According to the 2014 Royal College of Veterinary Surgeons' (RCVS') Survey of the Veterinary Nurse Profession (Institute for Employment Studies (IES), 2014):
- More than four-fifths of UK practising veterinary nurses expressed an intention to remain within the profession for the foreseeable future, but around one-fifth indicated that they intended to leave, citing low pay as the main reason for leaving.
- When asked if they would still choose veterinary nursing as a profession if they were to start their career over again, three-fifths affirmed that they would, but two-fifths indicated that they would not.
- Better pay and recognition from the public were the two most frequently mentioned ways in which the profession could be improved.
- Although there has been an overall improvement in nurses' views about the profession, the mean mental wellbeing score for the entire veterinary nurse sample surveyed was below the average population mean and had not improved since 2010.
- The survey reported that although veterinary nurses felt more useful and able to think more clearly and handle problems more competently, they also felt ‘less relaxed and less loved’ (IES, 2014, Executive Summary: 8).
To balance these negatives, the survey also identified a number of things that made veterinary nursing satisfying. Most veterinary nurses agreed that although it can be stressful, the best aspects of the job are working with animals, being able to make a difference, and the satisfaction inherent in the job itself, which is both meaningful and worthwhile (IES, 2014).
Since the majority of qualified and student veterinary nurses work within clinical practice (IES, 2014), it would seem to be a logical starting point for the owners and managers of these establishments to take note of the findings of the 2014 survey and to act now to implement measures to retain veterinay nurses and improve their working conditions in order to allow a better work–life balance and increased recognition. However, it is the author's contention that any measures which owners and managers put in place must address both job satisfaction and employee motivation if they are to achieve sustained high-quality work performance and continued commitment from veterinary nurses in the longer term. In order to do that employers must, first, understand the distinction between satisfaction and motivation and, second, gain a true appreciation of what really motivates veterinary nurses.
Motivation and satisfaction
Work motivation has been a popular research subject for many decades and consequently a substantial body of empirical knowledge has been accumulated including some very influential theories, practical strategies and methodologies for motivating staff (Locke and Latham, 2004). However, it is only possible to consider a few key theories in this article. Those wishing to explore the subject in more detail are referred to Locke and Latham's (2004) and Ramlall's (2004) reviews of employee motivation theories, as a starting point.
Clark (2003) defined motivation as the force that initiates and drives the continuous application of experience, expertise and skills. Hargie (2006) also subscribed to this definition arguing that individuals are by nature goal driven and that people work constantly towards satisfying their perceived needs by formulating and pursuing goals. It is motivation that determines the strength with which goals are pursued. Alshallah (2004) also espoused the definition of motivation as being the driving force to pursue and satisfy one's needs. Motivation is, therefore, an internal state arising within the individual. For motivation to be present, there need to be goals and a desire as well as ability to achieve them.
Ankli and Palliam (2012) distinguish between intrinsic motivation and extrinsic motivation and associate intrinsic motivation with the satisfaction or pleasure individuals derive from the activity itself. In contrast, extrinsic motivation is represented by tangible or non-tangible rewards which the individual desires to achieve. Morgan (2013) concurred with this distinction, describing intrinsic motivation as arising from a job's inherent interest and extrinsic motivation as being the need to perform and succeed in order to achieve a specific outcome arising from outside.
‘Low pay leads to continued dissatisfaction, but not to a loss of motivation.’
Motivation and job satisfaction are often used interchangeably in the literature, but they are not one and the same (Alshallah, 2004). Zangaro and Socken (2007) define job satisfaction as an individual's emotional response to their current job situation or, put more simply, the extent to which employees like their jobs. So, while motivation is the driving force for the achievement of goals, satisfaction is the positive feeling a person gets from this pursuit.
Veterinary nursing is an inherently satisfying job from which veterinary nurses gain enjoyment and personal fulfilment and so veterinary nurses can be said to possess a high level of intrinsic motivation. However, because of poor pay, work stress and a lack of recognition, as experienced and reported by the veterinary nurses in the survey, extrinsic motivators are limited or non-existent (IES, 2014). Nevertheless, despite the lack of extrinsic motivators, veterinary nurses continue to be motivated in their work. Herzberg et al (1959) provide one possible explanation for this. They identified two main factors within the working environment which influence how employees feel about work. These two groups of factors they called ‘motivators’ and ‘hygiene factors’. Achievement, recognition, responsibility and the work itself were identified as motivators, which resulted in improved employee performance and increased job satisfaction. Salary, work conditions, organisational policies and rules were identified as ‘hygiene factors’. If the ‘hygiene factors’ were managed well, they were found not to give rise to job satisfaction or increased motivation, but rather to an absence of dissatisfaction. However, if these factors were managed badly or were contrary to employee expectations, they tended to cause deep dissatisfaction and loss of motivation. Probably the most controversial finding of Herzberg et al's (1959) research was the conclusion that pay and financial incentives do not motivate and that any increase in employee satisfaction and motivation, which may be observed immediately following a pay rise or reward of a bonus is generally short lived.
The relevance of Herzberg's motivation theory for today's employees and workplaces may be questioned, developed as it was more than five decades ago, but a number of more recent studies have shown that it is has been able to withstand the test of time (Bassett-Jones and Lloyd,2005; Sachau, 2007). Following considerable criticism and many attempts to disprove his theory over the years, Herzberg himself felt moved to restate its basic tenets in an article written for the Harvard Business Review in 2003, in which he distinguished between movement and motivation. Herzberg (2003) argued that movement is achieved when employees exhibit the work behaviours desired by managers without necessarily being motivated. So it is possible for managers to achieve movement through the implementation of various incentives, reward schemes or punishments, but they will not be able to really motivate employees by these measures.
And so, to apply Herzberg's theory, veterinary nurses continue to be motivated in their work because there are plenty of intrinsic motivators within the job itself, but also because veterinary nurses value intrinsic motivators more and extrinsic motivators, including pay, much less.
It has always been Herzberg's contention that superior work performance can only be achieved from truly motivated employees and that true motivators are intrinsic. The fact that most veterinary nurses continue to demonstrate superior work performance in the absence of a number of important hygiene factors appears to bear this out. However, to contradict this somewhat, there is growing evidence that the role of pay, and particularly low pay, is gaining greater significance for today's veterinary nurses.
Pay
In the UK veterinary nursing is a low paid job and so most nurses' choice of veterinary nursing as a career is unlikely to have been motivated by money. As has been shown, pay is an extrinsic hygiene factor, which plays an important role in job satisfaction. Low pay leads to continued dissatisfaction, but not to a loss of motivation.
According to the Society of Practicing Veterinary Surgeons (SPVS) 2014 Salaries Survey, the value of the total annual salary package for full-time nurses (those working 35 hours or more per week) fell within the range £17 550 and £23 811 with the median value being £21 000 compared with £20 100 in 2013 (SPVS, 2014). The salary package includes basic salary plus a range of additional employee benefits paid for by the employer. There are, of course, regional variations which need to be borne in mind. According to a Vetsonline 2013 report, the average registered veterinary nurses (RVN) salary was £20 208 in 2013 compared with £19 075 in 2012. While the salaries of RVN in the UK have continued to rise year-on-year, in 2013 the average VN salary was still £6000 below the national average, as reported by Vetsonline (2015), which is an ongoing cause for concern.
The proportion of respondents to the survey who mentioned low pay increased from 45% in 2008 to 54% in 2014 (IES, 2014) indicating that the issue of low pay is gaining in importance. If the issue of low pay is not addressed soon, the role of pay will change from being a hygiene factor incapable of influencing motivation to becoming a mover, moving VNs to leave the profession and this is why employers should never take for granted the fundamental intrinsic motivation of VNs.
Stress and wellbeing
There was general agreement among the respondents to the survey that veterinary nursing is stressful (IES, 2014, Executive Summary: 8). Bakker and Demerouti (2007) argue that job characteristics can have a profound impact on employee wellbeing and, consequently, on motivation. Within their Job Demands-Resources (JD-R) model the various job factors were divided into two main categories, job demands and job resources. Job demands are all those aspects of a job which demand sustained physical and/or psychological effort and which, therefore, carry a cost to the employee. Examples of job demands for veterinary nurses are high workloads, excessive working hours and emotionally demanding encounters with clients. According to the authors, job demands are not always negative and only turn into stressors when meeting them requires sustained high effort with few opportunities to recover.
Job resources, on the other hand, are all those aspects of the job that support the achievement of the employee's goals, minimise personal cost and lead to growth, learning and development. Examples of job resources are career opportunities, role clarity, participation in decision making and pay. Certain job resources are intrinsically motivational, such as social support, performance feedback and autonomy. Bakker and Demerouti (2007) demonstrated that stress develops when job demands are high and job resources are limited and too many nurses' jobs are like this.
Zangaro and Socken (2007) concur with Bakker and Demerouti's (2007) findings. They discovered that there was a strong consistent negative correlation between job stress and job satisfaction. A normal amount of stress can add challenge and variety to a job, but an abnormal amount can diminish motivation.
Veterinary nurses deal with a variety of difficult situations on a daily basis, including angry and upset clients, pet death and euthanasia and demanding bosses who may themselves be stressed, not to mention very busy workplaces and a growing list of basic but essential maintenance tasks, which must be fitted in in between caring for hospitalised sick and injured patients. It is essential that practice owners and managers take the necessary steps to ensure that there are sufficient job resources present in the workplace to counteract negative job demands. In the author's experience, all too often owners and managers absolve themselves of responsibility by viewing the stress of veterinary nursing simply as an inevitable and inescapable part of the role which nurses sign up to when they choose this career and so nurses are simply expected to cope.
Respect and recognition from the public
As part of the RCVS survey, VNs were asked what would make the veterinary nursing profession a better profession in which to work and were provided with a tick list of ten options. The second most frequently selected option after pay was ‘more respect/recognition from the public’ (IES, 2014).
A number of studies have shown that recognition is an important intrinsic motivator (Luthans, 2000; Hansen et al, 2002) for all employees. Unlike pay, recognition is an intangible reward, which is about noticing and honouring people for their work and is more powerful than pay in motivating the employee to demonstrate inventiveness, commitment and initiative (Hansen et al, 2002). According to Luthans (2000), the importance of providing employees with non-financial rewards is often overlooked by managers, but their potential to increase motivation and sustain employee commitment is significant. Participants in the survey Luthans (2000) carried out of public sector workers were asked, amongst other things, to indicate what type of recognition they favour. While a significant number of respondents mentioned tangible recognition rewards such as gift vouchers or meal vouchers, a greater number mentioned public acknowledgement as being sufficient for them.
Until very recently veterinary nursing was a job done behind the scenes and not in the public eye. Veterinary nursing was not recognised as a profession in its own right and the veterinary surgeon was held accountable for the outcomes of both their own and their nurses' work. Because of this, there was a lack of recognition and poor awareness of the role of the veterinary nurse by the general public. However, recent changes which have taken place in the UK are likely to change this.
In 2011, a separate disciplinary system was introduced for registered veterinary nurses and a new Code of Professional Conduct was implemented in 2012. Veterinary nursing in the UK became a profession in its own right. On the 17th February 2015 the new RCVS Royal Charter came into effect meaning that the whole of the veterinary nursing profession in the UK is now regulated (RCVS, 2015). On the 10th June Lord Sandy Trees on behalf of the RCVS submitted his Veterinary Nurses (Protection of Title) Bill to the House of Lords and it is hoped that this bill will succeed thus ensuring that only those individuals who have undergone appropriate training and completed the necessary examinations can use the title of Veterinary Nurse (RCVS, 2015). So, much has been done in recent years to raise the profile of veterinary nurses in the UK and continues to be done. Veterinary associations and organisations in the UK, including the RCVS and British Veterinary Nursing Association, are continuing to campaign on behalf of the profession. In time, public recognition will follow from an increased public awareness and so VNs should begin to see positive results from this.
Conclusions
The RCVS survey results give rise to concerns about veterinary nurse retention over the longer term (IES, 2014). If nothing is done to address the causes of dissatisfaction, specifically low pay and high stress levels, the supply of qualified RVNs may well be insufficient to meet the needs of the veterinary profession in the future. Veterinary nursing is intrinsically satisfying and motivating primarily because the work is meaningful and worthwhile. However, it has been shown that high stress levels and a lack of recognition counteract these intrinsic motivators and lead to a reduction in motivation and performance.
Although VNs are not motivated by pay, low pay is the number one reason for nurses leaving the profession. Practice owners and managers are responsible for ensuring that the work environment is supportive and should not give any employees reasons to feel that they have no choice but to leave.
Many practice owners and managers do value, recognise and reward the contribution that nurses make, but as the survey results show many more still do not. They need to take action now. First, they need to examine the reasons why they pay their nurses low salaries and to identify ways in which this situation can be improved. No one expects things to change overnight, but a consensus from all employers and the veterinary profession as a whole to seek ways in which to address this issue would at least be a start. Second, practice owners and managers need to address the work–life balance of veterinary nurses in order to ensure a better ratio of job demands and job resources. And finally, they need to set up systems and processes whereby veterinary nurses are formally recognised for the contribution that they make both within the practice and outside with clients.
It is anticipated that public recognition will follow on from the efforts that the RCVS and other organisations are already making to raise the profile of veterinary nursing as a profession in its own right, but this effort must be sustained and supported by everyone.
Key Points
- Veterinary nursing is a rewarding and satisfying career, but in the UK low pay is the main reason for nurses leaving the profession.
- Motivation plays a key role in determining the strength with which individuals pursue their goals.
- Motivation is the force that initiates and drives the continuous application of experience, knowledge and skills and job satisfaction is the extent to which a person enjoys their job.
- Of all the things that are capable of boosting an employee's motivation, the single most important one is making progress in meaningful work and veterinary nursing provides this.
- Any measures which employers put in place must address both job satisfaction and employee motivation if they wish to secure continued commitment from veterinary nurses over the longer term.