From support staff to a regulated professional, the veterinary nurse's (VN) role has dramatically evolved since its formation (Ackerman, 2012). Development of the profession has brought about law and legislation changes, including the introduction of Schedule 3 of The Veterinary Surgeons Act 1966, specifying tasks and professional responsibilities the VN is permitted to legally carry out. Despite advancements in training, registration, and regulations, the author believes there is a lack of public awareness and recognition of the VN's role.
According to the RCVS Survey of the Veterinary Nursing Profession (Robinson et al, 2019), 41% of the 4993 respondents claimed that more respect and recognition from the public would make the VN profession a better place to work. The RCVS survey also identified a lack of public recognition and respect of VNs, with 31% of respondents identifying this as one of the main challenges facing the VN profession (Robinson et al, 2019). The public are often uninformed of the VN's role and contributions to animal care, sometimes mistaking VNs for ‘mini vets’ (Maryniak, 2005; Ackerman, 2012), unaware of the training and qualification involved (Deamer, 2018). Waters (2019) proposed that veterinary surgeons should promote VNs as their co-professionals to clients and to those who may perceive the VN as little more than a glorified cleaner because of underutilisation of VNs. Clients may be unaware of the difference between a VN and a registered VN (RVN) because of a lack of knowledge surrounding the veterinary nursing qualification and registration. The appropriate title must be used for registered and non-registered staff to ensure public clarity (Royal College of Veterinary Surgeons, 2012; Kernot, 2016).
The VN title remains unprotected by law, allowing anyone to call themselves a VN. Jeffery (2010) suggested that the VN profession has evolved to the stage where it warrants statutory regulation. Statutory regulation would protect the VN title within law, meaning only those who are suitably qualified and registered are legally permitted to call themselves a VN (Garlick and Orpet, 2014). This would prevent unqualified persons from using the VN title and consequently misleading the public and compromising animal health and welfare (ANON, 2015). Statutory regulation would ensure that the public are receiving the highest standard of care for their pets from a qualified professional. Ultimately, it would be a crucial step to strengthen the profession, enhance animal welfare and raise public recognition of the VN's skilled role (ANON, 2015).
Methods
A cross-sectional study was designed in the form of an online questionnaire to target the UK pet owning general public over the age of 18. Ethical approval was gained from the ethics committee of the author's institution to ensure that the research posed no risk to potential participants. Recruitment of voluntary participants was conducted on the social media platform Facebook, using pet owner focused groups to share the survey. Exclusion criteria included all veterinary professionals including students and support staff. Participant consent was required before undertaking the survey, details of the study were provided with informed consent required before the questionnaire. Participants were debriefed after survey completion.
All responses remained anonymous to ensure personal data protection in accordance with the General Data Protection Regulations of The Data Protection Act 2018. The online software ‘Novi Survey’ was used to facilitate the gathering, analysis and presentation of data. The survey consisted of 14 questions, including demographics, experiences, and opinions. The questions were predominantly multiple-choice, with some allowing open comments for participants to explain their answers. Other question types included categorical, multiple response and Likert scale.
Results
A total of 148 responses were received that met the inclusion criteria. Female respondents represented 82% of participants, and 57% were between 18–24 years of age. 30% reported owning at least one pet (Table 1). The results more accurately describe the perceptions and opinions of females within the 18–24 age group that own at least one pet, and are not wholly representative of the target population intended for the study.
Table 1. Demographics of survey respondents (n=148), showing gender, age, and the number of pets that respondents own by number and percentage
| Gender | N | % |
|---|---|---|
| Female | 122 | 82.4% |
| Male | 23 | 15.5% |
| Non-binary | 3 | 2% |
| Age | ||
| 18–24 | 85 | 57.4% |
| 25–34 | 19 | 12.8% |
| 35–44 | 14 | 9.5% |
| 45–54 | 20 | 13.5% |
| 55–64 | 9 | 6.1% |
| 65+ | 1 | 0.7% |
| Pet ownership | ||
| 0 | 40 | 27% |
| 1 | 45 | 30.4% |
| 2 | 30 | 20.3% |
| 3 | 14 | 9.5% |
| 4 | 5 | 3.4% |
| 5+ | 14 | 9.5% |
Perception and opinion of the veterinary nurse's role
Respondents were provided with a list of clinical tasks. They were asked which ones they believed the VN could legally undertake, some were outside of the legal capabilities of the VN's role (Figure 1). Of respondents, 49% thought that VNs could carry out physiotherapy, 30% believed that VNs could diagnose animal health problems, and 24% thought that VNs could undertake minor surgical procedures.
When asked about the importance of the VN role, 83% thought the VN's role is important (Figure 2a). When asked if they thought the title of ‘Veterinary Nurse’ is protected by law, 57% of respondents said they did not know. Of respondents, 91% had a positive opinion of VNs (Figure 2b). Participants acknowledged the VN's work:
‘I'm sure that like medical nurses they work hard and do a lot of thankless jobs!’, and
‘Just as important as the vets themselves’.
Only 10% of respondents indicated that they have an unsure opinion of VNs. One participant said:
‘I was unaware of the distinction between ‘veterinarian’ and ‘veterinary nurse’.
Veterinary Nurse Awareness Month
Of respondents, 96% were unaware that May is Veterinary Nurse Awareness Month (VNAM) (Figure 3a). However, one respondent commented:
‘My practice and practice social media makes a huge effort to recognise the amazing job that the nurses do!’.
When asked if they believed the VN role could be promoted further in addition to VNAM, 50% of respondents answered yes (Figure 3b). Open comments for increased promotion included displays to explain the VN's role and responsibilities, and promoting the VN profession through schools and social media. One participant commented:
‘To be honest I didn't really know there were nurses for pets!’.
Discussion
As a result of the lack of current research surrounding public opinions of the VN, this study was designed to investigate public perceptions and awareness of the VN's role; however, the study more accurately displayed the opinions of 18–24 year old females within the UK than the general public. Therefore, the results cannot be assumed to represent the opinions of the general population because of the small sample size of the study.
Survey results found that over 90% of respondents have a positive opinion of VNs. Female respondents accounted for 82% of participants, with only 16% identifying as male, and 2% identifying as non-binary. More research with an equal sample size is required to accurately describe the general public's perceptions of VNs. Additional methods of distribution are recommended in future research to be representative of the target population.
Of respondents, 57% were aged between 18–24 years of age. There is no strong evidence to suggest a reasoning for the large percentage of 18–24 age group completing the survey on VN perceptions. Research shows that 25–34 year olds make up the largest group of Facebook users within the UK, with 35–44 and 18–24 age groups close behind (Statista Research Department, 2021).
Opinion of veterinary nurses
Results of the study show that over 98% of respondents believed the VN's role to be important. Comments from participants indicate they believe that VNs provide an essential role in the functioning of a veterinary practice. The public deems the VN role important, but is somewhat unfamiliar with the VN's clinical responsibilities. It could be possible that the public assumes the VN's role is important without fully understanding what they do. Only 14 respondents indicated that they had an unsure opinion of VNs, this was mainly as a result of being unaware of the VN's role and not knowing the difference between the veterinary surgeon and the VN.
The unfamiliarity of the VN role could be explained by the absence of financial identity within the veterinary practice. The VN is rarely acknowledged on veterinary invoices, making them invisible to the client. Subsequently, they are unaware of the VN's contribution to their pet's care (Davidson, 2017a; Davidson and Marsh, 2017). This could explain why VNs believe they are underappreciated and feel that clients value the veterinary surgeon's work but not the VN's (Robinson et al, 2019). In addition, VNs are often underutilised, which causes a lack of client interaction, contributing to decreased visibility and awareness of the VN's role (ANON, 2017; Harvey and Cameron, 2019). This view is supported by survey results from the British Veterinary Nursing Association (BVNA): responding VNs felt that their skills are underused (ANON, 2017). Furthermore, the British Veterinary Association revealed that 89% of veterinary surgeon survey respondents believed that half of their clients do not understand the VN role (Kernot, 2016). Despite this, some respondents from the current study highlighted that clients are unaware of the hard work VNs do behind the scenes, and that VNs are often overlooked. Fully utilising VNs within legal limits by increasing their tasks and responsibilities could improve job satisfaction, public recognition, and client appreciation (Coates, 2015).
Veterinary nurse interaction
A lack of distinction between the veterinary surgeon and the VN was a common theme throughout the survey responses. This could be explained by the veterinary team wearing the same uniform, underutilisation of VNs and underrepresentation in the media (Davidson, 2017b, 2017c). One survey respondent mentioned that they were never introduced to someone as if they were a VN. Veterinary professionals should introduce themselves to clients and have a name badge present stating their job title. An appropriate introduction ensures client clarity, prevents confusion of job roles, and forms the basis of the client relationship (Spear, 2012; Guest, 2016). An absence of staff introduction could explain why some respondents said they did not know if they had seen a VN for an appointment. Additionally, Davidson (2017b) mentioned that VN uniforms do not always differentiate them from other veterinary staff. Consequently, VNs become unrecognisable, making it hard for the public to visualise and define the VN role (Davidson, 2017b).
Human and veterinary nursing
A recurring theme within the survey responses was the comparison of the VN to registered nurses (RNs) in human healthcare. Comments stated that the VN is key to the functioning of a veterinary practice, just as RNs are vital to the National Health Service. Additionally, respondents acknowledge that, like RNs, VNs are overlooked and often do thankless jobs. Other survey comments highlighted the similarity between a VN and an RN at a medical practice when booking a routine appointment instead of seeing a doctor. In healthcare, RNs perform routine procedures, run clinics, and offer advice, so this resemblance is accurate (National Careers Service, n.d.).
Perceptions of the veterinary nurse's role
Respondents were given a list of clinical tasks, including some Schedule 3 tasks, and were asked which tasks they thought a VN could legally carry out. Robinson et al (2017, 2019) identified a lack of veterinary surgeon and VN knowledge surrounding the VN's role within the Schedule 3 Amendment (The Veterinary Surgeons Act 1966, Order 2002), causing restrictions to the VN's role. This could explain the underutilisation of VNs, causing decreased client interaction and subsequently impacting awareness of VNs. A survey by the Royal College of Veterinary Surgeons found that veterinary surgeons and VNs believe VNs should be permitted to undertake clinical responsibilities not currently authorised under the Schedule 3 Amendment (RCVS, 2017). Some VNs believe extending Schedule 3 would further improve the profession and increase public appreciation of VNs (Robinson et al, 2017, 2019).
Forty-five respondents believed that VNs could diagnose health problems, indicating that 70% of respondents understand that the VN cannot diagnose animals. One respondent's comment supports this acknowledging the supportive role of the VN to allow the veterinary surgeon to focus on diagnosis. Respondents may have noticed similarities between veterinary surgeons and doctors, concluding that only the veterinary surgeon can diagnose animal patients.
These results support the findings of Belshaw et al (2018) on client perspectives of the VN's role. The study indicated that some clients were unsure of what VNs were qualified to do within the veterinary practice. This view is reflected in the results of the current study. Tasks that VNs cannot undertake were chosen less by respondents compared with tasks that they can legally carry out, but still showed a notable response rate. This suggests that respondents have a limited idea of what the VN role encompasses, and limited knowledge of the legal limitations. Almost all survey respondents believe that VNs have qualifications. However, unqualified staff can use the VN title despite not being RCVS registered. Is it indicated that the public requires education on the differences between a VN and an RVN to fully understand the roles. This also highlights the need to protect the VN title, as the public may believe that anyone with the VN title has a qualification. Non-qualified persons using the VN title have not undergone the required training to work as an RVN. Legal protection of the VN title would reassure the public that all VNs are fully qualified professionals.
Over 50% of respondents were unsure if the VN title was protected by law. This suggests that the public may be unaware of the legal campaigning aspects for title protection and statutory regulation of the profession. The Department for Environment, Food and Rural Affairs (Defra) dismissed a call for title protection in 2015. Defra stated that criminalising the use of the VN title was a harsh solution (Woodmansey, 2016). Nevertheless, protection of the VN title would acknowledge the training and experience of a qualified VN, promote the role and increase public respect (Robinson et al, 2017).
Veterinary Nurse Awareness Month
Almost all respondents were unaware of VNAM, one participant commented that their veterinary practice uses social media to promote VNAM. The RCVS Survey of the Veterinary Nurse Profession (Williams and Robinson, 2014; Robinson et al, 2019) found that the percentage of VN respondents thinking that increased public recognition would improve the profession has fallen since 2014 from 46% to 41% in 2019. This implies that public awareness is increasing, possibly because of increased social media usage and the promotion of the profession by veterinary practices. The RCVS survey results indicated that the veterinary profession is utilising social media for this purpose. Veterinary practice websites can positively influence public opinions and understanding of the veterinary team, and practices should use their online presence to promote the VN profession (Molhoek and Endenburg 2009; Kinnison, 2017). Survey responses support this with comments mentioning social media and advertisements to promote the VN role further. The responses suggest that social media could be instrumental in promoting the VN profession and educating the public, as indicated by Deamer (2018).
The introduction of the Royal Charter in 2015 may be responsible for the slight increase in public recognition of VNs, which was suggested by responding VNs in the 2019 RCVS survey results (Robinson et al, 2019). Coates (2015) anticipated that professional developments would increase public awareness and recognition; however, a lack of recognition is still present and support from the whole veterinary team is needed to promote the VN role (Coates, 2015). Veterinary organisations such as the BVNA are continuing to campaign on behalf of the VN profession. The VN Futures initiative aims to address the future of the VN profession over the next 15 years by creating a sustainable workforce, rewarding career paths, and maximising VN potential (VN Futures, n.d.). In time, VNs should see positive results from increased public awareness and recognition (Coates 2015).
Study limitations
Although the survey reached the set response goal by the author, a large percentage of the participants were confined to the same gender and age category. Therefore, further research should focus on obtaining a balanced sample to determine the differences between genders and ages of respondents. Distributing future surveys to multiple online platforms and recruitment through physical surveys within veterinary practices could improve inclusivity and represent the target population.
Conclusions
The findings of this survey suggest that females within the 18–24 age group of the UK public have a positive opinion of VNs. Unsure opinions stem from a lack of interaction or knowledge of the VN's role within the veterinary practice. Veterinary clients are aware of the VN's varied role to a certain extent, and some appreciate the VN's supportive role. Social media could be instrumental in promoting the VN role and can potentially impact public perceptions and opinions of the VN positively. The whole veterinary profession should strive to promote the VN's role and push for increased public recognition of and respect for the VN profession.
KEY POINTS
- Members of the UK public identifying as female and between the age of 18–24 have a positive opinion of veterinary nurses and believe their role to be important.
- Increased promotion of the veterinary nursing role and profession is required to increase public respect and recognition.
- Utilisation of social media could be instrumental in promoting and educating the public about the veterinary nurse's role.
- Further research is required to identify the opinions and perceptions of the UK general public as a whole.