The changes humans across the planet have made over the past 2.5 years to attempt to deal with the COVID-19 pandemic have been huge. The veterinary profession, and perhaps particularly emergency veterinary workers, have had to cope with huge upheaval to working practices. As it becomes clear that ‘things will never be quite as they were before,’ we need to work out which of the changes that we have made that we want to continue with if possible and which working practices we would like to return to pre-pandemic methods. It is also worth considering how the pandemic has impacted the veterinary team and what we can learn from this.
Positive Changes?
While it can seem difficult to think of positive aspects of COVID-19, some of the changes made to working practices may well be ones we want to maintain. One of the most notable changes for many workers was the practice of working from home. This would often previously have been thought of as impossible for those working in veterinary practices, but actually many roles can be performed very effectively at home including telephone reception duties, many administrative duties (standard operating procedure (SOP) preparation, prescription writing, etc.) and continuing professional development. Whether remote consultation (and prescription) is allowable is governed by the veterinary professional bodies, but while clearly not possible for many patients and disease processes, its efficacy for others may be good. Allowing people to work at home in this way may increase worker satisfaction, removing their commute and, therefore, decreasing their working day. It can also allow them to work more flexibly.
Telephone triage has been performed for emergency out-of-hours patients for a long time but has been developed further during the pandemic, with the BSAVA providing simple clear guidance for which cases must be seen. If higher caseloads continue, this tool can be used going forwards to allow non-veterinary professionals to help determine which cases need to be seen most urgently. Alongside working from home, the requirement for more flexible working patterns was present, particularly during periods of full lockdown when many of those with children or other caring responsibilities found it difficult to work normal shifts. This was often stressful for all involved, but it did teach us that we can afford to be more flexible with schedules when required and that an understanding employer who allows changes to be made will often reap the rewards from an employee who feels more appreciated and, therefore, more bonded to a practice.
Impact of the Pandemic Upon Veterinary Staff
Changes in staffing due to sickness, vulnerable people ‘sheltering,’ isolation and furlough schemes led to huge stress, both for those at work and those not working. In the UK, veterinary practices reported a large decrease in income. Staff were asked to reduce their hours and/or pay in many cases adding potential financial strains to a difficult time. They were also asked to change their working practices, with clients often no longer allowed in the hospital, which could be stressful. For many hospitals, client numbers increased, and routine (perhaps simpler) work decreased. A Romanian study of veterinary professionals found that a high number felt exposed to a medium to high risk of COVID-19 infection and a majority felt their professional environment was more stressful during a lockdown period, while a multi-national study found the frequency of ethically challenging situations had markedly increased during the pandemic. Overall, therefore, work seemed more stressful and coping mechanisms such as outdoor/group exercise, socialising with friends and family, and travelling were all curtailed. Those with caring duties had less ‘down time,’ trying to fit in work around these duties and, therefore, often had long and interrupted working days.
People also often had concerns outside of work, being worried about friends and family with health issues, illness, and also possibly having to cope with bereavement. Studies of the general public revealed lower psychological well-being and higher anxiety and depression scores compared to before COVID-19, and studies investigating healthcare workers specifically found increased depression/depressive symptoms, anxiety, psychological distress, and poor sleep quality. In medical workers, the impact on nurses and women seemed to be greater than on doctors and men respectively.
The challenge for vets, nurses, managers, and other veterinary workers is how to deal with these issues. It seems that some team members feel undervalued, and this is leading to decreased job satisfaction and some people looking at leaving the profession. The WSAVA reports that this is a trend that has been increasing in recent years and was exacerbated by the pandemic. Therefore, making sure people do recognise that they are valued members of the team, that they are listened to and appreciated is paramount for managers. If people are working from home, it is thought to be important to maintain contact with ‘catch ups’ at least once weekly, even if they are virtual, ensuring these staff members feel included in the team. For those at work, having brief daily team catch-ups to discuss patients and to give everyone a quick chance to relax and relate to one another is thought to be beneficial. Providing the team with resources for them to understand if they have poor mental health and how to proceed if they do is useful. And trying to help deal with an increase in caseload is also very important. Part of dealing with this increased caseload though may be about changing both staff and client perceptions of what is ‘an appropriate standard of care.’ The level of contact clients expect in terms of phone calls and updates may need to be addressed, for example. And staff may need to recognise that, particularly in emergency practice, the use of triage tools will prevent some patients from being seen which would have been seen previously, but that this will lead overall to better care to those patients who are treated. Finally, it is worth looking at the CIA model when considering how we, as individuals, can cope with increased stress within the workplace. This involves identifying what you can control in a situation (e.g., your personal response, any ability you have to change protocols, etc.), what you can influence (e.g., talking to a manager and explaining changes you would like to occur), and what you have to accept (e.g., other people’s decisions, world events, government restrictions). This can help an individual feeling overwhelmed or unhappy at work to deal with their stressors and to come up with a positive plan.
References
1. BSAVA. Triage tool for cats and dogs for use during lockdown & circuit or fire-breaks. www.bsava.com/covid-19/triage-tool-for-cats-and-dogs-for-use-following-lockdown 2020. (VIN editor: Link updated 4/21/23)
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5. Quain A, Mullen S, McGreevy PD, et al. Frequency, stressfulness and type of ethically challenging situations encountered by veterinary team members during the COVID-19 pandemic. Front Vet Sci. 2021;8:647108.
6. RCVS. RCVS survey #2 on the economic impact of Covid-19 on veterinary clinical practices. www.rcvs.org.uk/news-and-views/publications/rcvs-survey-2-on-the-economic-impact-of-covid-19-on-veterinary [accessed 18th January 2021]. 2021.
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