Stress First Aid: 4 types of stress injuries

Stress First Aid identifies four types of stress injuries, including trauma, loss, inner conflict, and wear & tear. These have been exacerbated during the COVID-19 pandemic, significantly impacting the mental and emotional wellbeing of those in the veterinary field.

By Melyssa Allen, MA, NBC-HWC, DACLM

When you are getting trained in first aid, you also need to recognize what kind of injuries you are dealing with in order to provide proper care. As we highlighted in our previous article within the Stress First Aid series, stress injuries can often pose a greater challenge in terms of identification, as they lack visible physical symptoms.  

By acquiring a comprehensive understanding of stress injuries, veterinary professionals can significantly enhance their awareness and aptitude for identifying signs of stress injuries in both their co-workers and themselves during the first “C “of Stress First Aid: “Check.”   

Stress First Aid identifies four types of stress injuries: Trauma, Loss, Inner Conflict, and Wear & Tear. Chances are you’ve experienced one or all of these at some point during your lifetime, but throughout the COVID-19 pandemic, these stress injuries were exacerbated more than ever and experienced simultaneously.  

This created a compound effect of the impact of these stress injuries for veterinary professionals, leading to the rising challenges posed to mental and emotional wellbeing in veterinary medicine. Recognizing these stress injuries can help you take more effective action to mitigate the symptoms and harmful effects through the 7 Cs model of Stress First Aid. 

4 Types of stress injuries 

Trauma—Traumatic injury 

  • The unfortunate reality of veterinary medicine is you will experience cases of trauma at some point in your career. For those in ER, especially, trauma can occur on a regular basis., but veterinary professionals as a whole will encounter situations where they must treat intense injuries, witness horrific cases of neglect, and regularly deal with death. 
  • Another type of possible trauma  is assault on veterinary teams,, whether verbal or physical. This type of trauma has been on the rise since COVID. 

Loss—Grief injury  

  • The nature of your roles as veterinary professionals requires you to deal with death and dying on a much higher level of frequency than most other professions.  
  • Loss showed up in many other capacities throughout COVID as well: loss of jobs, opportunities, loved ones, travel, connection, and celebrations.  
  • There are often various versions of guilt experienced when facing a grief injury, which can be a normal reaction to grief but can ultimately lead to complications in the grieving process.   

 Inner conflict—Moral injury 

  • This type of stress injury results from engaging in or witnessing actions that you feel conflict with your values.  
  • This type of injury was prevalent during COVID when faced with difficult decisions made for team and client safety, such as protocols that prevented clients from being with their extremely ill pets.  
  • Moral injury can be experienced on other levels when it comes to your own wellbeing. For instance, you know that your clinic is short-staffed. You don’t want to create a difficult day for your team, but it is also supposed to be your day off—and you don’t have anything planned, so you could go in, but should you? Your time off and days off are crucial to help you rest, refresh, and recover from your own shifts, otherwise you could also be facing the next type of stress injury. 

Wear and tear—Fatigue injury 

  • This type of injury is no stranger to those within high stress occupations like veterinary medicine. Wear and tear is experienced with the accumulation of stressors, both professional and personal, without sufficient time for rest and recovery from those stressors.  
  • This is why your days off and vacations are crucial for maintaining your wellbeing, resilience, and performance. There will always be stressful situations to face in your job and life, and that emphasizes the importance of not only finding time to manage your stress throughout your day, but also creating periods of time for yourself to recover from your stress throughout the week. 

By understanding and identifying these stress injuries, veterinary professionals can take proactive steps to address and mitigate the potentially harmful effects if they go unmanaged. Through raising awareness of these types of stress injuries, the veterinary community can work together to create a culture that supports the overall resilience and mental wellbeing of the veterinary profession as a whole. 

This includes fostering a supportive work environment (which may include adopting the Stress First Aid framework), encouraging regular engagement in self-care practices, and ensuring sufficient rest and recovery from stress.  

Awareness: The key to Stress First Aid  

As you’ve probably noticed by now, a common theme among Stress First Aid is building a sense of awareness for what is happening and what needs to change, checking in on your stress zone, understanding the stress injuries, and noticing behavior or mood changes in yourself and co-workers. One of the most effective ways awareness can be created is through practicing mindfulness, which helps to strengthen your skills of present-moment awareness.  


Cover photo credit: © Iman Raza Khan E+ via Getty Images Plus      

Stress First Aid resources are available from the US Department of Veterans Affairs at — veterinary graphic courtesy of Mind-Body-Thrive Lifestyle. 

Disclaimer: The views expressed, and topics discussed, in any NEWStat column or article are intended to inform, educate, or entertain, and do not represent an official position by the American Animal Hospital Association (AAHA) or its Board of Directors. 




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