How can we increase the number of veterinary nurses entering and staying within the profession? asks guest blogger

‘Where are all the veterinary nurses?’ is the opening gambit of the September 2015 guest blog, which examines the current undersupply of veterinary nurses in the industry and examines what more can be done to increase the number of students and retain experienced nurses.

This month’s blog was written by Laura Kidd, a veterinary surgeon, VN lecturer and clinical skills tutor for veterinary students.

In the blog she argues that, despite year-on-year increases in the number of veterinary nurses, this seems to be insufficient to meet demand and that, furthermore, there is a trend towards people leaving the profession relatively early, with the average age being just over 30.

“Identifying the reasons for VNs leaving the profession at a young age and addressing these, is one potential way of increasing VN numbers in the future,” she writes.

She argues that poor pay, stress, not feeling rewarded or valued and perceived lack of career progression all contribute to people leaving the profession, although she welcomes initiatives from the BVNA, BVA, RCVS and others to increase the status of the profession, create more diverse career opportunities and improve the profession’s mental wellbeing.

However, she adds that “perhaps we may, reluctantly, have to accept that, for the time-being, veterinary nursing is a young profession with a high turnover.”

With this in mind she suggests that training more veterinary nurses will be the key to increasing the number of qualified members of the profession in the immediate future. In order to do this she believes that more practices need to be supported to become RCVS-approved Training Practices offering clinical training and work experience for student veterinary nurses and that an alternative training pathway for veterinary nurses may need to be looked at.

She adds: “The entry requirements for the VN Diploma are relatively low, yet the qualification is academically demanding: the volume and depth of knowledge is considerable for the level and qualification and the requirement to demonstrate critical reflection through academic writing can be challenging.

“It is regrettable that some student veterinary nurses, who appear to have the qualities to be very good VNs, are lost to the profession, unable to pass awarding body exams. Should we be developing an additional VN training pathway which allows more students to demonstrate they have the required skills to provide high quality nursing to their patients?”

In response to her proposal, this month’s poll asks visitors “Is there a need for another VN training option?”

Last month’s poll asked if vets always acted as animal welfare advocates. This was in response to an article by animal welfare expect Professor David Main in which he argues that the profession should do more to demonstrate its animal welfare credentials and introduce safeguards against excessive profit-seeking. Although just 22 people took part in the poll, around two-thirds (67%) of them said that vets do not always act as animal welfare advocates.

Only half of recent graduates say their career has matched expectations

Only half of veterinary surgeons who graduated within the last eight years say their career has matched their expectations, according to a survey that the Royal College of Veterinary Surgeons (RCVS) and the British Veterinary Association (BVA) are dubbing a “wake up call” to the profession.

The results form the latest output from Vet Futures, a joint RCVS and BVA initiative that aims to help the veterinary profession prepare for and shape its future.

The online survey gathered views from 892 veterinary students (via the Association of Veterinary Students) and 1,973 veterinary surgeons who had graduated within the last eight years, during May and June this year.

Although 37% of graduates reported that their working lives had met their expectations, and a further 13% said it had exceeded them, this left 50% partly or wholly unsatisfied. Furthermore, 10% said they were considering leaving the profession entirely.

Vets who have been qualified for five years or more were least optimistic about the future, rating their opportunities for career progression less positively than more recent graduates, and were also least likely to feel that their degree had prepared them for their current work. Meanwhile, only 34% of students felt that their degree was preparing them ‘very well’ for the work they wanted to do.

Almost three-quarters (73%) of students intended to work in the UK, with most aspiring to work in small animal/exotic or mixed practice, although one in 10 was as yet undecided. Of students, 45% said they wanted to become practice owners or partners, yet this aspiration dropped to 25% among graduates. In addition, nearly double the amount of graduates said they wanted to work outside clinical practice (18%), compared to students.

When seeking a role, the three factors that both graduates and students agreed would have the greatest influence on their choice of career were intellectual satisfaction, location and a supportive environment.

This last requirement chimes with the fact that among the most popular suggestions for improvement to the veterinary degree were compulsory modules on managing stress, personal development and work-life balance, alongside more teaching of business and finance skills, and extra-mural studies (EMS) placements in a wider range of settings, such as industry.

The results are “a wake up call to the profession”, according to BVA President, John Blackwell, who adds: “The drop off in career satisfaction for vets during this crucial first eight years in practice is something we can’t afford to ignore. It points to frustration over career development opportunities and dissatisfaction with support available in practice. For the veterinary profession to remain sustainable, and an attractive career choice for the best and brightest, we need to address these issues with some urgency.”

RCVS President, Dr Bradley Viner, commented: “We clearly need to address the disconnect between expectation and reality for many recent graduates. Reviewing the educational foundation of the profession is a thread that runs through many of the proposed actions that will be outlined in the Vet Futures report due this autumn. The teaching and assessment of non-clinical skills – both as part of the undergraduate curriculum and within postgraduate education – will be important, as will be the promotion of non-clinical career pathways.”

The survey also covered issues such as students’ aspirations in terms of the type (size, ownership, sector) of practice in which they would like to work, and graduates’ future career plans. It also considers attitudes from both groups with respect to new technology.

The full research report “Voices from the future of the profession,” can be found here.

The Vet Futures report and action plan will be launched at the London Vet Show on Friday 20 November, at 1.20pm, in the Pillar Hall of Olympia London, as part of BVA Congress.

David Main

Veterinary professor argues that the profession should prove its animal welfare advocacy credentials

In this month’s guest blog, an academic specialising in animal welfare argues that the profession needs to do more to deliver on society’s expectation of vets as animal welfare advocates.

David Main is Professor of Animal Welfare at the School of Veterinary Sciences at the University of Bristol, with research interests in welfare assessment, animal welfare education and intervention strategies to improve welfare.

In his blog Professor Main makes two key arguments. His first is that the profession urgently needs to deliver on society’s expectation of vets as animal welfare experts and, second, the introduction of safeguards to prevent inappropriate profit-seeking behaviour.

“Veterinarians could perhaps… do more at an individual level to act as animal welfare advocates. It is easy to inform clients on the technical rationale for a specific husbandry change but then walk away knowing full well the client will not action the advice. In the medical profession, advanced communication techniques are becoming more widely accepted to promote positive change within their patients. Perhaps we should be more explicit in teaching our veterinary students influencing skills,” he says on the first point.

On the second aspect of his argument, he believes the vast majority of individual veterinary surgeons and practices are not motivated by money and do have animals’ best interests at heart. However, he argues that “perceptions as well as reality matter amongst our clients and society,” adding: “The obvious difference between the business structure of veterinary and medical practitioners in the UK means the profession will always be at risk of challenge for excessive profiteering.

“Since we still live in the age of the media scare story, it would seem prudent for the profession to embed some anti-profit seeking safeguards in our regulatory controls before, rather than after, a problem is highlighted.”

He believes that such safeguards, which he says could be incorporated into the RCVS Practice Standards Scheme, would be a “healthy demonstration” that the profession has animal welfare rather than profit as its main priority.

In response to David’s blog, this month’s Vet Futures poll asks visitors ‘Do vets always act as animal welfare advocates?’ If you have a view on this topic, do make sure to take part in the poll and leave a comment on the blog.

The previous month’s poll, which was based on the blog co-written by Erwin Hohn and Adi Nell from MediVet, asked to what extent vets would be willing to work collaboratively with others if it would benefit all. Of the 50 who answered, 60% said they would be completely willing to work with others, 32% a lot and 8% to some degree – no one said they would be unwilling to work with others.

Fortune favours Lincolnshire vet as winner of ‘Headlines of tomorrow’ competition

A Lincolnshire veterinary surgeon has won the Vet Futures ‘Headlines of tomorrow’ competition for his suggestion that the veterinary and medical professions work together to tackle obesity in animals and humans.

The competition was held at BSAVA Congress in April where our Vet Futures-themed fortune cookies contained a message asking those attending ‘What future headline do you want to see?’ and providing a weblink to enter the competition.

The winner, as chosen by the Project Board which oversees Vet Futures, was David Bull with his headline of ‘Vets and medics collaborate to prevent human and animal obesity’.

David, a joint partner at Vets4Pets in Lincoln South and an Advanced Practitioner in General Small Animal Surgery, has now received a Kindle Fire for his efforts.

Speaking of the inspiration behind his entry he said: “The headline was inspired by topical issues, having ‘One Health’ in mind and the issue of obesity in our patients, as well as the general human population. I feel that these are some of the big issues of our time, especially that of obesity which has been linked to so many other diseases and is essentially a self-induced problem.

“We see so many overweight cats, dogs and rabbits on a daily basis. It seems to be becoming a more common problem, as well as seemingly more accepted in society. This is to the extent that we have some clients that come in worried because they have been told that their dog is too thin, when in actual fact they are in an ideal body condition and are being compared to overweight pets which have become perceived as normal.”

Some of the other topics raised in the competition include the veterinary profession taking the lead in tackling ‘superbugs’, veterinary surgeons topping job satisfaction and wellbeing polls and the profession taking a leading role in One Health and medical advancements.

Remember, you can also enter our essay-writing competition, in which you can pen an essay of no more than 1,000 words on an idea that will transform the profession by 2030. The deadline for submitting an entry is Monday 31 August and the winner will receive an all-expenses paid trip to the London Vet Show in November.

Can vets work better together by playing to our strengths? ask guest Vet Futures bloggers Erwin Hohn and Adi Nell

In this month’s blog, Erwin Hohn and Adi Nell, Senior Partners at Medivet, argue that the way forward for veterinary practices large and small is to work better together by following nineteenth-century economist Daniel Ricardo’s stricture – stick to what you do best.

In Medivet practices, say Erwin and Adi, “we play to our vets’ strengths by allowing each one to do what they do best. We’ll refer to each other internally or between branches in a group. That’s just what Ricardo suggested.”

The innovation suggested by Erwin and Adi is for individual vets to expand this principle out to work collaboratively with external parties – even “those we think of as competitors, both veterinary and non-veterinary. This would serve to advance the health and wellbeing of our patients, not just cure or prevent disease.”

Taking on board the Vet Futures ethos of the veterinary profession shaping its future for itself, Erwin and Adi argue for an extension of what, to a certain degree, happens already, such as the sharing of out-of-hours work or referrals to specialist centres. The pair argues:

“We can apply this more widely. Breeders could refer puppies to a small vaccination clinic. That branch does the vaccination, but sends the puppies to a larger practice for x-rays when they’re lame. In turn, the larger practice sends its inoculations to the vaccination clinic or small satellite, and they refer clients who want to buy puppies back to the breeder. I could, for example, support your investment in an MRI unit and you could support my laparoscopic surgery.

“This is how many human community health programmes work all round the world, right now.”

Refuting the claim that such working might be ‘pie in the sky’, Erwin and Adi make the case that such a collaborative approach deals with many of the challenges the profession  has identified, including reducing costs and enhancing financial viability as well as offering a way in which corporates can become part of the solution for smaller and independent practices. Erwin and Adi argue:

“It’s easier to develop business skills for a narrower range of services than a much broader one – and it’s easier to choose your own hours. That same focus makes regulators and legal compliance easier. Non-veterinary competitors become collaborators. Rising costs are controlled by the same narrower focus, and evidence-based medicine is enhanced by sharing outcomes.”

In relation to Erwin and Adi’s blog this month’s Vet Futures poll asks “To what extent would you be willing to work collaboratively with others if it would benefit you all: Not at all, To some degree, A lot or Completely?”

Last month’s poll focused on the balance between business skills and veterinary practice as a caring profession, asking “Can vet practice embrace the need for better business skills without damaging its reputation as a compassionate profession?” This was based on the blog written by John Sheridan, a management and business consultant to the veterinary profession and former BSAVA and VPMA President, who argued that veterinary businesses must be viable to continue to care and that “better business is essential for better medicine.” A significant majority of those who responded to the poll agreed that veterinary practice can embrace better business skills without damaging its reputation as a caring profession: 81% of respondents answered “Yes”, 14% said they were “Unsure” and only 5% answered “No.”

Image with sign depicting bright future ahead

The veterinary future’s bright, but levels of stress causing concern, finds survey

A new Vet Futures survey of more than 600 veterinary surgeons and students has found that they are generally positive about the future of the profession, with 59% saying they are very or fairly optimistic.

However, vets also highlighted the need to reduce stress – the single highest priority goal for the future, with nearly a fifth (19%) of respondents choosing it from a long list of options – and secure greater public recognition for the profession.

The survey was carried out by Vet Futures through the British Veterinary Association’s Voice of the Veterinary Profession panel which tested findings from the early research phase of the project, explored attitudes towards the profession, and asked them to prioritise the key issues and rank some of the major threats and opportunities for the profession.

Priority goals for veterinary surgeons varied according to different areas of work and seniority in the profession. However, an overriding and uniting theme from the findings is the pursuit of greater recognition for the role vets play across the board.

Vets’ perception of the veterinary contribution to non-clinical roles, such as research, food supply and security, and public health, is high, but they don’t believe the general public values their contribution in these areas.

Looking ahead to the future, four of the respondents’ top five goals for 2030 relate to recognition:

  • Veterinary leadership on animal welfare
  • Respected and valued role in society
  • Valued role for vets in education on responsible animal ownership
  • Higher profile on animal-related issues that affect public health

In relation to the “respected and valued role of vets in society” priority, the Vet Futures national ICM opinion poll of more than 2,000 members of the public found that 94% of the general public trusts the veterinary profession generally or completely.

In terms of their own careers, 59% felt that they had met or exceeded their expectations, leaving 41% saying their careers had only met some expectations (38%) or not met any (3%). Amongst this large minority of dissatisfied vets the reasons for their responses included few opportunities for progression; pay; and working hours.

The survey also asked vets to rank threats and opportunities for the profession and found that respondents considered the three greatest opportunities to be:

  • Increasing expectations around customer service – seen as the greatest area of opportunity
  • The structure and content of undergraduate courses – vets want training to reflect the real breadth of career choices and allow students to specialise earlier
  • Public health concerns relating to animal disease – vets are eager to increase awareness and understanding of their contributions to public health

The full survey results can be found here.

Commenting on the findings, BVA President John Blackwell said:

“It’s heartening to see that, at the moment, the veterinary glass is half full for many. But we know that younger vets are disproportionately represented amongst those who are feeling less positive about their own careers, which is a real concern for future generations. There is clearly work to be done, through Vet Futures, for the profession to think innovatively in order to tackle some of their concerns around career progression, pay and working hours, as well as stress.

“The good news is that, through the Vet Futures UK-wide roadshow and our online engagement, we have been hearing new and interesting ideas for the future. We want to hear from as many vets, vet nurses and others who have a stake in the future of the profession as possible and I would encourage people to get involved through our ‘Veterinary Vision’ essay competition or via the Vet Futures website.”

RCVS President Stuart Reid added:

“There is a lot for the veterinary profession to be proud of but the Vet Futures survey shows that vets are concerned the general public doesn’t understand or value the variety of roles we undertake outside clinical practice.

“We have also heard through our guest blog that vets working outside of practice sometimes feel that they are treated as second-class vets.

“Through the Vet Futures project the RCVS and BVA aim to address the lack of public awareness about the variety of roles undertaken by members of the profession, as well as increase understanding and access to these varied career opportunities amongst the profession.

“We want to enable all veterinary surgeons to not only feel optimistic, but confident in their future.”

Please feel free to take part in our Vet Futures ‘Veterinary Vision’ essay competition, where you could get the chance to win an all-expenses paid trip to the London Vet Show.

Pen your vision for a chance to win London Vet Show trip

The Vet Futures team is offering the chance to win an all-expenses-paid trip to the London Vet Show (Olympia, 19-20 November) to the lucky winner of its ‘Veterinary Vision’ essay competition.

London Vet Show logoThe winning entry will also be included in a time capsule, to be opened by the veterinary profession in 2030.

Entrants – who could be vets, VNs, practice managers, students, in fact anyone with a veterinary interest – are being asked to pen an essay in no more than 1,000 words which outlines ‘An idea that will transform the veterinary/veterinary nursing profession by 2030’.

The topic might look at a new business model, a new approach to education, a technological innovation or perhaps a way that the working lives of those in the practice team could be improved – the approach is totally up to the author.

The entries will be judged by the Vet Futures Project Board, which includes the Presidents and Chief Executives of both the Royal College of Veterinary Surgeons and the British Veterinary Association.

Entries will be anonymised then scored on a range of criteria, including originality, potential impact for the future and realistic prospects of change.

The closing date for entries is midnight on Wednesday 30 September 2015, and the winner will be notified the week commencing Monday 5 October 2015.

The full rules and details of how entries can be submitted can be found on our competition page.

 

19.08.15 Note the deadline for competition entries has been extended from the original deadline of 31 August 2015.

Does profit-making damage the veterinary profession’s reputation?

In this month’s blog, a former President of the British Small Animal Veterinary Association and the Veterinary Practice Management Association argues that practices should be more ‘business-minded’ when it comes to managing their resources.

John Sheridan, who is now a management and business consultant to the veterinary profession, argues that veterinary practices are over-reliant on generating profit from sales of medicines and that they should be seeking to make more from their professional services.

This is in line with one of the objectives identified during the first Vet Futures Group meeting in January 2015 which said that ‘practices should be less focussed on margins from medicine sales’.

John says: “My experience over the years as a management consultant to the profession indicates that the margin generated by the sales of medicines and other products after allowing for an appropriate share of establishment, overhead and staff costs is modest but certainly not excessive – whilst the margin generated by the sale of professional time and expertise hovers around nil and, in many practices, is negative.”

He says that, at a time of increasing competition and greater corporatisation, veterinary practices must be viable to thrive and points out that, based on available data, the amount of profit generated by independent practices is poor and declining in contrast to corporate groups.

While some independent practices may be concerned about their reputation and relationship with clients if they charge more for professional services, John argues that, with high trust levels in the profession (as demonstrated in our recent survey), vets should not be afraid of having a greater business focus – something he believes should be encouraged from vet school onwards.

“That reputation is our brand. It has been slowly built over many generations by veterinary surgeons and their practice teams up and down the country, every day of the week, dealing first hand with practical animal welfare challenges and delivering professional, caring and compassionate services for their owners.

“Will it continue? Of course it will – but only if veterinary practices continue to be viable businesses generating the revenue necessary to enable them to thrive, cover all their costs and, when judged appropriate by their owners, to offer professional services on a pro-bono basis for wild animals, stray animals and those belonging to individual owners in need,” adds John.

Overall, he argues that “better business is essential for the delivery of better medicine” as it allows for investment in facilities, equipment and skills.

In relation to John’s blog, this month’s poll asks ‘Can veterinary practice embrace the urgent need for better business skills without damaging its well-earned reputation as a compassionate profession primarily concerned with the welfare of the animals under its care?’

Last month’s poll looked at issues around the growth of palliative and hospice care in the veterinary profession and asked if this should become a standard part of practice. This was based on a blog written by former veterinary surgeon Kath Dyson arguing that additional expertise in end-of-life care could help the profession better provide lifelong care to their animal patients. A slim majority (56%) of the 193 people who took part in the poll argued that hospice care should not become a part of standard practice – 28% said it should, while 16% said they were not sure.

94% of British public says “We trust you, you’re a vet”

A national opinion poll, commissioned by the Vet Futures project and carried out by ICM, of more than 2,000 members of the public has found that 94% of the general public trusts the veterinary profession generally or completely. This puts veterinary surgeons above GPs, dentists, and head teachers in terms of how well the key professions are trusted in Great Britain.

In a list of key professions the veterinary profession came third in terms of overall trust. Vets are just behind opticians, who attracted a 95% trust rating, and pharmacists, who took the top position with 97%.

The survey also found that 78% of people using veterinary services are satisfied or very satisfied with the level of service they receive. This puts veterinary surgeons in the middle of the field ranging from 87% of people satisfied with the service they receive from pharmacists to 55% satisfied with the service from accountants.

Finally, the survey found that 70% of those who use veterinary services rate the value for money offered by their veterinary practice as fair, good or excellent.

Commenting on the findings Stuart Reid, President of the RCVS, said: “Throughout the Vet Futures project we have been listening closely to the hopes and fears of the veterinary profession and heard a lot about how veterinary surgeons and nurses perceive themselves. To complete the picture, RCVS and BVA felt it was essential that we also gain a deeper understanding of how the general public perceives the veterinary profession.

“The results are extremely encouraging; particularly in relation to how well the public trusts members of the profession, including both animal owners and non-animal owners.

“But it is also clear that there is more to be done in relation to public perceptions of value for money. We will explore these issues further as the Vet Futures project progresses and we are keen to hear ideas from all members of the veterinary team.”

John Blackwell, President of BVA, added: “The veterinary profession sets itself very high standards and we know from our own member research that vets are particularly concerned, and sometimes worried, about how their clients – and wider society – perceive them. So it is particularly heartening to learn that the general public holds the profession in such high regard in relation to trust.

“Vets also score well in relation to the levels of satisfaction experienced by clients, and practices constantly strive to improve the service they deliver to their patients and animal owners.

“Through the Vet Futures project we hope to raise awareness of the very wide range of essential roles carried out by veterinary surgeons from clinical practice with livestock and pets to groundbreaking research, and from safeguarding the food we eat to upholding and promoting the very best animal welfare standards. Vets should be proud to be part of one of the most trusted professions in Britain.”

Guest blogger asks if palliative care will become mainstream in veterinary medicine

May’s topic of the month blog asks if, now that hospice and palliative care has become mainstream in human medicine, a similar development might be occurring in veterinary medicine.

Kath Dyson, a former veterinary surgeon who qualified from Glasgow in 1989, writes that veterinary palliative care, while a relatively recent phenomenon, has been growing in stature, particularly in the United States with symposia and conferences on the subject as well as webinars and chapters in text books.

Kath says that an increasing number of UK vets offer hospice care. However, she also notes differences between palliative services offered in human and veterinary medicine as well as debates within the profession over the advantages and disadvantages of palliative care versus euthanasia.

“In animal hospice it is the pet’s owner who takes on all the financial, practical and emotional costs involved, whereas human patients have a lot more support available. Euthanasia is always an option in veterinary medicine, and indeed euthanasia of an animal can legally be carried out by anyone, so long as it is done humanely,” she writes.

On the euthanasia debate she adds: “Some regard euthanasia as more of a last resort, with hospice assisted natural death being seen as more preferable and only a minority of patients requiring euthanasia. Others feel that euthanasia is more often likely to be the preferable outcome of a period of hospice care in the animal patient, even though they do not rule out a natural death.”

Overall she argues that additional expertise from veterinary surgeons in end of life care will help the profession be “even better able to provide truly lifelong care to all their animal patients”.

To accompany Kath Dyson’s article our poll this month asks if hospice care will become a standard part of practice.

Last month’s poll asked if vets are given adequate information, guidance and support on ethnic and cultural diversity in relation to a blog written by a British Asian vet about prejudice he encountered from a client.

The vast majority (90%) of the 118 people who responded to the poll thought that the profession was lacking in support when it came to diversity. Diversity in the profession and how to increase it has been a key topic identified by the project and it will be one of the issues addressed in our final report published later this year.