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What about the nurses?

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HAVING so far focused mainly on veterinary surgeons, the RCVS/BVA Vet Futures project has this month rightly turned its attention to veterinary nurses (VNs). The project is looking at some of the challenges currently facing the veterinary profession with a view to developing a strategy for the future – and it would be difficult to imagine a future without veterinary nurses, who form a vital part of the veterinary team. In a thought-provoking blog on the Vet Futures website1, Laura Kidd, a veterinary surgeon, VN lecturer and clinical skills tutor for veterinary students, looks at some of the factors that might be contributing to an apparent shortage of VNs, and asks what might be done to increase the numbers entering and staying within the profession.

The blog, which has already attracted a number of comments, notes that, while RCVS figures indicate that the number of veterinary nurses is increasing each year, anecdotally there doesn't seem to be enough of them to meet demand. The 2014 RCVS Survey of the Veterinary Nurse Profession2, like similar surveys in 2010 and 2008, found that, despite veterinary nursing having been around for a long time, those making up the profession are relatively young, with an average age of 31 (compared with 44 for veterinary surgeons), so one way of addressing the shortage will be to reduce the numbers leaving the profession at a young age. An important part of that will be identifying the reasons they are leaving and addressing these.

The other main approach to the shortage would be to train more students and increase the numbers qualifying annually. In her blog, Ms Kidd draws attention to the high standards of training that are needed to produce veterinary nurses with the knowledge and skills required to work in the profession and argues that it is essential that these standards are maintained and developed. She identifies the availability of RCVS-approved Training Practices as a limiting factor in producing more nurses and asks whether more practices can be supported to become Training Practices in the future. Noting that some student veterinary nurses who appear to have the qualities to be very good VNs are lost to the profession because they are unable to pass the academically demanding awarding body exams. Ms Kidd also asks whether, without lowering standards in any way, it might be possible to develop an additional training route to allow more students to demonstrate that they have the required skills to provide high quality nursing care to their patients.

Hard data may be lacking but, if the shortage of veterinary nurses is as severe as Ms Kidd suggests, it may be necessary to tackle the problem from both ends. Regarding training, an online poll accompanying her blog on the Vet Futures website poses the question ‘Is there a need for another VN training option?’, and it will be interesting to see how people vote. In the meantime, given all the effort involved in training, it cannot be considered satisfactory that, having worked hard to achieve the necessary knowledge and skills, many veterinary nurses end up leaving the profession at an early age, with all the potential loss of talent that that entails.

Some of the factors that might be contributing to the loss of VNs, including low pay, stress and nurses not feeling rewarded or valued, are discussed in the blog and are reflected in the results of the 2014 RCVS survey. About 80 per cent of nurses responding to the survey indicated that they intended to stay in the profession for the foreseeable future. However, among those intending to leave, pay came top of the list of reasons given for planning to leave (as it did in the survey in 2010), being mentioned by 70 per cent. Next on the list was not feeling rewarded or valued, followed by dissatisfaction with veterinary work in terms of, for example, working hours and stress, followed by the desire for a career change or a new challenge, and concern about a lack of career opportunities.

Like some of the issues that have been identified as being of concern to veterinary surgeons during the Vet Futures project, many of these issues could be addressed by better management. Improving nurses' pay might be seen as a challenge when the profitability of practices is not as high as many members of the public might expect, and when earnings might ultimately be constrained by what people are willing or able to pay for the care of their animals. However, making full use of veterinary nurses' skills can contribute to improved profitability as well as better patient care in practice, and there can be little doubt that, in this and many other areas, making best use of people and resources must be a key part of any future strategy.

In her blog, Ms Kidd welcomes the various initiatives that are underway aimed at improving the status of VNs, including the efforts being made to gain protection for the VN title, noting that, as the BVA President, John Blackwell, has remarked, this could lead to increased recognition of the skills of veterinary nurses and their unique contribution to the veterinary team. At the same time, there will be a need to develop a career structure that reflects and rewards this changing status.

Discussing the factors that might be contributing to the loss of nurses, she suggests that maybe it isn't surprising that VNs leave the profession at a young age and remarks, ‘Perhaps we may, reluctantly, have to accept that, for the time being, veterinary nursing is a young profession with a high turnover’. That might reflect the situation as it stands, but it is not a situation that should be accepted for long, and it certainly shouldn't be something to aspire to for the future.

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