When you’re struggling, it helps to know you’re not alone.

And as much as your hospital staff has struggled with the challenge of practicing good veterinary medicine during a worldwide pandemic, veterinary staff around the world have been struggling with many of the same issues.

That’s among the findings of a new survey on ethically challenging situations (ECSs) faced by veterinary staff around the world during COVID.

Researchers from the University of Sydney in Australia developed the online, mixed-methods survey to determine the frequency, stressfulness, and types of ECSs experienced by veterinarians, veterinary technicians, and other veterinary staff since the advent of the global COVID-19 pandemic in March 2020.

The authors write, “The COVID-19 pandemic has been described as a ‘creeping crisis,’ with undefined endpoints, no clear path to exit from restrictions, and potential to ‘change shape along the way,’ causing challenges that are much harder to manage than those generated by acute crises that are more sharply delineated in time. It is likely, therefore, that veterinary team members may experience different and perhaps even totally unique ECSs, associated with varying degrees of stress, at different time points in the pandemic.”

The researchers analyzed responses from 540 veterinary team members from 22 countries collected between May and July of 2020.

“It’s important that, as a profession, we look carefully at moral stress—the stress arising from ethical challenges—as this impacts the wellbeing of all veterinary team members,” corresponding author Anne Quain, MVetStud, DECAWBM, told NEWStat.

Quain, a lecturer in veterinary science at the University of Sydney in Australia and a PhD candidate in veterinary ethics, said it’s the first study to describe the impacts of the pandemic on ECSs experienced by veterinary teams globally. It identifies an increase in the frequency of ECSs associated with the COVID-19 pandemic as well several stressors unique to the pandemic.

Nearly everyone has faced COVID-related hardships in the past year. But one of the challenges unique to veterinary professionals is the daily struggle to balance their responsibility to preserve animal welfare with the responsibility of ensuring their own health, as well as that of their colleagues, families, and the public.

Quain said universal themes emerged quickly: Concerns about biosecurity, client financial limitations, animal welfare, and safe working conditions. The most common ECSs reported by respondents were: 

• Challenging decisions about how to proceed when clients have limited finances (64.4%)
• Conflict between personal wellbeing and professional role (64.3%)
• Conflict between the interests of clients and the interests of their animals (59.6%)

Quain told NEWStat that, “A key stressor identified in our survey was conflict between one’s personal wellbeing or the wellbeing of one’s family, and one’s professional role and commitment to animal welfare.” Early in the pandemic, the global shortage of personal protective equipment (PPE) led to veterinary staff going without to make sure there was enough for human healthcare workers. “So veterinary team members literally found themselves having to decide which was more important—their own health and safety, or caring for animals and the people who depend on them.”

Another big ethical challenge: Determining which, if any, veterinary services counted as “essential” and whether to run noncontact consultations: “Respondents shared heart-breaking experiences of their distress around performing noncontact euthanasias, separating an owner and a closely bonded companion animal at the time they needed each other most.”

Quain said disagreements about biosecurity—what measures should be taken, how, and by whom—within veterinary workplaces were common. Quain thinks that’s partly because, while veterinary teams are used to treating animals as a source of zoonotic infection, “We were less prepared to consider our clients, our colleagues, and ourselves as sources of a highly infectious disease.”

And while client financial limitations have always been a major concern, that really ramped up during the pandemic due to many clients losing their jobs or having a restricted income. “This manifested as more clients declining recommended diagnostics and treatment,” Quain said. That led to an increase in euthanasia of animals with treatable conditions, “Which was distressing for owners and veterinary teams alike.”

Quain says the good news is that there are strategies that veterinary teams can employ to help them better navigate ethical challenges like these, not just in a pandemic, but postpandemic as well: “The first step is to recognize that ethical challenges are common, they’re a source of moral stress, and they’re experienced by all veterinary team members.”

The second step is to talk about them.

“When asked what resources respondents used to try to resolve ethically challenging situations, the most common was discussion with colleagues,” Quain said, with 63.1% of respondents saying talking things over with coworkers helped. “Colleagues get it,” Quain said. “They appreciate the challenges we experience, [and] they can offer practical advice.”

As can management.

Quinn said one-third of respondents reported looking to workplace policies for guidance, and that represents an opportunity for the profession: “Veterinary workplaces and professional organizations can help develop policies designed to help veterinary team members successfully navigate common ethical challenges.”

That’s important now as well as going forward, she said.

“It was very clear from the responses that veterinarians [and veterinary staff] around the world struggled with huge ethical challenges [during the pandemic], in the context of often rapidly changing guidelines, global uncertainty, staff shortages, and significantly increased workloads.”

As to how particular stressors differed by country or region, Quain said she’s “still working through the stats,” but it will be the subject of her next paper.

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