Veterinary human support is a useful umbrella term and can include anything related to supporting people in veterinary roles, from recruitment and training, through to workplace support and career development.
In recent years, many terms incorporating the word ‘human’ have appeared in conversations about the veterinary industry. Veterinary human factors, veterinary humanities, veterinary social work, veterinary human support – what do these all mean? Are they all different, or just different terms for the same thing? This article attempts to clarify what these terms mean, bring them together under the banner of veterinary human support, and to show how they might have a substantial impact on the role of the veterinary nurse.
We will start with veterinary human factors. This term comes directly from the concept of clinical human factors in medicine, defined as:
‘Human factors are organisational, individual, environmental, and job characteristics that influence behaviour in ways that can impact safety in clinical and healthcare contexts that means lives are at stake.’ (Ives and Hillier, 2015)
Human factors comes from the acknowledgement that all healthcare actions are delivered by humans, and humans make mistakes (Agarwal and Agarwal, 2020). Systems of work must be designed with this in mind and include the ability to recognise and correct error. The above definition comes from a report by the Clinical Human Factors Group, a charity set up by Martin Bromiley after his wife Elaine died during what should have been a routine procedure (Bromiley, 2011). A subsequent report showed that communication failures within the team had been a major factor in her death, and particularly noted that the nurses present tried to subtly let the doctors know they were concerned, but didn't feel comfortable speaking out openly (Mcintosh, 2018). This parallels known communication issues in other industries. The 1977 Tenerife airport disaster, where two passenger planes collided resulting in the deaths of 583 passengers, was found to be largely due to poor communication between the pilot, co-pilot and tower staff (PBS, 2006). These events and others like them have resulted in major changes in safety protocols in air travel and medicine. Especially important is the concept of psychological safety: when all staff feel that they can safely speak up about potential errors, the number of errors has been shown to dramatically reduce (Rosenbaum, 2019). Human factors studies cases of error to help develop protocols and procedures that minimise risk.
Veterinary humanities
The discipline of veterinary humanities is concerned with similar issues, but takes a research approach (Skipper and Gray, 2021). Veterinary humanities is an academic discipline; much of the research conducted in the sphere of veterinary medicine and nursing is quantitative, measuring outcomes such as the effect of medications, or time to recovery from surgery based on different anaesthetic protocols (Christley and Perkins, 2010). Qualitative research, such as that used in the humanities, is often focussed on less measurable factors, such as the experiences or attitudes of veterinary nurses to incivility in the workplace, or perceptions of career possibilities. The methodologies employed include surveys, interviews, ethnographic observation (eg observing workplace interactions) or textual analysis (eg analysis of public social media posts by veterinary nurses on a certain topic) (May, 2018). These methods allow in-depth research into the human elements of the profession. Any veterinary nurses interested in this type of research can contact the veterinary humanities group via their website: https://www.vethumanitiesuk.org/.
Veterinary social work
Veterinary social work is the movement to bring qualified social workers into the veterinary profession, as their skill set offers potential support for both clients and staff. Originating in the US, veterinary social work has four main areas of focus (Sutton-Ryan, 2023):
- Conflict resolution
- Bereavement support
- Animal-assisted therapy
- The link between human and animal violence (often referred to as The Link).
Veterinary social workers bring substantial training and experience in managing difficult situations to the veterinary environment, once they have been trained in the industry-specific issues they are likely to face (Holcombe et al, 2015). Using such external expertise can support veterinary professionals; for example, social workers can help make connections between possible animal abuse and possible domestic abuse and support the process of reporting concerns to the relevant authorities. This reduces the pressure on vets and veterinary nurses to manage these complex situations and reduces their need to be aware of all the complexities involved.
Veterinary human support
Veterinary human support, by contrast, is a much less specific term. The University of Tennessee was the first US university to offer a master's degree in veterinary social work, and they also offer a Certificate in Veterinary Human Support (University of Tennessee, 2024). This latter qualification is aimed at veterinary professionals who wish to learn about veterinary social work and covers many of the same topics as veterinary social work. In the author's opinion, veterinary human support is a useful umbrella term covering all of the approaches described above. It can include anything related to supporting people in veterinary roles, from recruitment and training, through to workplace support and career development. For example, there is much discussion in the veterinary world about topics such as equality, diversity and inclusion, flexible working, reasonable adjustments for physical and mental health conditions, and making workplaces suitable for neurodiversity. Veterinary human support allows us to look at these from the point of view of making workplaces safe and effective for everyone, rather than treating anyone affected by any of these issues as if they somehow don't fit with normal practice.
Issues facing the profession
Why are these concepts important? Surveys of veterinary professionals have shown significant challenges regarding interactions with clients, co-workers and managers. Irwin et al (2022) identify high levels of incivility in the veterinary profession as a major problem, with client incivility being a predictor of burnout and senior colleague incivility being a predictor of turnover. Smith (2016) surveyed UK veterinary nurses and found that 92.8% were at moderate risk of burnout, and cited issues with clients as a causal factor. Williamson et al (2022) found that UK veterinary professionals were at risk of moral injury, including seeing others perform unethical acts or feeling betrayed by senior staff. Armitage-Chan (2019), studying UK veterinary surgeons, found that interpersonal interactions had a strong impact on the formation of professional identity and that negative interactions could reduce personal wellbeing. These studies, and others completed in other countries, show that the quality of our interactions with others can affect our professional wellbeing.
Additionally, veterinary professionals are exposed to stressors not common in other working environments. Animal euthanasia and the decision-making process around it can impact wellbeing, both directly for the veterinary professionals involved (Matte et al, 2019) and as a result of experiencing the bereavement of pet owners (Morris, 2012). Navigating the challenges and risks of advanced veterinary care, especially for animals with a poor prognosis, creates ethical challenges (Quain et al, 2021). While the link between violence towards humans and animal abuse is well studied, veterinary surgeons often have little training in this area and may find it challenging to know what action to take when presented with clients who may be suffering from interpersonal violence (Monsalve et al, 2017), potentially resulting in distress. King et al (2024), providing a scoping review of veterinary nurse and student veterinary nurse mental health, identify multiple published issues, but point out that there are still large gaps in what is known, limiting the possibilities for identifying the most useful support options. In a survey of quality of life factors for veterinary professionals in the UK, Rohlf et al (2021) identified several operational factors that influenced burnout, such as managing client expectations, poor feedback and limited options for development. Many of the factors affecting burnout, compassion fatigue, trauma and intention to leave are systemic, and cannot be solved by only personal action. Providing suitable support to veterinary professionals is likely to have positive outcomes in staff wellbeing, reduced conflict and increased retention.
Implementing veterinary human support
How would the concepts of human support described above look in practice? Taking a human factors approach, practices can evaluate their policies and see if there are any changes that could make systems work better for people. One common system in veterinary practice that exemplifies this approach is checking doses. If the wrong dose of medication is delivered to the patient, that not only risks the patient's safety but also means having to discuss the error with the client, and the possible negative outcomes from that. When everyone checks each other's doses, it normalises the fact that everyone can make an error, and the checking process protects the animal, the client and the staff. Systems such as surgical checklists have also been shown to reduce human error and prevent negative outcomes for patients (Treadwell et al, 2014). Other approaches include simulation training to practice complex teamwork without the risk of harm to patients, or ethics rounds, where staff have the opportunity to speak about issues that affect them psychologically, emotionally or morally.
Another place to implement human support is in hiring, training and management systems. When hiring, blinding the staff making interview decisions as to the gender or race of applicants has been shown to make hiring decisions fairer. Some businesses have implemented systems of providing interviewees with questions in advance, as this can help mitigate issues such as anxiety, and allow the candidate to show their abilities evenly, rather than skewed towards candidates who are more confident in interviews. Graduate training programs for new graduate veterinarians and similar approaches for new graduate veterinary nurses can provide a safety net for staff to transition from the limited agency of a student to having personal responsibility within the team. Management issues are commonly identified as a factor for those leaving a role or the profession; there is a great deal of literature on how to provide a positive environment for employees, as well as the benefits that accrue when adopting these systems.
Introducing non-clinical support roles is another approach. Veterinary social work, as described above, is one of these. Having access to trained counsellors can help staff who are experiencing difficulties, and support clients with difficult decision making. This allows for staff who are specifically trained to work in these spaces to take on these issues and allow clinical staff to focus on their own areas of expertise. For example, there are the challenges around end-of-life decision making. Veterinarians and veterinary nurses both have expressed finding it difficult when the client either moves to euthanasia faster than the clinical staff would, or alternatively keeps on with treatment when staff regard this as poor animal welfare. There are complicated psychological and social factors that can affect this decision making process; having a human support professional to join in these discussions can help with supporting both staff and client to make a decision that mitigates harm to animal and humans. Similarly, having a staff member knowledgeable about reporting welfare concerns and cross-reporting to police or domestic abuse services can help clinical staff be sure they are following the correct procedure and let them focus on animal health and welfare, as discussed above.
Human support roles also provide a professional development opportunity for vets and veterinary nurses who might wish to work in this area. Just as there are advantages to having external experts bringing their knowledge into the industry, there are benefits to having clinical staff who know the industry well moving into these roles. Some people have already done this, cross-training in counselling, bereavement support or ethics rounds in order to support their colleagues. Creating clearer paths for veterinary nurses who wish to specialise in this area would make it easier for this to become another veterinary nurse specialty, just as veterinary nurses might move from clinical nursing to behaviour and training or nutritional support. This in turn benefits the industry; more options for veterinary nurse careers means a greater likelihood of retaining staff long-term, and not losing their experience.
Conclusions
In summary, human interactions can have a strong effect on the wellbeing and resilience of veterinary professionals. Veterinary human support staff within practices, or as externals on call, can help to mitigate the effect of negative interactions and improve interpersonal interactions with clients and co-workers. There are clear potential benefits to the industry, such as improved staff retention, better client retention and feedback, improved teamwork and increased patient safety. While no single approach will fit all practices and areas of industry, specific options might be identified based on the particular issues relevant to each practice. Increased research on veterinary human support topics would be beneficial in providing an evidence-based approach to veterinary human support practice.
KEY POINTS
- Terms like veterinary human factors, veterinary humanities, veterinary social work and veterinary human support all relate to methods of evaluating, managing and supporting humans in the veterinary industry.
- Each area has a main focus, but there is a great deal of overlap.
- Veterinary human support is an umbrella term for a range of approaches to supporting veterinary professionals.
- Veterinary human support offers potential to reduce stress, burnout, compassion fatigue and other issues, and improving wellbeing.
- Veterinary human support creates new opportunities for personal and professional development of veterinary nurses.