A 'must-have' book for vets working with aquatic species

Reviewed by Matthijs Metselaar, a specialist in fish health and production.

Chickening out of seeing pet poultry? Gain confidence at BVA Live!

There aren't many poultry vets in the UK - and even fewer who focus on pet poultry. It is likely, therefore, that people who keep a few hens as pets will present them to their regular veterinary practice when they become unwell. Henrietta Kodilinye-Sims hopes her session at BVA Live will give vets who do not regularly see poultry the skills they need to approach these cases with confidence.

Sustainability and modern pet ownership

Booming pet ownership in the UK and elsewhere brings significant implications for the carbon pawprint. Yet it is unlikely people will ever stop owning pets, so how can pet ownership be made more sustainable? At BVA Live, Justine Shotton and Jen Gale will explore the role of vets in this complex area and how they can support clients in minimising the impact of their pets on the planet.

Finding a care plan that suits everyone

In a recent survey, Hannah Capon asked the owners of arthritic dogs what they would like vets to do differently. She'll be using her findings to help delegates at BVA Live better understand the owner experience of veterinary care and contextualise their approach accordingly.

Client's understanding of instructions for small animals in a veterinary neurological referral center

BACKGROUND

It is not known how much information clients retrieve from discharge instructions.

OBJECTIVE

To investigate client's understanding of discharge instructions and influencing factors.

ANIMALS

Dogs and cats being hospitalized for neurological diseases.

METHODS

Clients were presented questionnaires regarding their pet's disease, diagnostics, treatments, prognosis and discharge instructions at time of discharge and 2 weeks later. The same questions were answered by discharging veterinarians at time of discharge. Clients answered additional questions regarding the subjective feelings during discharge conversation. Data collected included: data describing discharging veterinarian (age, gender, years of clinical experience, specialist status), data describing the client (age, gender, educational status). Raw percentage of agreement (RPA) between answers of clinicians and clients as well as factors potentially influencing the RPA were evaluated.

RESULTS

Of 230 clients being approached 151 (65.7%) and 70 (30.4%) clients responded to the first and second questionnaire, respectively (130 dog and 30 cat owners). The general RPA between clinician's and client's responses over all questions together was 68.9% and 66.8% at the 2 time points. Questions regarding adverse effects of medication (29.0%), residual clinical signs (35.8%), and confinement instructions (36.8%) had the lowest RPAs at the first time point. The age of clients (P = .008) negatively influenced RPAs, with clients older than 50 years having lower RPA.

CONCLUSIONS AND CLINICAL IMPORTANCE

Clients can only partially reproduce information provided at discharge. Only clients' increasing age influenced recall of information. Instructions deemed to be important should be specifically stressed during discharge.

Knowledge and perception about the welfare and mistreatment of dogs in Brazil

Animal welfare encompasses the overall well-being of an animal, spanning both its physical and mental health, assessable through potential measurements. It stands in contrast to mistreatment, which involves actions, direct or indirect, that endanger an animal's well-being. This study sought to appraise the factors influencing the Brazilian population's understanding of dog welfare and mistreatment. The survey questions were adapted from the Animal Welfare Examination Protocol, utilized by veterinarians to evaluate suspected passive abuse cases in dogs. Out of 1377 responses, 1353 were valid and analyzed. Among the 19 assessed indicators, 15 demonstrated an adequate response rate surpassing 90% of all 1353 responses. However, for three questions related to comfort, a smaller yet notable percentage of responses were only minimally adequate. Moreover, in one question within the comfort assessment, 186 participants (13.74%) provided inadequate responses. This implies that these people could potentially subject animals to a state of low Animal Welfare. Lack of knowledge emerged as a potential root of passive abuse, specifically negligence. In the assessment of nutritional indicators, water supply and quality received unanimous adequate responses. In evaluating comfort perceptions, significant associations were noted between gender, dog ownership, family income, and responses regarding resting surface. Regarding health indicators, the majority responded appropriately. Female gender and dog ownership correlated with providing the appropriate response, while not owning a dog was associated with minimally adequate responses. In the context of comfort indicators, "Hitting the Dog" also demonstrated an association with gender, with females tending towards appropriate responses. Given the lack of significant correlation between educational levels and the most suitable responses, it underscores the urgency of implementing environmental education programs in schools with a focus on animal protection.

Differences in perceptions and satisfaction exist among veterinarians employed at corporate versus privately owned veterinary clinics

OBJECTIVE

To compare and contrast the views of benefits and general work conditions of participants working in corporate hospitals compared to those working in privately owned hospitals.

SAMPLE

Veterinary members of the Veterinary Information Network (VIN) working as associate veterinarians in corporate- or privately owned hospitals.

METHODS

An electronic survey distributed via the VIN data collection portal.

RESULTS

A total of 896 responses from associate veterinarians working full time were received, of which 286 (31.9%) reported working in private practice and 610 (68.1%) in corporate practice. Fifty-five percent of participants indicated a preference for working in private practice compared to 12% preferring corporate practice. Veterinarians working in corporate practice were more likely to report receiving insurance (health, dental, life, and short-term disability), mental wellness programs (eg, counseling), wellness mobile apps, VIN membership, and continuing education paid by their employer than those working in privately owned practices. However, participants in private practice reported higher satisfaction with feeling known as an individual by upper management, hospital culture, the ability to fire difficult or abusive clients, and mentorship. Those working in corporate practices reported feeling more pressure than those in private practice to generate revenue and see more clients per shift.

CLINICAL RELEVANCE

There are positives and negatives of corporate-owned hospitals when compared to privately owned practices. Corporate hospitals may be well positioned to make large organizational-level changes that can improve work culture and, as a result, the well-being and retention of small animal practitioners.

Securing lethal means for suicide: a focus group study exploring perceptions and barriers among practicing veterinarians

OBJECTIVE

Veterinarians are at higher risk for suicide than the general population, and 1 reason for this may be veterinarians' access to and knowledge of pentobarbital-a common suicide method in this population. One possible approach to reducing suicide risk is means safety. This study examined the acceptability and feasibility of means safety protocols in the veterinary workplace.

SAMPLE

43 veterinarians from a mix of specialty areas aged 26 to 53 years, currently practicing in the United States, recruited via social media and listservs.

METHODS

Participants completed a 60- to 90-minute focus group with pre- and post-test surveys. Focus group content was qualitatively analyzed.

RESULTS

Survey responses indicated that that 30% (n = 13) of veteriarians reported storing their pentobarbital unlocked at least part of the time. During focus group discussion, participants perceived work/life balance or being overwhelmed as the most common suicide risk factor in veterinarians, with normalizing mental health emerging as a primary way to improve mental health in veterinarians. Additionally, adding an extra lockbox for pentobarbital/firearms emerged as the most acceptable and feasible means safety method. Finally, at post-test, veterinarians increased in willingness to implement storage protocol changes (P = .02) and were more likely to endorse concern about a coworker's suicide risk than concern about their own suicide risk (P < .01) as a reason to change pentobarbital storage methods.

CLINICAL RELEVANCE

Results from this study will inform public messaging campaigns and policy changes for pentobarbital storage and suicide prevention efforts in the veterinary workplace at the individual and organizational level.

The moral deliberation pathway in veterinary practice: a qualitative study

BACKGROUND

Veterinarians may face various ethical decisions and potential moral conflicts in clinical practice. The ethical decision-making process often leads to a satisfying resolution. However, when such a process is accompanied by a perceived inability to act according to a person's values, it can lead to psychological distress that characterises moral distress. Theoretical models in professions such as nursing attempt to explain the evolution of moral conflict into moral distress. In veterinary professionals, a model has been proposed to explain this pathway (the moral deliberation pathway). However, empirical data are still lacking on whether veterinary clinicians experience a moral deliberation pathway as hypothesised.

METHODS

Using thematic analysis, this qualitative study investigates veterinary clinicians' experiences with moral distress and aims to explain the moral deliberation pathway in these veterinarians.

RESULTS

The results suggest that veterinarians' experiences with moral distress follow a deliberation process that can be explained by the proposed moral deliberation pathway. Experiencing a moral conflict leads to moral stress, then either to moral distress or resolution into moral comfort.

LIMITATIONS

Self-selection of participants and possible recollection bias may have biased the findings.

CONCLUSIONS

The empirical data provided by this study can inform future research and intervention strategies to identify, measure and manage moral distress in the veterinary context.

Relieving veterinarians' workloads and stress: leveraging Australia's veterinary technologists and nurses

Like the rest of the world, Australia is in the throes of a dire shortage of veterinarians, while the demand for veterinary professional services grows. This combination has a very real impact on veterinarians' workload and stress, with significant mental health impacts. Times have changed in our profession and it is time for a change in our practice. We need to look at a different way of managing veterinary workloads and demands and, in particular, better utilise our paraprofessional staff. It is the solution right under our noses embracing our veterinary technologists and nurses.

Psychological safety, purpose, path, and partnership reduce associate veterinarian desire to leave current employment

OBJECTIVE

To identify demographic and employment variables associated with an associate veterinarian's intent to remain at their organization in the next 5 years and to assess the impact of positive leadership in the practice and on veterinarians' well-being.

SAMPLE

2,037 associate veterinarians in private practice who participated in the 2021 and 2022 AVMA Census of Veterinarians surveys.

PROCEDURES

Associate veterinarian demographic and employment information was used in regression analysis to determine the likelihood of remaining employed at their organization in the next 5 years and the impact leadership has on an associate veterinarian's employment.

RESULTS

Higher levels of burnout, living in an urban community, and working in corporate practice were associated with lower odds of remaining in the next 5 years. Associates who worked in a practice in which they believed their leaders practiced positive leadership had higher odds of remaining in the next 5 years. An increase in a practice's leadership index was associated with a likelihood to remain employed over the next 5 years. Decreases in the leadership index were associated with higher burnout levels among associates, more work experience, working more hours, and specialty/referral practices.

CLINICAL RELEVANCE

Findings supported anecdotal evidence that lack of positive leadership in a private practice may lead to higher odds of retention issues in a practice, as well as lower job satisfaction, organizational commitment, and workplace well-being among associates. Positive leadership practices might provide protective factors to critical veterinary business outcomes like team member retention and engagement.

On-site communication skills education increases client-centered communication in four companion animal practices

OBJECTIVE

To evaluate veterinarian-client communication before and after a 15-month on-site communication skills training intervention.

PROCEDURES

Multipractice, pretest-posttest intervention study.

SAMPLE

A convenience sample of 4 companion animal practices owned by a single practice group in Austin, Texas (n = 9 veterinarians; 170 audio recordings).

RESULTS

After intervention, visits were 8 minutes longer (P = .005), and veterinarians' client-centered scores increased significantly (2.30 vs 2.72; P = .006). Veterinarians' biomedical questions decreased by nearly a third (P = .0007), while veterinarians' facilitation (ie, partnership-building) statements were 1.15 times as great (P = .04) after intervention due to an increase in asking for the client's opinion (P = .03) and use of back-channel statements (P = .01). Agenda-setting skills, including agenda-setting questions (P = .009), summary of the client's agenda (P = < .0001), and a check for remaining concerns (P = .013), increased significantly after intervention. Clients asked 1.9 times as many lifestyle-social related questions (P = .02) and provided 1.3 times as much lifestyle-social information (P = .0004) after the intervention. Additionally, clients offered 1.4 times as many emotion-handling statements (P = .0001), including showing concern (P = .03) and optimism, reassurance, or encouragement (P < .0001), after intervention. Paraverbally, clients presented as more anxious/nervous (P = .03) and emotionally distressed/upset (P = .02) after the intervention.

CLINICAL RELEVANCE

Results suggest that client-centered communication skills increased after intervention. This study builds upon previous case-based studies examining practice-based communication training, emphasizing that long-term interventions positively enhance veterinarian-client communication, which is likely to have a positive impact on client and patient care.

Veterinarians and moral distress

OBJECTIVE

Assess veterinarians' reported levels of moral distress and professional well-being. Determine the predictive value of moral distress, controlling for demographic factors, on veterinarians' levels of Professional Fulfillment, Work Exhaustion, Disengagement, and Burnout.

SAMPLE

Members of the Veterinary Information Network.

PROCEDURES

An electronic survey distributed via the Veterinary Information Network data collection portal.

RESULTS

A total of 1,919 veterinarians completed the survey. For both associates and owners, gender and age were significant predictors of moral distress with younger female veterinarians reporting higher levels of distress than older male veterinarians. For associates, age was a positive predictor and moral distress score was a negative predictor of Professional Fulfillment. Age was a negative predictor, and female gender and moral distress score were both positive predictors for Work Exhaustion. For Interpersonal Disengagement and Burnout, age was a negative predictor and moral distress score was a positive predictor. For owners, age was a positive predictor and moral distress score was a negative predictor for Professional Fulfillment. Age was a negative predictor, and female gender and moral distress score were both positive predictors of Work Exhaustion, Interpersonal Disengagement, and Burnout.

CLINICAL RELEVANCE

We found that, controlling for age and gender, higher levels of moral distress predicted lower levels of Professional Fulfillment and higher levels of Work Exhaustion, Interpersonal Disengagement, and Burnout. Given the prevalence of moral distress and its impact on mental health, it is imperative that the veterinary field provide training and education on how to recognize and navigate ethical conflicts.

Reducing occupational distress in veterinary medicine personnel with acceptance and commitment training: a pilot study

AIMS

To determine whether an educational programme targeting the reaction of veterinary personnel to difficult client interactions reduced burden transfer, stress and burnout in veterinary staff.

METHODS

Employees of three small-animal veterinary hospitals in the south-western United States of America were recruited and randomised to intervention (educational programme; n = 16) or control (no intervention; n = 18) groups. Participants of this randomised, parallel arms trial completed pre-programme assessment including the Burden Transfer Inventory (BTI), Perceived Stress Scale, and Copenhagen Burnout Inventory. Assessment was followed by two, group-format educational sessions, based on acceptance and commitment training, tailored to reducing reactivity to difficult veterinary client interactions (intervention group only). After training was completed, both groups were assessed using the same measures and the intervention participants provided use and acceptability ratings.

RESULTS

Intervention participants rated the programme as useful and appropriate, and reported that programme techniques were used a median of 43 (min 9, max 68) times during the 2 weeks prior to retesting. Relative to pre-programme scores, median post-programme scores for reaction (subscore of BTI) to difficult client interactions decreased in the intervention group (33 vs. 54; p = 0.047), but not in the control group (51 vs. 59; p = 0.210). Changes in median scores for stress and burnout from pre- to post-programme were non-significant for both groups.

CONCLUSIONS

This pilot and feasibility trial showed high rates of acceptability and use by participants, as well as promising reductions in burden transfer. A larger scale clinical trial with follow-up at extended time points is needed to more fully examine the efficacy of this novel programme.

CLINICAL RELEVANCE

Preliminary findings suggest this programme may be a useful approach to reducing occupational distress for individuals working in veterinary practice.

Exploring Valued Personality Traits in Practicing Veterinarians

We examined differences in valued Big Five personality traits of small animal veterinarians between members and nonmembers of the veterinary medicine community. Between fall 2019 and spring 2020, data were collected from an online survey sent to eligible persons across a US midwestern state. Eligible persons included veterinary office clients (i.e., pet owners) and persons practicing/training in veterinary medicine. Participants completed demographic questions and 10 Likert scale items about which Big Five personality characteristics they prefer in a veterinarian. Descriptive data were determined and checked for assumptions of linearity and normality. Data for the primary analyses were analyzed using Spearman's correlations and Kruskal-Wallis H tests. Participants who were members of the veterinary community of practice valued the characteristic openness more than clients but valued emotional stability less than clients. Moreover, tests revealed that young adults (aged 18-24) valued extraversion more than all other age groups but least valued agreeableness. Last, participants aged 55 and older valued agreeableness and emotional stability more than the 18-44 age groups. Findings indicate individuals from different membership and age groups have varying preferences in what personality traits they expect in a veterinarian. Clients care more about their veterinarian being able to handle adversity. Older adults want their veterinarian to be trusting and creative. These findings encourage veterinary medical education to spotlight the development of skills congruent with these desired personality traits. Gaining such skills will be useful for veterinarians who seek to grow or build lasting relationships with clientele and colleagues.

The moral of the Swaledale tups

A story from early in Liz Barton's career demonstrates the high expectations those in the veterinary world often have of themselves - and the value of self-compassion. Being kind to oneself is something she and her colleagues are now trying to embed widely.

Perception of poultry veterinarians on the use of antimicrobials and antimicrobial resistance in egg production

This study aimed to describe the perception of veterinarians who work with commercial laying hens in the state of Rio Grande do Sul, Brazil, regarding the use of antibiotics and their possible impacts on animal, human, and environmental health. A descriptive epidemiological study was carried out through face-to-face or web conferencing interviews with the veterinarians that provide technical assistance at commercial laying hen operations. A standardized and structured questionnaire was developed based on the literature and expert opinion, which contained 1 opened and 40 closed questions. Conventional non-probabilistic sampling was used, based on an initial list of 15 veterinarians registered in the Poultry Production Association of Rio Grande do Sul, followed by the snowball technique. The acquisition of 26 contacts of veterinarians was accomplished, and 16 were interviewed. Through the answers obtained it was possible to verify that the interviewees' understanding regarding both the antibiotic resistance impact and the decision-making about the use of antibiotics seem to be linked to their practical experiences. Besides that, according to the veterinarians, farmers can acquire and administer the antimicrobials on their farms. Moreover, both farm storage and administration of lower doses of antibiotics than the recommended one could be contributing factors to resistant bacteria selection. Furthermore, controversially, the professionals believed that resistant bacteria can be transmitted to humans from eggs, but they said that there are no bacteria in eggs. Therefore, the veterinarians´ practices can be improved considering national and international guidelines on antimicrobial resistance to minimize the development of resistance. Finally, it is expected that the present results will contribute to a more complex discussion about antimicrobial resistance, helping to formulate public policies in the egg production industry.