Hartpury University Repository

Nankervis, Kathryn J.

Bradley, Francesca

Kosek, Katherine

Dyson, Sue J.

Investigation of the Reliability of Saddle Fitters to Determine the Position of the Last Thoracic Vertebra of Horses Using Palpation Techniques: A Pilot Study

Chiew, Samantha J.

Hemsworth, Paul H.

Sherwen, Sally L.

Melfi, Vicky

Coleman, Grahame J.

English

The effect of regulating zoo visitor-penguin interactions on zoo visitor attitudes

Kay, Alex

Nicholls, Richard

Understanding the Scope of In-Store C2C Influence in Retailing.

Vivian, Sarah

Godbehere, Jennifer

FACTORS CONTRIBUTING TO REGISTERED VETERINARY NURSES DECIDING TO LEAVE THE 
VETERINARY PROFESSION IN THE UK
J. Godbehere and S. Vivian*
Hartpury University, Hartpury, Gloucestershire, United Kingdom, GL19 3BE, 
*Corresponding author: sarah.vivian@hartpury.ac.uk
INTRODUCTION In 2017, the majority of RVNs
in the United Kingdom were aged between 26 and 35 (RCVS,
2017). The high number of RVNs leaving the profession has
created a shortage across the UK, leading to an increase of
untrained, unregulated and unregistered support staff taking
on some responsibilities of an RVN in practices (Waters, 2017;
Johnson, 2017; Coats, 2015).
Research into the wellbeing of veterinary professionals has
shown that RVNs face many of the same risk-factors for
occupational stress as VSs (Deacon & Brough, 2017;
Macdonald, 2014). Research undertaken around the subject of
veterinary wellbeing suggests that there are many different
factors that contribute to occupational stress in RVNs, with
many stating reasons including fear of professional mistakes,
financial circumstance, time management within the working
day, working relationships and management issues (Bedford
and Anscombe-skirrow, 2018; Hunt, 2018; Johnson, 2017; Hunt,
2017; Deacon and Brough, 2017; Bonnema, 2017; Coats, 2015;
Macdonald, 2014; Ackerley, 2014).
METHOD Telephone interviews, lasting an average of ten minutes, were conducted
over a one month period in 2019. These interviews were audio recorded to enable them to be
transcribed at a later date. Six candidates were selected using a convenience sampling method
once it was established that the participants fit the criteria of previously being RNVs and that
they considered themselves to have left the profession. Social media was used to initially contact
the participants and then determine their eligibility. An in-depth guide was followed to ensure
that all questions were covered throughout each interview. The qualitative data collected was
then thematically analysed to identify common themes that were highlighted from the
interviews.
REFERENCES: Ackerley, N. (2014) ‘BVNA survey – Hot topic 2: Stress’ Veterinary Nursing Journal. 29. pp. 294-295. Bedford, s., Anscombe-Skirrow, E. (2018) ‘Bullying and disillusionment in veterinary nursing. ‘Veterinary Nursing Journal’. 33 (9). pp. 250-
256. Bonnema, L. (2017) ‘A Registered Veterinary Nurse’s (RVN’s) secret struggle…: A short communication on mental health in the profession’. Veterinary Nursing Journal. 32 (3). pp. 63-65. Coates, C. R. (2015) Motivation and job satisfaction in 
veterinary nursing, The Veterinary Nurse, 6 (6). Deacon, R, E., Brough, P. (2017) ‘Veterinary Nurses’ psychological well-being: The impact of patient suffering and death’. 69. pp. 77-85. Hunt, G. (2017) ‘Understanding and overcoming the effects of 
compassion fatigue within the veterinary profession’. Veterinary Nursing Journal. 32 (5). pp. 141-143. Hunt, G. (2018) ‘The influence veterinary practice management teams have on the welfare of veterinary nurses within the work environment’. 
Veterinary Nursing Journal. 33 (4). pp. 114-117. Johnson, S, D. (2017) ‘The past is our future’. Veterinary Nursing Journal’. 32 (12). pp. 379-380. Macdonald, J. (2014) ‘VN Well-Being Survey Update’. Veterinary Nursing Journal. 29 (3). pp. 78-79. RCVS. 
(2017) RCVS Facts (2017) Available from: https://www.rcvs.org.uk/news-and-views/publications/rcvs-facts-2017/. Waters, A. (2017) ‘Optimising the value of VNs’ Veterinary Record. pp. 336. 
RESULTS 100% of the participants stated that the low
salary was a contributing factor to them leaving the profession.
66% stated that under utilisation of their skill set was also a factor.
Whilst 50% said that the hours also contributed to them changing
their career path.
50% of participants said that they knew about the Mind Matters
and Vet Helpline resources, however, they felt support was lacking
in practice. Only 1 participant had felt the need to use the
publicised resources.
CONCLUSIONS Occupation stress was not the main
reason given for RVNs leaving the professional, however, it does still
need to be taken into consideration because stress can be
exacerbated by factors such as those identified as common themes
in this study.
The multitude of themes identified from all participant responses
leads to the idea that there are many factors that could be
improved or changed in order to increase the wellbeing of RVNs
within their role in practice. There is unfortunately still distance to
be travelled to ensure RVNs feel valued and rewarded in their roles.
RESEARCH OBJECTIVES:
 To identify whether the majority of interviewed RVN’s feel that they are utilised
professionally;
 To identify common themes that lead to RVN’s leaving the profession;
 To establish whether the resources provided (Mind Matters, Vet Helpline) are being utilised
by RVN’s who are considering leaving the profession.
“I enjoyed the job, really loved it I loved caring for the animals, I loved dealing 
with the clients”  
“My last job they certainly thought that my problems were just down to my 
personal problems, not anything that was going on in the workplace and yeah 
there was very little support to be honest”  
“I see some RVN’s used to their full potential…the skills and roles we can fill 
are actually phenomenal, and I’ve seen others that barely use their RVN’s for 
anything other than cleaners” 
“I’d love to [go back], absolutely love to if I won the lottery”  
Reasons given by respondents for leaving the profession 
“We’ve been told no you’re not doing that because  
clients pay for it and they want it to be done very well”  
“Some practices I think they really focus on it and they did lots of really 
brilliant things, and others I think tried to pretend that mental health didn’t 
exist” 
Suggested areas of improvement for RVN retention 
“There’s not many  
experienced nurses  
still in the role…I  
think a lot of it down  
to the salary”  


Factors Contributing to Registered Veterinary Nurses Deciding to Leave the Veterinary Profession in the UK

Lesniak, Kirsty

Gibson, Adam

The Effect of Heel Studs on Retraction Kinematics of the Equine Hind-limb during Canter on Grass

Middlecote, Lucy

Brown, Hieke

Do owners administer inappropriate doses of anthelmintic based on an inaccurate perception of their horse's bodyweight?

Merrifield-Jones, Megan

Tabor, Gillian

Williams, Jane

Inter and Intra-Rater Reliability of Soft Tissue Palpation Scoring in the Equine Thoracic Epaxial Region.

Longworth, Martin

Corsby, Charles L. T.

Edwards, Christian N.

Exploring The Reality of Student-Coaches’ Work-Based Learning

Introduction: 
Veterinary practices are presented with a diverse range of conditions. Some conditions, such 
as cases involving wound care, can be unpredictable in both the duration of recovery and the 
outcome. Patients may have to undergo a number of visits to the practice and experience a 
range of procedures in regards to the long term care of wounds including, but not limited to: 
 Initial consultation 
 Bandage/dressing changes  
 Surgery 
 Suture removal 
 Aftercare and follow-up appointments 
Some veterinary professionals believe that it is normal for pets to be scared whilst at the 
veterinary practice and Lloyd (2017) states that it has become customary to accept that 
negative responses to the veterinary environment are typical. As veterinary professions, 
veterinary nurses, should be creating positive patient experiences, to ensure that they are 
reducing patient stress and doing no harm. Utilising low-stress handling can avoid 
undesirable behaviours, provide a safer working environment and promote a higher 
standard of animal welfare.  
Problems that can occur in patients receiving long-term care:  
Mariti et al. (2016) discovered that dogs which were uncomfortable with their owners 
carrying out procedures at home would also be intolerant of the veterinary nurse or surgeon 
doing the same in the consultation room. The veterinary nurse can therefore have the 
advantage of determining which patients will need additional support throughout a bandage 
change on a sensitive area, such as the tail, by completing a thorough history with the client 
prior to undertaking the procedure. Throughout this time the veterinary nurse can phrase 
questions, such as “How tolerant is he/she of you going near the wound?” to determine their 
course of action. Preventing a negative experience from occurring is an essential role of the 
veterinary nurse (Edwards et al, 2019), and anything that can be done to prevent a stress 
response from escalating disproportionately during long term treatment will benefit the 
welfare of the animal.   
Balsa & Culp (2015), Calder (2014) and Bellah (2006) explain that the success of a bandage 
can be limited by the movement of the area and the tension of the bandage applied. 
Immobilising the patient is therefore especially important because incorrect application can 
cause bandages to move (Bellah, 2006). This, when coupled with the fact that it could be an 
area that cannot be prevented from moving in itself can make for a challenging situation. 
Methods, such as, forcing the animal into unnatural positions via physical restraint should be 
avoided because they restrict patient choice (Ryan, 2018) therefore increasing the chances of 
an animal reacting adversely to the situation they find themselves in. Chemical restraint can 
be used to prevent the animal developing negative associations with the treatment (Hargrave, 
2017) and Edwards et al (2019) found that chemical restraint can be more beneficial to some 
animals than manual restraint because it allows for improvements in their co-operation and 
behaviour. Ultimately, however, it is imperative that the veterinary team find the best 
method of control for each individual patient whilst working in a calm and professional 
manner. 
An aspect of successful wound management, in long-term cases, is the relationship between 
the patient, owner and veterinary team (Edwards, 2019). From the owner’s point of view, a 
veterinary nurse who shows compassion and respect towards the pet must therefore 
understand the animal and its needs (Lloyd, 2017). It is imperative that veterinary nurses refer 
to their declaration (Table 1) and are constantly trying to reduce fear and anxiety in animals 
thus instilling a comfortable nurse-pet-client relationship (Lloyd, 2017). A visit to a veterinary 
environment can be extremely stressful for the animal (Arhant, 2019) and patients that 
repeatedly visit a practice because of long term treatment may develop anxiety. Anxiety can 
lead to undesirable behaviours developing in response to their experiences, for example, 
refusing to exit the car on arrival at the practice or withdrawing when the veterinary 
professional approaches. If these behaviours are left unchecked then they can become harder 
to train out at a later date and a qualified trainer/behaviourist may have to be sought.  
Table 1: Declaration of Profession Registration (RCVS, 2019).  
 
 
When dealing with patients that are undergoing long-term treatment the veterinary team 
need to be aware of potential signs of stress. Knowledge of these stress signs and appropriate 
low-stress handling techniques are a vital aspect of the team’s education to ensure that they 
are able to respond appropriately and skilfully in these situations. Low-stress handling can 
help towards maintaining relationships between the veterinary professional and the patients 
whilst the patient is adjusting to the novel environment they find themselves in, thereby 
preventing anxieties from becoming phobias (Figure 1). Lloyd (2017) explains that owners are 
often unwilling to put themselves or their pets through potentially stressful situations. The 
veterinary nurse is therefore ideally placed to endorse ways in which the animal’s, and 
therefore the owner’s, welfare (Lloyd, 2017) can be promoted and making procedures, such 
as bandage changes, more agreeable. 
 
 
 
 
 
 
Fear: normal 
response to 
actual or 
perceived threat 
Phobia: 
exaggerated 
response to fear 
Anxiety: 
response to fear 
through 
anticipation of 
threat 
Figure 1: Definitions of stress responses 
Signs of stress: 
Overall (2013) emphasises that negative experiences in the veterinary practice can lead to 
long lasting anxiety in the patient. Reducing stress whilst undergoing treatment can therefore 
improve the welfare of patients, staff and owners (Edwards et al. 2019). Stress can present 
itself it many different ways (Table 2) and the effects it can have on the patient may vary. 
Stress can impair physical well-being and social relationships (animal and human) and reduce 
the animal’s ability to relax (Hargrave, 2015). The physiology and psychology of the animal 
must be considered (Lloyd, 2017; Williams, 2016) because parameters and behaviours 
displayed, when undergoing long-term treatment, may not be ‘normal’ for that animal. It is 
also essential for the veterinary team to remember that an animal might be in pain, which on 
its own or coupled with anxiety can lead to unpredictable behaviours from the animal (Mariti 
et al. 2016), such as, aggression or avoidance and escape strategies. Muzzles or chemical 
restraint may therefore be necessary to safeguard those working with the patient. 
Interventions such as these must be assessed on an individual basis because each animal will 
respond differently and even the same animal’s responses can vary from visit to visit. The 
veterinary team must always be aware of the importance of every interaction that the animal 
has in the practice and how undesirable behaviours can affect current and future visits 
(Hargrave, 2017). Hargrave (2017) and McMillan (2002) suggest that the way to minimise 
stress in animals is to make experiences as enjoyable as possible. Ryan (2018) suggests the 
use of positive reinforcement techniques and responding appropriately to the patient’s 
emotional needs. 
Table 2: Signs of anxiety in dogs (not exhaustive) (adapted from Yin, 2011). 
Licking lips: when no food nearby. 
Panting: when not hot or thirsty. 
Brows furrowed and ears to the side. 
Moving in slow motion. 
Acting sleepy or yawning: when they shouldn’t be tired.  
Hyper-vigilant 
Suddenly won’t eat; but was hungry previously.  
Moving away 
Pacing. 
 
Solutions: 
Tail wounds can be particularly difficult to manage because of their vulnerable location and 
the fact that they can easily be contaminated by urine and faeces (Bellah, 2006). It is 
important therefore to ensure that the patient remains mentally stimulated so it does not 
begin interfering with the bandage due to boredom during recovery. Lick mats can be used in 
both the home and veterinary setting to distract patients whilst undergoing long term 
treatment. These can be placed on the wall or floor in front of the animal and covered with a 
palatable paste; allowing for treatment to occur with the minimum of fuss. Interactive feeders 
filled with frozen or fresh fillings, such as peanut butter or soaked dog food, can also be used; 
they are not static and stable like lick mats and their use might therefore need additional 
supervision. Lick mats are preferable if the dog needs to be immobilised. The distraction 
provided by the food may also allow the low-stress handling to be established in a calm 
environment.  
Patients should be given multiple opportunities to adapt to the new situation (McMillan, 
2002) and mental stimulation can be a useful tool at this time. Devising short exercises that 
can be repeated throughout the day can keep the animal’s mind active and stave off 
boredom. Equipment for these purposes can be prepared by the veterinary nurse in advance 
and includes grooming implements, feed puzzles and games (Jefferies, 2016; McMillan, 2002). 
Sprinkle feeding can provide more stimulation during feeding times for an animal on 
restricted exercise by not only making the actual activity of eating last longer, but also 
providing environmental enrichment to distract the patient from their wound (McMillan, 
2002). During times of potential stress, the nurse can provide the patient with these mental 
stimulation activities to distract from the situation whilst conducting low-stress handling of 
the animal.  
The owner should be considered throughout the treatment of the animal (Jefferies, 2016) to 
ensure their concordance and therefore hopefully a smoother and quicker recovery for the 
patient. Barry (2018) states that the education of owners by the veterinary team can 
dramatically increase compliance with treatment in relation to medical illnesses. This idea can 
be transferred to wound care and recovery by ensuring that the treatment is discussed fully 
with the owner (Barry, 2018). The veterinary nurse should understand their own role in the 
owner’s education (Jefferies, 2016) throughout the process and be able to demonstrate low-
stress handling techniques and be confident discussing its benefits.  
 
 
 
 
 
 
 
 
 
 
 
 
Case Study: 
“Gin” a three year old entire female working gun dog Labrador had a traumatic tail tip injury 
following numerous incidents during the shooting season. Initially the tail was bandaged to 
promote healing and an antibacterial cream was applied. The owner was not keen on tail 
amputation so conservative management, including therapeutic laser and bandage 
changes, were utilised over the following weeks. After several weeks of unsuccessful 
conservative management, it was decided that amputation of 3 cm of her tail at the distal 
tip was necessary. Dressings, ranging from Allevyn to silver impregnated dressings were 
used following surgery and the wound was assessed every 48 hours to check for signs of 
infection. Unfortunately infection took hold during the healing process and antibiotics were 
then introduced (1.5 x 50mg Amoxycillin twice daily increasing to 1 x 500mg Amoxycillin 
twice daily). Once the healing process was established the wound was left open to 
granulate. At the onset of treatment Gin was compliant, however, as it progressed she 
began to withdraw whenever the bandage material was produced. To 
prevent this sign of anxiety developing a low-stress technique was devised 
to distract her during the treatment. Gin was provided with a lick mat, her 
body language changed remarkably on the production of this and negative 
associations were prevented from developing during the lengthy treatment 
and recovery. Following the use of this technique Gin was able to tolerate 
the bandage changes both at home and in the veterinary environment and 
no longer withdraw from the bandage materials.  
 
“Gin” working: Image courtesy of S. Burton (S.B. Photography) 
 
  
“Gin” being distracted during low-stress handling: 
Image courtesy of Z. L. Goode (Bark Malvern Ltd) 
 
Conclusion: 
Veterinary nurses should play an active part in ensuring that patients are as comfortable as 
possible throughout the different procedures that they may encounter at the veterinary 
practice. Utilising opportunities for low-stress handling should always be considered, 
especially in situations that involve long or repeated treatments. Providing occasions during 
which the patient can become acclimatised to potentially stressful situations, can lead to 
decreased anxiety when being approached for treatment. Incorporating low-stress 
techniques could therefore lead to both the animal and the owner being more relaxed in 
the veterinary environment, leading to quicker and less stressful consultations. Veterinary 
professionals have a diverse range of low-stress techniques available to them and must 
ensure that they consider the individual animal throughout the process.  
 
References: 
Arhant, C. Horschlager, N. Troxler, J. (2019) ‘Attitudes of veterinarians and veterinary 
students to the recommendations on how to improve dog and cat welfare in veterinary 
practice’, Journal of Veterinary Behaviour, 31, 10-16. 
Balso, I. M. & Culp, W. T. N. (2015) ‘Wound care’, Veterinary Clinics: Small Animal Practice, 
45, 1049-1065. 
Barry, L. M. (2018) ‘The veterinary practice’s role in ensuring compliance to a treatment 
plan for dogs with insulin-deficient diabetes’, Veterinary Nursing Journal, 33 (2), 52-55.  
Bellah, J. R. (2006) ‘Tail and perineal wounds’, Veterinary Clinics: Small Animal Practice, 36 
(4), 913-929. 
Calder, C. (2014) ‘Gold-standard bandaging’, Veterinary Nursing Journal, 29 (6), 198-202.  
Edwards, P. T. Smith, B. P. McArthur, M. L. Hazel, S. J. (2019) ‘Fearful Fido: Investigating dog 
experience in the veterinary context in an effort to reduce stress’, Applied Animal 
Behavioural Science, 213, 14-25.  
Hargrave, C. (2015) ‘In-practice management of stress in cats and dogs – improving the 
welfare of companion animals and practice finances’, Companion Animal, 20 (5), 292-299.  
Hargrave, C. (2017) ‘Canine stress in a nutshell – why does it occur, how can it be 
recognised, and what can be done to alleviate it?’, The Veterinary Nurse, 8 (3), 140-147. 
Jefferies, S. (2016) ‘Veterinary nurses and wound management’, Veterinary Practice, 
Available at: https://veterinary-practice.com/article/veterinary-nurses-and-wound-
management (Accessed 16 July 2019).  
Lloyd, J. K. E. (2017) ‘Minimising stress for patients in the veterinary hospital: why it is 
important and what can be done about it’, Veterinary Sciences, 22 (4), 1-19.  
Mariti, C. Piearantoni, L. Sighieri, C & Gazzano, A. (2016) ‘Guardians’ perceptions of dogs’ 
welfare and behaviors related to visiting the veterinary clinic’, Journal of Applied Animal 
Welfare Science, 20 (1), 24-33. 
McMillan, F. D. (2002) ‘Development of a mental wellness program for animals’, Journal of 
the American Veterinary Medical Association, 220 (7), 965 – 972.  
Overall, K. L. (2013) Manual of Clinical Behaviour for Dogs and Cats. Elsevier Mosby: St. 
Louis. 
RCVS (Royal College of Veterinary Surgeons). (2019) ‘Code of Professional Conduct for 
Veterinary Nurses, Available at: https://www.rcvs.org.uk/setting-standards/advice-and-
guidance/code-of-professional-conduct-for-veterinary-nurses/ (Accessed 17 September 
2019). 
Ryan, L. (2018) ‘Better veterinary visits – working towards a patient-friendly practice’, 
Veterinary Nursing Journal, 33, 6, 171-174. 
Williams, L. (2016) ‘Cat handling and associated stress: a clinical nursing perspective, 
Veterinary Nursing Journal, 31, 88-93.  
Yin, S. (2011) Body language of fear and anxiety in dogs, Available at: 
https://drsophiayin.com/blog/entry/free-downloads-from-drsophiayin/ (Accessed 19 
September 2019).  
 
 


Low-stress handling for long-term wound care

Harniman, Suzannah

Don’t forget the foal: The nursing requirements of hospitalised foals when the mare is the primary patient.

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