Mental health of veterinary nurses and student veterinary nurses: A scoping review.

BACKGROUND: Research has shown that veterinarians around the world are at high risk of mental health problems, but far less research has examined the mental health of veterinary nurses (VNs) and student veterinary nurses (SVNs). This scoping review aimed to map existing evidence on this topic and identify knowledge gaps. METHODS: Literature searches of MEDLINE, PsycINFO, PubMed, Web of Science and Google Scholar were conducted, and a structured screening and selection procedure was applied. To be included, studies had to be peer reviewed, report relevant results specific to VNs and/or SVNs, and provide descriptive statistics if using quantitative methods. RESULTS: Of the 2118 publications identified, only 13 journal articles met the inclusion criteria. The findings were summarised in five categories: mental health and wellbeing, burnout, stress, compassion fatigue and moral distress. While the findings of five of the studies suggested that some VNs and SVNs experienced some form of poor mental health, these studies lacked generalisability or transferability for multiple reasons. There was also inconsistency and ambiguity in the interpretation of findings, as well as incompatible or oversimplified definitions of mental health problems. LIMITATIONS: Our review excluded grey literature, such as reports, theses and conference presentations, as a preliminary search found very little empirical research on VNs' and SVNs' mental health in this type of publication. CONCLUSIONS: More research is needed to address the gaps in the existing evidence supporting our understanding of VN and SVN mental health. This should establish baseline measures and include comparisons with other occupational and national populations.

Understanding psychological outcomes following exposure to potentially morally injurious events in animal care: development of the Moral Distress-Posttraumatic Growth Scale for Veterinary Professionals.

AIMS: To generate a taxonomy of potentially morally injurious events (PMIE) encountered in veterinary care and develop an instrument to measure moral distress and posttraumatic growth following exposure to PMIE in the veterinary population. METHODS: Development and preliminary evaluation of the Moral Distress-Posttraumatic Growth Scale for Veterinary Professionals (MD-PTG-VP) employed data from veterinary professionals (veterinarians, veterinary nurses, veterinary technicians) from Australia and New Zealand across three phases: (1) item generation, (2) content validation, and (3) construct validation. In Phase 1 respondents (n = 46) were asked whether they had experienced any of six PMIE and to identify any PMIE not listed that they had experienced. In Phase 2 a different group of respondents (n = 11) assessed a list of 10 PMIE for relevance, clarity and appropriateness. In Phase 3 the final instrument was tested with a third group of respondents (n = 104) who also completed the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT), a measure of posttraumatic stress, and the Stress-Related Growth Scale-Short Form (SRGS-SF) a measure of perceived posttraumatic growth. Spearman's correlation coefficients were calculated between respondent scores on each of the MD-PTG-VP subscales, the SPRINT, and the SRGS-SF to assess construct validity. RESULTS: A 10-item taxonomy of PMIE encountered in veterinary care was generated in Phase 1. Items were deemed relevant, clear and appropriate by veterinary professionals in Phase 2. These were included in the developed instrument which measures frequency and impact of exposure to 10 PMIE, yielding three subscale scores (exposure frequency, moral distress, and posttraumatic growth). Assessment of construct validity by measuring correlation with SPRINT and SRGS-SF indicated satisfactory validity. CONCLUSIONS: The MD-PTG-VP provides an informative tool that can be employed to examine professionals' mental health and wellbeing following exposure to PMIE frequently encountered in animal care. Further evaluation is required to ascertain population norms and confirm score cut-offs that reflect clinical presentation. CLINICAL RELEVANCE: Once fully validated this instrument may be useful to quantify the frequency and intensity of positive and negative aspects of PMIE exposure on veterinary professionals so that accurate population comparisons can be made and changes measured over time.

The need for recovery: An investigation into short-term work-related fatigue in veterinary nurses.

BACKGROUND: Veterinary nursing is physically and emotionally demanding, putting veterinary nurses at risk of acute work-related fatigue (AWRF). Despite the increased recognition of chronic occupational syndromes such as burnout and compassion fatigue in recent years, few studies have investigated how AWRF impacts individuals and the profession. METHODS: An anonymous survey open to all UK-based registered veterinary nurses (RVNs) was distributed via email and social media. The survey investigated work patterns, hobbies, opinions about work and intentions to leave the veterinary profession. An English translation of the need for recovery (NFR) scale was used to quantify the AWRF. RESULTS: The median NFR score from 387 responses was 81.8, indicating high levels of AWRF. Long shifts, sole-charge work and overtime were associated with higher scores, while having support at work and a better work-life balance were associated with lower scores. Higher scores were correlated with intentions to leave the profession. LIMITATIONS: Although validated as a measure of AWRF, the unidimensional NFR scale oversimplifies the complexities of fatigue. A limited number of RVNs responded to the survey, reducing statistical power. CONCLUSION: Although there is no single solution to staff turnover, the results from this survey suggest that addressing AWRF may improve retention of RVNs.

Horse owner perceptions of equine veterinary nursing roles in the United Kingdom.

BACKGROUND: Registered (equine) veterinary nurses (R(E)VNs) typically provide few client-facing services. Better utilising R(E)VN skills could help address workforce shortages, improve morale and benefit patient health. The aim of this study was to explore horse owner perceptions of R(E)VN roles. METHODS: An online cross-sectional survey of horse owners gathered data on their understanding of R(E)VN roles, their experiences of R(E)VNs their openness to further R(E)VN services and perceived facilitators of and barriers to such services. Participants were recruited via practices, social media and snowball sampling. Descriptive analysis of the quantitative data and manifest content analysis of the qualitative data were conducted. RESULTS: Three hundred and forty-seven useable responses were received. Eighty-one percent (282/347) had heard the term R(E)VN. Most talked positively about their experiences with R(E)VNs. Eighty-seven percent (285/326) were open to an R(E)VN visiting their horse under the direction of a veterinary surgeon, with more than 90% being extremely or somewhat comfortable with R(E)VN visits for bandaging and suture removal. LIMITATIONS: It is unclear how closely respondents' perceptions reflect those of the wider UK horse owner population. CONCLUSIONS: Horse owners appear to be open to further nursing services, with key procedures such as bandaging being a potential starting point. Understanding the career goals of the individual nurses and the needs of the practice will be key to the successful implementation of these services.

Exploring the sociocultural experiences of student veterinary nurses in the clinical learning environment through the lens of situated learning theory.

BACKGROUND: Student veterinary nurses (SVNs) complete significant time in clinical placements and this training can have a positive or negative impact on the development of professional skills and identity. METHODS: A cross-sectional design, using semi-structured interviews, explored 12 SVNs' experiences of clinical placements. Interpretative phenomenological analysis was used to explore each individual participant's experience, prior to the identification of themes across participants' experiences. RESULTS: Most students reported a sense of belonging within the practice team, which fostered engagement. Clinical supervisors were considered key role models and vital support for student progress. Students reported conflict between the demands of the practice and the requirements of their student status. Some poor interpersonal interactions led to reduced confidence. LIMITATIONS: The results may not reflect experiences of the diversity of student demographics, such as those students with protected characteristics, as described in the Equality Act 2010, who may encounter specific workplace challenges. CONCLUSION: To ensure parity and positive experiences, accredited educational institutes can plan regular engagement with student feedback and support of the training practice. Training practice teams can ensure they are meeting the student's needs and fostering a positive learning environment by adhering to the RCVS Framework for Veterinary Nurse Education and Training, which will, in turn, benefit the whole team. Clinical supervisors can play a convening role in increasing belonging and participation within the clinical learning environment.

Suffering in silence.

Caring for research animals can take a severe mental toll. Is anyone listening?

Knowledge, attitude, and practice on antibiotic use and antibiotic resistance among the veterinarians and para-veterinarians in Bhutan.

INTRODUCTION: Antimicrobial resistance is (AMR) an emerging global public health problem. Rationale use of antibiotic can prevent the rise of antimicrobial resistance. The objective of this study was to understand the knowledge, attitude and practice on antibiotic usage and AMR among the veterinarians and para-veterinarians in Bhutan. METHOD: A cross-sectional questionnaire survey among the veterinarians and para-veterinarians was conducted from June to July 2020. A score of one to the correct answers and zero for the wrong answers was allotted to each respondent answers. The total score was added and those who scored above the mean was categorized as having good knowledge and favourable attitude. RESULT: A total of 219 animal health workers participated in this study. The mean knowledge score was 12.05 ±1.74 with 38.8% of the respondents having good knowledge on antibiotic use and AMR. Similarly, the mean scores for the attitude level were 8.32±1.61 with 51% them having favorable attitude towards antibiotic usage and AMR. The mean practice score was 3.83±1.06 with 77% of them having good practices on antibiotic use. The respondents who read national plan on AMR were found to have good knowledge on antibiotics and AMR (AOR: 2.39; 95% CI: 1.19-4.82). The female respondents (AOR: 2.16; 95% CI: 1.01-4.61), respondents from the eastern region (AOR: 2.53; 95% CI: 1.18-5.44), west central (AOR: 3; 95% CI: 1.30-6.92), animal health supervisors (AOR: 9.77; 95% CI: 1.98-48.29), and livestock production supervisors (AOR: 2.77; 95% CI: 1.21-6.35) have favorable attitude towards antibiotics and AMR. CONCLUSIONS: Our study identified that most animal health workers in Bhutan had poor knowledge on antibiotics usage and AMR. Therefore, regular awareness education on antibiotics and AMR in the form of refresher course/training must be provided to the animal health workers in the country to avoid inappropriate use of antibiotics.

Hand hygiene compliance in companion animal clinics and practices in Switzerland: An observational study.

BACKGROUND: Hand hygiene (HH) is one of the most important measures to prevent healthcare-associated infections. Data on HH compliance in companion animal veterinary institutions in Europe are sparse. METHODS: This observational study assessed HH according to WHO standards in three large and two medium-sized clinics and two primary care practices in Switzerland. Associations with HH indication, professional group, clinical area and institution were determined using a generalized linear mixed effects model. RESULTS: Based on 2056 observations, overall HH compliance [95% confidence interval] was 32% [30%-34%]. HH compliance was highest in the consultation area (41% [38%-45%]) and after contact to body fluids (45% [40%-50%]), and lowest in the pre-OR area (20% [15%-24%]) and before clean/aseptic procedures (12% [9%-15%]). Veterinarians showed a higher HH compliance (37% [34%-40%]) than veterinary nurses (25% [22%-28%]). HH compliance was lower before clean/aseptic procedures compared to all other indications (all p < 0.015 except 'before touching a patient' in medium-sized clinics/practices, p = 0.095) and higher in the consultation area compared to all other areas in large clinics (all p < 0.04). CONCLUSION: Effective HH training should urgently be promoted for all veterinary personnel with special emphasis on the importance of HH before clean/aseptic procedures.

Veterinary technology graduates' perceptions of their education and subsequent employment experiences.

AIMS: To describe the current employment status of Bachelor of Veterinary Technology (BVetTech) graduates in New Zealand, to assess how well they felt that their degree programme had prepared them for practice, and to explore their experiences in their current job roles. METHODS: All 195 individuals who completed the BVetTech degree at Massey University between 2011 and 2018 were invited to participate in a cross-sectional survey regarding their education and employment experiences. Descriptive statistics were provided for all quantitative study variables and thematic analysis was performed on the free-text survey comments. RESULTS: The survey was completed by 125/195 (64.1%) BVetTech graduates. Of these, 96/125 (76.8%) were engaged in full-time or part-time veterinary work. The most common work environments were small animal practice (55/125; 44.0%) and mixed animal practice (19/125; 15.2%). The median reported annual salary was NZ$42,640 (mean $45,817; min $34,515; max $80,000) while the median reported hourly wage was NZ$20.00 (mean $21.01; min $17.70; max $27.00). Most respondents generally agreed with statements that their degree had prepared them well for different aspects of their subsequent work as veterinary technologists with "understanding the scientific rationale behind clinical decisions in practice" and "gaining hands-on practical experience that directly linked with their classroom learning" highlighted as being the best aspects of their education. However, respondents expressed the need for more training in client interactions and veterinary business management. Common themes that emerged when respondents were asked to describe the best things about their work were "forming relationships with animals, clients, and co-workers," "making a meaningful difference through their work," and "having opportunities to use and develop their skills" while the worst things about their job were "underutilisation of their skills," "poor pay in relation to their education and skill," and "compassion fatigue arising from dealing with euthanasia and difficult clients." Another common theme across free-text questions was the lack of employer awareness about the capabilities of a veterinary technologist. CONCLUSIONS AND CLINICAL RELEVANCE: Recent BVetTech graduates were generally satisfied with their educational experience, but perceived that employers underestimated the value of their training and consequently underutilised their skills. This highlights the need for additional research to better estimate the value of veterinary technologists to the New Zealand animal health industries as well as additional extension efforts to increase awareness amongst employers about the scope of responsibilities that veterinary technologists are legally able to perform in practice.

Taking the lead for veterinary nursing.

Earlier this year, after becoming chair of the RCVS veterinary nurses council, Matthew Rendle spoke to Josh Loeb about his career in nursing. This week, following a special celebration of vet nurses organised by the British Veterinary Nursing Association, we profile his story.

What is the make up of the vet professions today?

The RCVS last conducted a major demographic survey of the vet professions in 2014 and 2019. Georgina Mills analyses the main findings.

Cognitive Dissonance in Laboratory Animal Medicine and Implications for Animal Welfare.

People experience cognitive dissonance when they entertain 2 conflicting ideas at the same time. Cognitive dissonance may cause a negative emotional state, which can lead to engagement of compensation mechanisms to resolve the conflict. Here we describe a survey that explores cognitive dissonance in laboratory animal veterinarians and veterinary technicians and various ways in which veterinary staff manage dissonance associated with research animal use. Respondents-164 veterinarians and 145 veterinary technicians-were asked to rate their opinions of various statements on a sliding scale of 'strongly disagree' to 'strongly agree' or 'never' to 'always.' Statements assessed negative emotions (discomfort, powerlessness, frustration) and compensation mechanisms (devaluing, emotional distancing, shifting responsibility) as bases for inferring effects on welfare states of animals. Responses were evaluated overall and were compared according to level of training (veterinarian compared with veterinary technician), years of work experience (0 to 5, 6 to 10, greater than 10), and species tended (large, mixed, small species). Respondents strongly agreed that animal wellbeing and animal use in research were important. Respondents reported feelings of discomfort, powerlessness, and frustration associated with work. In addition, respondents reported feeling empowered to initiate changes affecting animal welfare. The most frequent compensation mechanism noted was shifting responsibility onto the IACUC and institutional rules. Devaluing the animals was another reported compensation mechanism. Responses to emotional distancing statements were divided. Survey responses supported the existence of cognitive dissonance associated with laboratory animal medicine. Potential negative and positive effects on animal welfare are discussed.

Exploring the loss and disenfranchised grief of animal care workers.

This article explores the psychological distress of Animal Care Workers (ACWs), and the disenfranchisement of this distress through mixed methods study conducted as an online survey. In all, 139 participants responded about their experiences as an ACW, related psychological distress, and the systemic disenfranchisement of distress. Findings indicate that nearly half of ACWs experienced symptoms of depression in the previous month. Over 66% indicated it was difficult to cope. Limited support often resulted in a disenfranchized loss. Implications suggest ACW distress and disenfranchisement related to animals they serve is similar to that of individuals who lose animal companions.

Investigation of burnout syndrome and job-related risk factors in veterinary technicians in specialty teaching hospitals: a multicenter cross-sectional study.

OBJECTIVES: To investigate veterinary technician burnout and associations with frequency of self-reported medical error, resilience, and depression and job-related risk factors. DESIGN: Cross-sectional observational study using an anonymous survey conducted between November 2017 and June 2018. SETTING: Four referral teaching hospitals in the United States and Canada. SUBJECTS: A total of 344 veterinary technicians were invited to participate. Response rate was 95%. Overall 256 surveys were ultimately analyzed. INTERVENTIONS: Burnout, depression, and resilience were measured using validated instruments. Respondents reported perceptions of workload, working environment, and medical error frequency. Associations between burnout and factors related to physical work environment, workload and schedule, compensation package, interpersonal relationships, intellectual enrichment, and exposure to ethical conflicts were analyzed. MEASUREMENTS AND MAIN RESULTS: Burnout, characterized by high emotional exhaustion, depersonalization, and low sense of personal accomplishment was common, and was positively associated with perceived medical errors, desire to change career, and depression. Burnout levels on all 3 burnout subscales were higher in this population than previously reported for a contemporaneous group of trauma nurses working with human patients (P < 0.05). Burnout was negatively associated with resilience. Respondents' feelings of fear or anxiety around supervisor communications, perception that patient load was too high to allow for excellent patient care, and perceived lack of available assistance during sudden workload increases were all associated with burnout. CONCLUSIONS: Burnout in veterinary technicians is common and is associated with numerous undesirable outcomes. Work-related interventions to reduce burnout should focus on improving supervisor relationships and maintaining an appropriate patient:caregiver ratio.

What makes a great clinical team? Stakeholder perspectives on the attributes of effective veterinary health care teams in Australia.

Extensive research in the business and organisational literature links teamwork to enhanced productivity and employee job satisfaction. Good teamwork capability is also a highly regarded graduate attribute linked to employability. This study explored desirable teamwork attributes for veterinary technology graduates in Australia, by surveying veterinarians, veterinary technology graduates, veterinary nurses, clients and academics. Respondents highlighted the importance of seven attributes sourced from the cross-disciplinary teamwork literature-'flexibility' (in approach to work), 'agreeableness', being 'cooperative', 'socially sensitive and perceptive', 'conscientiousness', being 'accepting of others' and 'sharing professional values'. The majority in each stakeholder group viewed all attributes important for teamwork concurring with findings in other fields. Few differences were found between and within groups with veterinarians and academics rating 'conscientiousness' higher than others and female clients placing more importance on relational attributes compared to male clients. Thematic analysis of an open-ended item asking the veterinary health care groups, and veterinary academics, to define teamwork generated nine themes centred on: collaboration, goals and outcomes, sharing values, relationships, diversity, communication, task-orientation, personal attributes, and workplace culture. This study illuminates an interprofessional perspective on veterinary teamwork. Results will be useful for veterinary technology, veterinary nursing and veterinary educators when developing a curriculum for interprofessional teamwork to enhance team performance, employability and, ultimately, the quality of veterinary services.

Looking for insight: The role of parasite tester opinions in farm management.

Gastrointestinal nematode (GIN) infections cause millions of dollars of economic loss annually. Increasing cases of anthelmintic resistance have resulted in calls for restricted drug use and implementation of sustainable management practices to slow the rate of resistance. The limited uptake of available management systems and advice has sparked multiple surveys into the psychology and behaviours preventing uptake. These surveys have looked mainly at the farmers, the majority of whom have reported they rely on the advice of their local veterinarian or suppliers for treatment and management. However, there is little research into the psychology of veterinarians and people performing animal health testing on this topic. In the current study, a short survey of people performing faecal egg counts on animals was conducted. The survey focused on identifying areas for improving diagnosis to encourage uptake, and found other areas of interest worth further investigation. Respondents most frequently named manual labour as the main contributor to the cost of testing (65% of respondents) with analysis (42%) and sample preparation (32%) being the main contributors to time. In the survey comments, there was little consistency or commonality in the issues raised. The disparity between onsite and laboratory testers is an area worth investigation, particularly into how to co-ordinate behaviour and advice between proactive farmers and parasitology/veterinary services. Further investigation could provide better insight into how to encourage and maintain sustainable practices on farms.

Wellbeing in partnership.

Simon Toye is all too aware of the pressures of the veterinary profession, given his wife works in the field. But he wonders whether vets are sufficiently aware of how those pressures affect their partners, and of how they can work together on wellbeing.

Tripping the reset switch.

Simon Toye and his wife, who is a vet, are just back from a trip through Asia. He says it was a journey that bolstered their wellbeing and left them better equipped to deal with the pressures of veterinary practice.