo: Dr. Katja Duesterdieck-Zellmer contemplates her approach to a procedure to take a fluid sample with a needle and syringe from a mass in a horse's abdominal cavity near the bladder and uterus. Dr. Robert "Bob" McCarthy holds the syringe and tubing.)

Duesterdieck-Zellmer is not alone | You are not alone
In 2021 Merck Animal Health in partnership with the American Veterinary Medical Association published a comprehensive veterinary wellbeing study that found 73.9% of veterinary staff and 43.5% of veterinarians self-identified as either suffering or just getting by. In the same survey, 18.1% of veterinary staff and 9.7% of veterinarians were in serious psychological distress. Listed first in the findings of the three most important things to promote wellbeing and mental health was “have a healthy technique for dealing with stress.” 

Several years back, Zellmer was at the national meeting of the American College of Veterinary Surgeons (the certification governing body for her specialty area) when she realized this burden of stress wasn’t unique to her.

“It was a talk about how to establish laparoscopic techniques in your practice when you're new and have never done laparoscopic techniques. And the surgeon there described that these are very stressful procedures, and I have always felt that they are stressful procedures, but I always thought it was just me: maybe my technique is not good enough, or I don't feel safe enough about what I'm doing,” Duesterdieck-Zellmer said. “And it was eye-opening for me to figure out that a lot of surgeons feel like that.” 

This realization was life-changing. She went on her own journey of reading, studying and starting to practice mental health awareness and wellness both in her personal life and in her professional life.

During this journey, the concept and practice of resiliency really stuck out to her. As a basic definition, resiliency is the ability to respond to stress in a healthy way and recover successfully from challenges.

She started reading further about how to put resiliency into practice as a veterinary healthcare professional and realized she wanted to bring this personal learning to her veterinary colleagues in the college. 

If she had felt alone, maybe they did too. If she was looking for strategies to cope with common stressors, maybe they were too. 

She especially wanted to share this knowledge with those at the early stages of their careers. “My driving force was that I wanted to incorporate this for our residents and clinical fellows, because I wished I had had more education in that area during my residency,” Duesterdieck-Zellmer said. 

Accessing expertise 

Duesterdieck-Zellmer approached college leadership and secured immediate backing to bring in outside expertise in the subject to add to the ongoing wellbeing efforts in the college. Through a grant she secured from the American Veterinary Medical Association, the college hired Resilience in Healthcare. “RIH is a team of clinicians with a mixture of medical, psychological, and educational expertise,” according to its website. “We bring together relevant principles in psychology and behavioral science to deliver a curriculum which supports physician wellbeing in clinical practice.”

At the college, RIH led four training modules. 

  1. Understanding and Managing Stress States: The Art of Self-Regulation
  2. Foundational Practices to Moderate Your State of Mind
  3. Navigating Conflict: Healthy Professional Boundaries
  4. Conscious Conflict – Asking for Change

The modules and accompanying sessions to put learning into practice have given Duesterdieck-Zellmer and fellow attendees a chance to gather and communicate in new ways outside of their typical in-the-thick-of-it teamwork and interactions. 

(Photo: Dr. Katja Duesterdieck-Zellmer and Dr. Erica McKenzie discuss a horse's case to determine the best course of action.)

“For me one of the most valuable things was getting to interact with our staff in conversations we don’t usually get to have in the work environment and to get their insights about professional interactions and their influence on wellness in the clinic,” said Dr. Erica McKenzie, professor of large animal internal medicine. “Our jobs seem progressively more demanding with escalating volume of patients, complexities of procedures, and expectations of clients, which takes a greater toll on time and mental health. Interpersonal communications can have a profound influence on how well professionals can cope with the load and the overall morale of an institution, so working to try to optimize communications and emphasize the influence they have is very timely and important.” 

Dr. Robert "Bob" McCarthy, a large animal surgical resident, echoes McKenzie’s sentiment. “I think it is important to understand that how we word things can change how it comes across to people and we don't get a chance to take it back. The modifications in communication will be beneficial to ensure that everyone feels heard and supported, and that's one of the most important parts of working in a team setting like veterinary medicine.”

In addition to fostering clear and open communication to help establish and reestablish the interpersonal relationships in the hospital, the curriculum teaches practical self-regulation and processing skills for veterinary professional to implement in their work. “I think that these training programs are important because they really drive home the fact that it is important to advocate for yourself. They give you different techniques to employ in varying situations because we are not always able to step away from a stressful situation and come back to it,” McCarthy said. “There are times when we are exhausted and we may be dealing with a difficult case or procedure that may not be going well and it's important to understand how to take five seconds to reorient your thoughts and to take a deep breath. We don't have the luxury of pausing and coming back to a strenuous procedure, but we do have the ability to change our mindset, and these training programs really help with that.” 

Sharing a laugh can help calm the nerves before a delicate procedure. Fourth-year veterinary student Jon Remy and Dr. Katja Duesterdieck-Zellmer.

Foreground: Dr. Robert "Bob" McCarthy and Dr. Katja Duesterdieck-Zellmer prepare an ultrasound probe that Duesterdieck-Zellmer will use to help guide her as she takes a fluid sample with a needle and syringe from a mass in a horse's abdominal cavity near the bladder and uterus. Background: Fourth-year veterinary students Erryn Smith, Emily Green and Jon Remy discuss the case.

Clear communication with the team is critical during a procedure. Dr. Katja Duesterdieck-Zellmer consults with Dr. Eleanor Anderson, imaging resident (second from right), while performing the ultrasound to determine optimum placement of the sampling needle. Dr. Zineb Kotbi, large animal clinical fellow (right) and veterinary students Emily Green (in green) and Shelby Hubick (in maroon) observe. 

For Duesterdieck-Zellmer, meditative practices that she learned in the training have become another tool in her surgical pack. Recently she was preparing for a surgery she hadn’t done before. “I am always nervous before surgeries,” she said. “I anticipated some difficulties and I was just really anxious, but I had five minutes, and I decided I'm going to my office and I'm going to meditate for five minutes. And that really helped me.” 

Dr. Thandeka Ngwenyama, a clinical assistant professor and emergency and critical care specialist, also found the modules helpful. “[You] learn vital life skills to navigate the stressors and challenges experienced by high performing individuals in a demanding profession; deliberate practice of resiliency activities can help mitigate burnout. Participants cultivate community, learn evidence-based strategies to navigate conflict, learn perspective taking, build emotional intelligence and learn structured communication tools.”

Duesterdieck-Zellmer hopes that there will be future opportunities for more colleagues to participate in the trainings and to continue opening up conversation and communication, so that no one feels they are carrying the burdens of the profession alone.  “I just hope that we all are more honest about veterinary medicine being a stressful profession and supporting each other.” 

“These trainings allow for a wider support system from within the hospital, and I think that is incredibly valuable,” McCarthy concurs.