Abstract
Orientation: The global concern for veterinarian well-being continues to grow owing to the pervasiveness of psychological illness and suicide in the profession.
Research purpose: To explore lived experiences of South African veterinarians from an identity theory perspective.
Motivation for the study: There is a paucity of South African research on well-being in the veterinarian profession. Identity theory offers a unique perspective for understanding well-being because a coherent identity, supportive of the self-concept, is central to sustaining professionals’ well-being in the workplace.
Research approach/design and method: A hermeneutic phenomenological methodology was used to direct an interpretive, qualitative research strategy. Purposive sampling was applied to select registered, practising veterinarians for the study. Two online focus groups (n = 10) and four semi-structured individual interviews were conducted, with data being analysed using interpretive phenomenological analysis.
Main findings: Findings describe the way participants are confronted with role, social and person identity tension as fundamental challenges to their well-being.
Practical/managerial implications: The study highlights the importance of empowering veterinarians to build a sense of self that supports positive identity adjustment and, in doing so, enhances their resilience in the workplace.
Contribution/value-add: This research addresses well-being in a profession where it is seriously needed. It points to intervention opportunities for coaching and consulting with the aim of enhancing veterinarians’ adjustment and resilience in the workplace. The study contributes to the emerging discourse on intentional identity work to facilitate coping and adjustment in uniquely strenuous professional work contexts.
Keywords: veterinary well-being; coping; identity; identity tension; identity work; hermeneutic phenomenology; interpretive phenomenological analysis; IPA.
Introduction
Veterinary well-being has become a critical concern considering the consistent exposure of these professionals to animal trauma and the need to deal with capricious customer emotions in a complex vet–pet–client relationship (Brannick et al., 2015; Cartwright, 2017; Morris, 2018). Well-being is a multifaceted construct, that is broadly defined as the absence of negative affect, the presence of positive affect, life satisfaction and fulfilment and optimal functioning (Bautista et al., 2023). In this broad conceptual context of well-being, veterinary well-being studies predominantly focus on mental health and psychological well-being (Calitz et al., 2022), emphasising debilitating levels of burnout, compassion fatigue, anxiety and depression in the veterinary profession across the world (Bell & Cake, 2018; Pohl et al., 2022). Even more seriously, in addition to reported psychological illness, the high rates of suicide and suicide ideation among veterinarians exceeds those of the general population and other medical professionals (Cardwell & Lewis, 2017; Kogan et al., 2020; Ouedraogo et al., 2021), reporting a strong link between practice-related stressors and veterinarians’ depression and suicidal behaviour (Griek et al., 2018).
While there is a significant body of research on veterinary well-being from the Netherlands, the United Kingdom (UK) and the United States (US), there is a lack of research in the South African context (Calitz et al., 2022; Chigerwe et al., 2020). Only three peer reviewed studies could be sourced, of which two focussed on the mental health and psychological well-being of veterinary students (Chigerwe et al., 2020; Eloff, 2019) and one on the happiness of registered, practising veterinarians (Calitz et al., 2022). In a study on the life-long learning needs of veterinary professionals, the ability to ‘manage stress, develop resilience, prevent burnout and maintain well-being’ was identified as one of the profession’s key concerns in the South African context (Mohr et al., 2023, p. 3). According to Chigerwe et al. (2020), the need for more South African studies is underscored by the fact that veterinarians in the country are exposed to contextual stressors and resources that are different from western, developed countries. Eloff (2019) moreover emphasised that tailored support strategies are needed to address the mental health and well-being of South African veterinarians. To add to the small body of South African research, this study aimed to explore the lived experiences of practising veterinarians in the South African context, by specifically applying an identity theory perspective.
In the context of veterinary practice, recent research demonstrates an increasing awareness about the importance of supporting veterinarians’ well-being by strengthening their sense of self or identity (Armitage-Chan & May, 2018; Scholz & Trede, 2023). This is in line with literature relating identity and identity development, to well-being and success in work and in life (Caza et al., 2018; Karaś et al., 2015). Various studies highlight aspects relevant to identity as significant to the stress experience of veterinary professionals; these include role-identity (Ruston et al., 2016), personality traits (Dawson & Thompson, 2017), professional identity (Armitage-Chan, 2020; Armitage-Chan et al., 2025; Armitage-Chan & May, 2018, 2019) and self-esteem (Kogan et al., 2020). Most of these studies focus on developing a strong professional identity to sustain career satisfaction and well-being (Bell & Cake, 2018), and do not consider the broader complex dynamics underlying the concept of identity. Scholz and Trede (2023) furthermore emphasise the need for identity research among veterinarians from a qualitative, narrative and dialogic perspective to enhance the understanding of how they make meaning of their professional practice experiences. Applying an identity theory perspective to make sense of veterinarians’ lived experiences, provides useful insights to helping professionals who coach, counsel and support them, because a coherent identity supportive of the self-concept is important to a person’s well-being.
This article discusses identity theory as the framework applied in this study, as well as the concepts of professional identity, identity tension and identity work. Thereafter, the research design is detailed and the findings are presented. A discussion of the findings follows and the article concludes with recommendations for practice and further research.
Theoretical framework
In the context of veterinarian identity research, the concept of professional identity has become a popular focus (Armitage-Chan, 2020; Armitage-Chan et al., 2025; Armitage-Chan & May, 2018; Bell & Cake, 2018; Mastenbroek, 2017; Morris, 2018; Scholz & Trede, 2023). To understand professional identity as a key concept, we locate it within the broader theoretical framework of identity theory.
Identity theory
Identity theory defines identity as all the meanings that a person ascribes to the self. Accordingly, a person’s self-meanings are derived from subjective psychological experiences of the self in relation to others (Brown, 2015; Vignoles et al., 2006). Identity is thus a socially constructed sense of self (Leeds-Hurwitz, 2006) that is dynamically formed in relation to one’s social contexts, roles and expectations (Stets & Serpe, 2013). Ultimately, one’s identity encompasses an integration of different identity bases, namely, one’s role identities (e.g., being a mother, a friend), social identities (e.g., relating to one’s race, gender, occupation or profession) and personal identities (e.g., reflecting one’s personality traits) (Stets & Serpe, 2013). The different identity bases constitute a complex network of self-meanings, or multiple identities, that synthesise to form a holistic sense of self. Identity is not static and self-meanings are fluid, as each identity base draws on and mutually affects the way another identity is formed. For example, work identity is a role-based identity that reflects the meaning that a person ascribes to the self, based on what they do and who they are in the work context (Dutton et al., 2010). To define their work identity, however, people not only draw from their work roles and tasks, but also from their personal identity as well as their membership to certain social groups (Ashforth et al., 2008). Equally, one’s personal identity draws from the meaning one ascribes to one’s personal characteristics and attributes but is also affected by the way one defines oneself by what one does in the work context.
Professional identity
Professional identity draws on the meanings one ascribes to the self in the context of a specific profession, based on one’s personal, social and work identities, and relates to the extent to which one identifies with the work, the values and other distinctive characteristics ascribed to a profession. Professional identity can therefore be regarded as a social and role-based identity (Caza & Creary, 2016; Pratt et al., 2006). According to the conceptual framework developed by Fitzgerald (2020), the professional identity of a profession is defined by its characteristic (1) behaviours and tasks (e.g., what they ‘do’); (2) knowledge, skills and experience (e.g., what they know); (3) values and beliefs (e.g., how they conduct themselves ethically); (4) context and socialisation (e.g., how social context determines expectations of practice) and (5) group identification (e.g., how individuals align with the distinctive character of the profession). Professional identity can be examined at either an individual or collective level of analysis (Alves & Gazzola, 2013). This study focusses on the individual level, and applying Fitzgerald’s (2020) framework, regards a person’s professional identity as strong if they identify with the five characteristics – they feel empowered and engaged when their personal actions, expertise and value system align with those of the profession, when expectations in the social context of their practice support theirs personal beliefs and when they identify with the profession as representative of a social group that they see themselves belonging to.
Implicit in Fitzgerald’s (2020) conceptual framework of professional identity is the notion that identity bases relate to the alignment or congruence that a person seeks and experiences between their personal identity and other identity bases. Such alignment has been described as the extent of identification with or congruence between work and organisational or professional-based identities (Brown, 2015). Identity incongruence affects a person’s well-being in that weak identification with or non-alignment between identity bases can lead to a poor sense of self-efficacy, lower self-esteem and burnout. Strong identification with and alignment between identity bases leads to positive affect and optimal functioning in work and in life (Stets & Serpe, 2013). Alignment between personal identity and work, role or social identities means that a person’s engagement in a specific work-role, occupation or profession (e.g., veterinarian) facilitates and supports personal values, beliefs and goals (Randall & O’Toole, 2017).
Identity tension and identity work
While identity conflict or tension negatively affects a person’s well-being, self-esteem, motivation and engagement (Gibson et al., 2021; Karelaia & Guillén, 2014; Rabinovich & Morton, 2015; Zagefka et al., 2021), it becomes the impetus for identity work to resolve the tension (Caza et al., 2018). Identity tension arises from work–life challenges and changes (Adams & Crafford, 2012; Brown, 2017) and from experiencing identity threat (Breakwell, 1988, 2010). Identity tensions are ultimately rooted in a sense of incongruence between identity bases (Galliher et al., 2017). In this instance, identity tension is often evident when a person’s desire for belonging and acceptance (social and role-identity) conflicts with what they need to do to fulfil their equally important need for distinctiveness (personal identity) (Knez, 2016; Kreiner et al., 2006). Similarly, people feel conflicted when their need to live and work in ways that make them feel authentic or true to the meaning and value that they ascribe to themselves are challenged in the work context (Randall & O’Toole, 2017). Positive emotions arise when identities align or when one experiences a sense of identity congruence; while discrepancies or a sense of identity non-verification can lead to psychological distress (Kalkhoff et al., 2016; Stets & Serpe, 2013; Szelényi et al., 2016).
To resolve identity tension, people engage in processes of identity development or identity construction (Galliher et al., 2017; Kreiner et al., 2006) which is commonly referred to as identity work (Caza et al., 2018). Identity work entails any activity directed at crafting, revising, strengthening or developing one’s identities to remain congruent with and supportive of one’s self-concept (Snow & Anderson, 1987; Sveningsson & Alvesson, 2003). Identity is therefore not a set of constant or fixed self-meanings, but a process-based phenomenon in which self-meanings are continuously developed and revised through self-reflexive processes (Brown, 2015) such as self-evaluation, self-verification and assimilation (Breakwell, 2010; Stets & Serpe, 2013; Szelényi et al., 2016).
Research design
Research approach
We applied a hermeneutic phenomenological methodology to construct interpretive, holistic and contextually relevant knowledge (Lindseth & Norberg, 2022; Suddick et al., 2020). Hermeneutic phenomenology is an interpretivist approach, favouring methods of inquiry aimed at eliciting narratives of participants’ lived experience and constructing an understanding of them by means of processes of interpretation (Lindseth & Norberg, 2022). In this double hermeneutic process of analysis, participants’ voices are integrated with the theoretical predisposition and perspectives of the researchers (Suddick et al., 2020) to create a ‘fusion of horizons’ (Alsaigh & Coyle, 2021, p. 2). Findings are not deemed conclusive but rather meaningful insights that contribute to a relevant knowledge base (Alsaigh & Coyle, 2021).
Research strategy
In line with the hermeneutic phenomenological methodology, the study employed interpretive phenomenological analysis (IPA). Interpretive phenomenological analysis is a research strategy, using qualitative, in-depth data collection and a double hermeneutic data analysis process (Alase, 2017; Pietkiewicz & Smith, 2014). Rigour in IPA studies furthermore require: (1) constructing a compelling narrative; (2) presenting meaning through an existential account of subjective lived experiences; (3) demonstrating a close analytic reading of verbatim narratives and (4) attending to similarities and differences between individual cases (Cena et al., 2024; Nizza et al., 2021). Details of how methods were applied to ensure alignment to IPA principles and methodological requirements are discussed further in the text.
Research methods
Research context and procedure
The study was conducted in the context of its target population, namely practising veterinarians who were registered with the South African Veterinary Council (SAVC) and were members of a professional body, the South African Veterinary Association (SAVA). Veterinarians were informed about the study on the SAVC and SAVA websites, and the Facebook pages of two non-profit organisations — Vets Supporting Vets South Africa and Vets in Christ South Africa. Interested veterinarians contacted one of the researchers via email and telephone. After the study had been explained, consent forms were finalised, and participants could choose to participate in either an online focus group or a semi-structured individual interview.
Sampling and participants
The inclusion criteria applied in purposive sampling (Alase, 2017) specified that participants had to be practising veterinarians registered with SAVC. Fourteen veterinarians (n = 14) participated in the study and were from varying fields such as private practice, animal clinics, academia, welfare and government. Three white males and two white females participated in online focus group 1, while one black male, one white female and three white males participated in online focus group 2. In addition, one white male and three white females participated in semi-structured interviews. After two focus groups and four interviews, data saturation was reached, as no new thematic interpretations emerged, and themes were rich and thick in their description (Alase, 2017). To assure confidentiality, participant codes were used; for example, IP1 refers to interview participant 1 and G2P1 refers to focus group 2, participant 1.
Data collection and recording
Data were collected through two online focus groups (n = 5 in each focus group) and four semi-structured individual interviews. The focus group entails an online community engaging in discussions in their own time and over a period. The two online focus groups were conducted simultaneously over a period of 4 weeks using free online software, FocusGroupIt (https://www.focusgroupit.com/). The software enables interactive, interval and unlimited log-in responses over a specified time. L.R. monitored the discussions daily and, when necessary, prompted and probed into issues needing further exploration. Semi-structured individual interviews followed the focus groups. In preparing participants for the discussions, they were informed about the aim of the study and invited to ‘share your lived experience in the veterinary work environment’. Focus groups were set up online with a confirmation of the research aim and the request ‘Please provide your own response to enable the diversity of unique and similar experiences in the veterinary work context’. Interviews were opened with the question ‘Tell me how you became a veterinarian’. Discussion topics were introduced in the focus groups, and in the interviews, follow-up questions naturally evolved, but focussed on the same discussion topics, which included challenges and stressors, motivation and job satisfaction and coping mechanisms and strategies. This approach elicited narratives about participants’ lived experiences of being a veterinarian, which were then later analysed from an identity theory perspective. This aligns with the existential concern underlying IPA namely, to make meaning of how lived experiences relate to the individual’s sense of self (Cena et al., 2024). Interviews lasted approximately 60 min and were conducted telephonically. The interviews were digitally recorded and professionally transcribed, and group discussions were exported from FocusGroupIt (https://www.focusgroupit.com/) as text files.
Data analysis
The study applied four analytic phases characteristic of IPA (Alase, 2017; Pietkiewicz & Smith, 2014; Smith & Shinebourne, 2012). Firstly, to enhance the close analytic reading of participants words (Cena et al., 2024) we engaged in multiple readings of the transcripts, and made preliminary notes about possible relevance to identity. Secondly, we identified meaningful units of text from the transcripts and transformed these into descriptive categories by condensing and rephrasing the verbatim text, using our own words to describe the meaning thereof. We then organised all the descriptive categories, sorting similar and unique categories. This enabled us thirdly to formulate higher order meanings encompassing similarly clustered categories into themes. Lastly, we reconstructed the themes into a compelling narrative (Nizza et al., 2021) about understanding participants’ well-being experiences from an identity theory perspective. The narrative demonstrates a grounding of our meaning making in the rich verbatim participant experiences and meanings. Throughout the data analysis we followed the principle of the hermeneutic circle by consistently comparing data, emerging categories, themes and identity theory (Pietkiewicz & Smith, 2014).
Data quality and ethics
To enhance the trustworthiness of the study, we incorporated strategies to ensure credibility, transferability, dependability and conformability (Loh, 2013). For credibility, findings were grounded in verbatim data and peer reviewed. Transferability was assured using contextual information about the study and its participants. The research design and methods enhanced dependability, and confirmability is evident in the construction of a thematic data structure mirrored in existing theory and research.
Ethical considerations
The study obtained ethical approval from the University of South Africa, CEMS Ethics Committee (ERC Reference no.: 2017_CRERC-012FA). Ethics was ensured through voluntary participation and written informed consent. Data were anonymised and password protected.
Findings
Three main themes were constructed based on the sub-themes depicted in Figure 1. The themes provide a unique understanding of how identity tensions related to veterinary well-being and describe the identity tensions that participants experienced in their (1) work-role, and (2) social and (3) personal identities.
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FIGURE 1: Thematic findings: Themes and sub-themes. |
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Theme 1: Work-role identity tensions
Three sub-themes conceptualise the way work-role identity tension derives from (1) non-alignment of self with the behaviours, tasks and activities of veterinary practice; (2) veterinarians not being recognised for their distinctive knowledge and skills and (3) conflicts of conscience when it comes to balancing values and beliefs in the pet–client–vet relationship.
Non-alignment of self with behaviours, tasks and activities of veterinary practice
Participants emphasised a discrepancy between their career ideal and the reality of the tasks, behaviours and actions they found in practice. As young aspiring veterinarians, career choice was motivated by ‘a desire to care for animals’ (G2P5 and G2P4). However, G2P3 noted that this work ‘starts with a love of animals, but the love of animals is not enough to endure and remain as a vet’ and described the tension veterinarians experience when they engage with daily tasks and behaviours incompatible with their passion for animals. Table 1 gives examples of participants’ verbatim quotes, noting the stress associated with the administrative, personnel and financial tasks central to managing a practice. They felt overburdened by these and insufficiently trained for them.
| TABLE 1: Verbatim quotes: Non-alignment of self with practice management tasks. |
The quotes indicate how participants felt overburdened by and insufficiently trained for these tasks, emphasising their non-identification with tasks related to veterinary practice management.
Not being recognised for distinctive veterinary knowledge and skills
Working with the pet–client relationship further creates role-identity tensions, as veterinarians who are usually invested in caring for and healing animals, must do their work by engaging with pet owners, who are in fact their clients. The interactions with clients often resulted in participants experiencing a disregard and disrespect for their hard-won knowledge and skills. IP1 noted that: ‘clients are just rude, obnoxious, and just difficult. It’s hard’. According to G2P2, people are motivated to be veterinarians because of their ‘interest in biological science but not wanting to deal physically with humans’. G2P3 concurred:
‘People have the impression that you don’t deal with people much and that you can just be busy with cute furry creatures all day long. So that’s why they want to become a vet’.
However, G2P5 concluded that ‘the human side of it is the side that makes this job so hard’. Like many of the participants who thrive on solving problems and helping animals based on their specialist knowledge and skills, G1P3 experienced role-identity tension when, as a result of difficult clients, he was unable to practise his skill set:
‘The interaction with people … this is the most annoying part of being a vet … [it hinders] figuring out what is wrong with the animal and being allowed to do what I am good at.’
Conflicts of conscience: Imbalanced values and beliefs
The participants’ self-concepts were affirmed when they experienced meaning and purpose in their daily work-role by, for example, serving the community (‘a desire to serve community or people, which are important aspects of being a vet’ [G1P5]); caring for and healing clients (‘The opportunity to provide care and healing to animals’ [G2P4]); and when they were ‘making a difference in people’s lives not necessarily through my knowledge and skill but just because I bothered to take the time to listen or explain something’ (G2P5). However, participants experienced identity tension when obtaining meaning and purpose through their work-role became difficult. Their consciences were conflicted by not being able to care for and heal as they wanted to, owing to costs: ‘Being constrained in what I can do by the client’s financial situation’ (G1P4). Clients’ resistance to paying is accompanied by their lack of respect for animals, as noted by G2P4:
‘A general feeling or attitude amongst the global community … towards animals that they are objects or possessions and not sentient beings … and therefore not as worthy … From this, I believe a lot of the disrespect arises.’
Identity tension resulting from conflicted values and beliefs was also articulated by IP1 in the context of euthanasia:
‘I think our happiness in life is due to if you can be true to yourself, if you can be authentic to yourself, your own belief, that you can stand up to your own belief. But unfortunately, in veterinary science we are pulled in a direction that we don’t have control of … We are a profession that has euthanasia … we can take life, but then unfortunately clients sometimes push you to take a life when you don’t want to take that life … and that, I think, can eventually wear away a veterinarian.’
She said that clients can ‘push you to do things that you are not comfortable with or what is against your moral and ethical beliefs’. Similarly, IP2 said: ‘Vets are trained to preserve quality of life. So, having to talk about death so much and having to dole out death … that’s something that vets struggle with’.
Another conflict of conscience became evident in the interview with IP4, in which she expressed the belief that ‘I do think as a vet you’re supposed to love your work, because we really are blessed to do what we do’. She then continued to narrate her personal experience of not enjoying ‘the horror, horror stories … the intense suffering – the blood and gore … that is something that does get to you’, to the extent that ‘I didn’t want to go to work anymore. I felt I was done’. She described how she acted contrary to her own beliefs in the way in which she took on her work-role and this led to:
‘[T]hat compassion fatigue – you don’t feel like working, you become useless in your position … Something that really worried me, is wanting your patients to die. You just want to get it over and done with, because you don’t want to struggle anymore.’
Believing she is blessed to work with animals conflicted with the compassion fatigue she experienced, and she ended up judging herself and feeling inauthentic: ‘I’m being lazy and being not myself’.
Theme 2: Social identity conflicts
Two sub-themes describe how participants experienced social identity tensions in (1) the struggle for professional legitimacy and (2) women battling for professional regard.
The struggle for professional legitimacy
Participants experienced a lack of respect for their profession and consequent bias towards and misuse of their services, despite their extensive training and complex occupational challenges. Stereotyping the veterinary profession as a welfare service underscores social identity tension, as expressed by G1P4: ‘People see veterinary work as charity work. You have to help because you love animals’. As a result, customers resist paying for services, despite veterinarians’ high level of training and personal sacrifices:
‘People perceive vets as money-grabbing when we try to demand the same compensation as other professionals with the same level of training … So, we vets are a bunch of stinky scrooges.’
This often leads to self-doubt: ‘It drains your passion and leads to a general fatigue, wanting to ask, “What’s the point?”’ (G1P3) and feeling disrespected: ‘not getting the same respect as other professions’ (G1P4). IP3 explained how the welfare stereotype denied their individuality and caused clients to take advantage: ‘Branding a vet as the intelligent and kind and nice person, because you devoted your life to animals, is a pressure in itself’ (IP3). Another participant noted that the community’s expectations of veterinarians, border on being inhuman. She expressed the need to be regarded as a human being and be respected as a doctor:
‘What I find very important is to know I’m not a sort of machine; to know that he recognises me as an individual … and he recognises that I am also a doctor.’ (IP2)
Their professional qualification and training seem to be at odds with their level of income compared to other medical professions, fuelling feelings of professional disrespect. Participants noted that they are not regarded as ‘real doctors’ (G2P4) and ‘vets receive less respect than other medical professions’ (G1P5); ‘It makes you feel like you are not appreciated and not trusted. Begging people to pay you for services rendered is demoralising’ (G1P3).
Veterinarians continued to elaborate on feeling professionally disrespected. One participant provided a picturesque description of a veterinarian’s undignified personal appearance in offering a reason for not feeling respected as a professional:
‘Being a vet can be a dirty, disgusting job. You get vomited, bled, shat, and drooled on, you are exposed to anal gland secretions and pus … you always stink to high heaven at the end of the day, not very dignified.’ (G1P4)
Ultimately, participants’ experience of not being respected professionally challenged their ability to maintain a positive social identity and affected their self-esteem.
Women battling for professional regard
A female participant further spoke about the gender stereotypes in their community, which challenged her competence and her acceptance in the community as a veterinary professional. Interpretive phenomenological analysis allows one to account for exceptional cases and therefore, despite limited evidence, the participant’s battle for professional regard is included here:
‘It was extremely difficult to get into veterinary practice as a woman, it was a male-dominated profession. We were discriminated against … there was definitely a reluctance of people to accept females in the veterinary profession, especially the large-animal sector … I think with small animals it is pretty much accepted that women can work with cats and dogs … and I’m not sure if it’s still accepted that a woman can work with cows and horses … They still talk about us as if we were incapable, in the sense that we don’t have the strength. So, you know, you must push and fight for your place in the large-animal world.’ (IP1)
Theme 3: Personal identity tensions
Three sub-themes describe the tensions between maintaining a unique sense of self and strongly identifying with the veterinary profession. These tensions emerged in the data as (1) internalising failure and disappointment lowers self-esteem; (2) overidentification with the profession heightens isolation and burnout and (3) spiralling from emotional labour to emotional exhaustion.
Internalising failure and disappointment lower self-esteem
Losing a patient is an everyday risk, that is affected by many factors beyond the control of the veterinarian. Although they know this, participants expressed a fear of failing patients and clients and often revert to self-blame and feeling like a failure. IP1 for example framed a situation wherein patients (animals) die, as failing at his job: ‘There are challenges of maybe failing at your job, the animal dies regardless of what you do and then the client will maybe possibly blames you’. Participants are not just afraid of losing patients, they blame and criticise themselves severely when they do. This is noted in IP3’s reflection:
‘One has to have a strong enough character, which I don’t believe I have. To put those disappointments behind you and not take them home with you and let them affect your moods and your attitude.’
Similarly, IP2’s words reflect self-blame and anger when not being able to save a patient’s life:
‘Look at me, I look super-efficient. I’m actually broken … I will make the very best decision I can at the time, it won’t work, and I’ll spend the next three days going, I should’ve done this, I should’ve done this, I should’ve done this. And you think – why didn’t you then? … and then you’re angry with yourself for not doing it. So, we’re much more critical on ourselves than on any other vet or any other person … what kills you, is twisting yourself up in knots in your own head.’
Being challenged by failing an animal’s life coupled with a lack of appreciation from clients leads veterinarians to reframe incidents as a personal failure, evident in the extreme self-disappointment when an animal dies: ‘many of them [veterinarians] feel like they are losers … if they can just have some affirmation [from clients]’ (IP2); and as noted by IP3:
‘You have to cope with failures and disappointments and when you believe you’ve done the right thing, but it doesn’t succeed; those are the biggest coping problems … when one fails, it feels like you’ve let your clients down.’
Frequent experiences of not being able to keep an animal alive become emotionally overwhelming to the veterinarians who love animals, and they start to internalise the failure and disappointment. Despite having a successful practice, G1P4 demonstrates how internalising failure and disappointment manifest in a sense of not being good enough: ‘I studied and worked hard to obtain my qualification … with my 7-year degree and shares in a fairly successful practice, I feel like the failure’. The narratives exemplify the personal identity tension that veterinarians experience, doing work because they have a passion for animals, yet doing work that often spotlights their inability to save animals. This tension becomes disproportionately self-blaming, leads to self-disappointment and negatively affects self-efficacy and self-esteem.
Difficulty to distinguish the individual from the profession heightens isolation and burnout
A strong professional identity is reflected in experiencing your occupation as a calling, as IP4 indicates: ‘At the end of the day it’s my calling. It’s not a job, it’s just what I do’. Similarly, IP3 compared his initial career decision to a spiritual metaphor of receiving a calling:
‘[I]n a flash, I promise you it was like old Paul saw as he was on the road to Damascus; I had a flash, and I knew what I was going to do for the rest of my life.’ (IP3)
While the experience of one’s career as a calling has many positive effects in establishing a strong professional (social) identity, participants’ narratives suggest that it may also elicit personal identity tension.
Firstly, a very strong identification with the profession was communicated by some participants in a way that highlighted their sense of loneliness outside of the profession. It makes them feel misunderstood by and sceptic about others, as illustrated in the words of IP2:
‘Nobody understands what we go through, not spouses, not psychiatrists, not human doctors just other vets. Advice from non-veterinarians is worse than useless … I try very hard never to discuss veterinary stressors with someone who’s not a vet … you just get angry because you know they don’t get it … they have no clue at all. One thing that makes the South African veterinary population even more difficult, is that we all qualified from one school. So, we are a very tightknit group, and we are basically, we’re simply distrustful of anyone who isn’t … qualified vets are like “who are you, you’re not a vet, bug off.”’
Secondly, feeling isolated is strengthened by the sense that society does not identify them as an individual, but as being a veterinarian – ‘wherever we go we are identified by our profession … get branded by your profession’ (IP3). As a result, participants create challenging self-expectations and relate a very strong conscientiousness, which often spirals into overworking themselves and the struggle to maintain a healthy balance between personal life and work and/or professional life. Despite being stressed, IP4 for example said: ‘I will just dive in and sort of work more if I get stressed’. Similarly, G1P3, explains: ‘I have an overdeveloped sense of responsibility’ which he should better manage by ‘setting up boundaries … compartmentalization is a useful strategy … dissociate work-life from personal life’, and G1P1 confirmed: ‘It is very important to set boundaries, so people don’t take advantage of the good intentions of the vet’. In addition to their strong identification with the profession, the sense of not being seen as a person outside of the profession, challenges their ability to detach the self from work. As IP3 continues to explain they can never shut off and just be themselves:
‘… you’re not unplugging, all of a sudden, you’re back to being a vet even if you are taking time out … I didn’t unplug in my professional life, not at all; not nearly enough.’
Their struggle to maintain a unique sense of self outside the profession, intensifies feeling physically and emotionally exhausted, as IP3 relates the difficulty to detach (‘unplug’) from the profession to ‘that exhaustion, it’s emotionally as well, and that means you can’t really perform optimum when your mind’s not sharp enough, because you’re exhausted emotionally as well as physically’. For some of the participants the exhaustion increased to the point that they not only experienced burnout but also suffered from suicidal ideation: ‘I’ve been through it [anxiety and depression] myself and tried to commit suicide once and I’ve suffered burnout’ (IP3). IP4 had a similar experience and proposed that it is necessary not to overidentify with the profession to the extent that you cannot break away and have a balanced personal life.
‘You do sometimes get more attached than you should, but our attachment to our patients is often a really, really deep connection … I think it’s going to come down to finding a way not to be so sucked into what I do … breaking away from work is the key to coping and which is difficult for vets to do.’
Spiralling from emotional labour to emotional exhaustion
A few participants related how they felt emotionally manipulated and abused by clients. Emotional manipulation and abuse were referred to as emotional blackmail by G1P4. He related how clients manipulate emotions to get veterinarians to attend to animal problems that result from their own negligence. He described ‘a nasty, demeaning client hurling abuse at you … [thinking] you loved animals, why don’t you wanna save my dog just because I can’t pay?’ as being ‘emotional blackmail of difficult clients … people who don’t want to follow the rules themselves, … but then complain about the outcomes and how vets are only in it for the money’.
Another participant similarly recounted a scenario where she had to work all night to save an animal, but it eventually died. Over and above her own disappointment, she had to deal with the blame and outrage of the client; causing her to feel emotionally abused and distressed:
‘I came to a point where I was unravelling … we were extremely, extremely, extremely busy. We were run off our feet, we were exhausted … I ended up staying up the whole night at work trying to save the monkey … and then the owner, instead of being grateful, started screeching about the bill.’ (IP2)
She explained feeling guilty when it appeared that she was placing her well-being above the animal’s life:
‘[M]y mental sanity is more important than an [animal] emergency … and I still feel very guilty about it … the stigma of feeling like you’re not successful because you’re not the same person as your coping persona.’ (IP2)
Her guilt dynamic demonstrates how feeling emotionally manipulated translated into emotional labour, because veterinarians often respond in ways that do not display their true emotions.
Having to deal with extreme emotions, yet not being able to express them accordingly, is not only related to difficult clients, but also happens as a normal part of everyday veterinary practice in relation to staff and patients. Firstly, participants experienced emotional tension in relation to staff because they felt they had to be emotionally available to them. G2P5 explained this as the ‘constant demand of your emotional attention. If it’s not a client wanting you to be responsible for their choices/decisions, then it’s your staff’. Affirming her emotional responsibility, IP2 also referred to her emotional tension in relation to personnel: ‘The practice isn’t just the practice; the practice is the seven people that I am responsible for giving salaries, and their families’. The emotional responsibility places a further burden on veterinarians’ already stretched emotional coping capacity, as they must regulate their emotions for the sake of their employees. In addition, emotional labour is frequently related to managing everyday patient situations, as recalled by IP2: ‘I put the rabbit to sleep … everyone was crying, it was awful. I have to then walk out of the room, walk into the next room and go “Hi, how are you, what a cute baby raccoon!”’.
The concerning consequence, however, lies in how the high level of constant emotional labour eventually leads to emotional exhaustion, as aptly noted by IP4 and IP1:
‘It makes you numb, you just have to, you just get through your job … it’s really difficult … the amount of work just being dumped and dumped and dumped … you see really, really horrible things that you have to sort of try to not get emotional about, and I think it’s that not getting emotional about that eventually leads to compassion fatigue. What you do is just hide the suffering and suffering and suffering.’ (IP4)
‘It’s not giving a fuck anymore about anything, I’m depressed, I cry a lot, I’m unhappy, listless and unenergetic, getting out of bed is an effort, I’ve pulled out all the phones for the weekend and padlocked the gate so no one can get in. Desperate measures for desperate feelings.’ (IP1)
Combining the words of IP2 and IP4, ‘Put the rabbit to sleep’ and ‘just hide the suffering’ poignantly illustrates how emotional tension spirals unabatedly into psychological distress and a cry for help.
Discussion
The objective of this study was to explore the well-being of veterinarians from an identity theory perspective in the South African context. The findings describe how veterinarians’ well-being relates to the identity tensions they experience in their work-role, social and personal identities.
The findings discussed in the first theme show that work-role identity tensions come to the fore firstly because of having to engage in tasks and behaviours that veterinarians are not naturally interested in or taught to do. Secondly, work-role identity tension resulted from not feeling respected for their hard-earned, specialised knowledge and skills, and thirdly, participants struggled to reconcile their caring values and beliefs with the expectations of their work-role. These work-role identity tensions align with Fitzgerald’s (2020) conceptual framework of professional identity, which presupposes that identification with work-role tasks and behaviours, knowledge and skills and values and beliefs is important for building a strong professional identity that makes individuals feel empowered, satisfied and engaged in their jobs. In the context of veterinary practice, these findings on work-role identity tensions align with the stressors reported in other studies. The tasks and behaviours underlying work-role tension noted in this study include practice administration, staff management, financial management, business administration and interacting with clients. These findings are comparable to those of a global mental health survey, in which organisational management issues and client interactions were two of the main veterinarian stressors identified (Paton et al., 2024). Similarly, a US study (n = 1422) reported practice management as well as client and coworker interactions as major sources of stress for veterinarians (Griek et al., 2018). In a meta-analysis including 30 studies on veterinarian stress, most stressors are noted to relate to interactions with animal owners (Stetina & Krouzecky, 2022). While these studies identify similar challenges as stressors or sources of stress in veterinarian practice, taking an identity perspective in this study, reframes the challenges as work-role identity tensions because they affect veterinarian well-being in a way that relates to veterinarians’ sense of self. Not identifying with the tasks and behaviours resulted in the veterinarians feeling incompetent, unworthy and disregarded. According to Carminati and Héliot (2023), values are of particular importance for the self-congruence and internal drive of professionals, and the conflicts of conscience participants reported in this study have a debilitating effect on their sense of self. Consequently, they start to question and negatively judge themselves, leading to feelings of inauthenticity and a lack of self-esteem.
The findings of the second theme further indicate that the struggle for professional legitimacy is a social identity tension emanating from discrepant social norms and expectations about the characteristics of veterinarians and the purpose of the profession. This is similar to research by Scholz and Trede (2023), which identified the struggle for professional legitimacy as generally characteristic of the veterinary professional’s identity. The struggle for professional legitimacy originates from competing and incommensurable expectations of financial reward and from society’s normative notion that the veterinary profession is a welfare service (Scholz & Trede, 2023). Furthermore, it seems that for women veterinarians, the battle for professional legitimacy is exacerbated by clients questioning their competence and skill. While there was not much evidence related to the implied gender–professional identity tension, the IPA approach allows for recognising exceptional cases or experiences and therefore we decided to make mention of this tension here. Limited evidence in this regard however points to the need for further research about the intersectional nature of identity tensions in the veterinary profession.
Other studies on veterinary stress however indicate that women experience discrimination in the profession (Knights & Clarke, 2019; Wallace & Kay, 2022), with two large-scale European surveys reporting that female veterinarians are most at risk for lower mental well-being (Jansen et al., 2024). Social identity aligns with the element of context and socialisation in Fitzgerald’s (2020) conceptual framework of professional identity, which presupposes that professional identity develops and changes in relation to others in one’s specific community and is influenced by social expectations and norms. People pursue a positive social identity by maintaining the social standing of their groups in relation to other groups. In this study, the social identity tensions in particular challenge participants’ sense of a congruent self, because they affected their self-efficacy, confidence and self-esteem. They generally felt that their professional legitimacy was challenged and questioned, and this may be an added burden for the female veterinarian.
Findings presented in relation to the third theme describe how personal identity tensions have a self-disparaging effect on the participants, causes them to feel lonely and spirals into burnout and emotional exhaustion. The personal identity tensions stem from experiencing conflict between personal identity with the work-role and social identities of being a veterinarian. Firstly, personal identity tension emanates from being someone who loves and wants to save animals yet, in their work-role, having to frequently deal with animals dying. Even though this is often beyond their control, the identity tension challenges their self-esteem. Secondly, the difficulty to detach the personal, unique self from being a vet (the social or collective identity), causes isolation and burnout. Ultimately, personal identity tensions stemming from the emotional labour often required in the work-role, further exacerbate emotional exhaustion. Personal identity tension can thus not be isolated from the work-role and social identity bases that constitute the self. The identity conflict dynamic that underlies personal identity tensions, mirrors the social identity theory assumptions underlying Fitzgerald’s (2020) conceptual framework of professional identity. The framework includes group identification as an element, and presupposes that professionals align their personal characteristics with those of the profession. This relates to a central theorem in social identity theory, which explains that identity tension is a result of people’s continuous challenge to balance their need for belonging with their equally important need for distinctiveness (Hornsey & Jetten, 2004). Balancing these innate needs is of importance for professional identity because while the individual identifies with the profession, they also need to maintain a distinct sense of self or authenticity. Veterinary literature in other parts of the world emphasises (1) the ambivalence that veterinarians experience because of the caring–killing paradox characteristic of the profession and (2) how animal welfare perceptions differ between veterinarians and pet owners, resulting in moral dilemmas and emotional stress for the vet (Paton et al., 2024; Stetina & Krouzesky, 2022). In this study, these conflicts are defined as identity tensions, which can be consciously worked with to resolve the self-disparagement, feelings of isolation and over-conscientiousness that lead to emotional exhaustion and burnout.
The personal identity challenges in this study further uncover and explain the extreme emotional burden that veterinarians carry within themselves and are similar to the emotional labour among veterinarians reported by Morris (2018). The internal emotional tensions that participants talked about result from a dissonance between the daily affective events they are exposed to and the emotional rules they apply when responding to these events. Hochschild (1983) refers to emotional labour as the process of managing emotions in the work-role and highlights the way it can lead to feelings of dissonance and inauthenticity, especially when the individual represses a genuine emotional response and instead expresses a faked response. When experiencing negative emotions at work, people tend to apply more restrictive rules of emotional display, inhibiting the expression and display of such negative emotions (Holman et al., 2008). For veterinarians it is evident that while such emotional tensions start out as external stressors, they manifest as an identity tension, which when not attended to can spiral into emotional exhaustion and potential psychological distress.
In summary, while the findings confirm that of other studies about veterinary well-being, this study contributes to the body of research in two ways: (1) it applies an identity theory perspective to veterinary well-being that extends focusing only on the professional identity development or the work identity of veterinary students. Identity theory is applied from the broader, multidimensional identity concept to include not only work-role identities but also social and personal identities. The study highlights the complexity of identity dynamics and how tension within and between these identities can negatively affect the veterinarian’s well-being as it causes low self-esteem, burnout and emotional exhaustion.
Conclusion
The limitations of this study are linked to its small qualitative sample and context-specific focus. Adding our voice to that of other researchers in other countries, we extend the call for further research. Because the need to address veterinarian well-being is of pragmatic and immediate concern, participatory action research would be valuable for generating knowledge while also engaging veterinarians’ participation in empowering resilience in their coping. To support and promote veterinarian well-being, there is a need for interventions that are tailored to their specific well-being needs in order to reduce the risk of poor mental well-being and lower the prevalence of suicide (Stetina & Krouzesky, 2022). This study sheds light on how the well-being of veterinarians is influenced by the identity tensions they experience daily. The findings corroborate those of research in other countries, emphasising the stressors that veterinarians typically experience. In taking an identity theory perspective, this study poses a unique contribution by highlighting the effect of identity tensions manifesting in the work-role, social and personal identities on the strength and coherence of veterinarians’ professional identity. Understanding the veterinarian’s various identity tensions enables an understanding of their struggle to maintain a strong professional identity, while also remaining congruent to their personal identity. Above all, it provides an avenue for intervention to empower veterinarians’ coping, resilience and well-being.
To cope with and resolve identity tension, people involuntarily engage in processes of identity work (Caza et al., 2018). Identity work processes usually occur as a natural, involuntary intrapersonal response and are not consciously thought of (Stets & Serpe, 2013) and can as a result often result in maladaptive identity work (Petriglieri & Stein, 2012). Based on the results of this study, it is proposed that conscious, intentional identity work should be facilitated with veterinarians on an individual or group basis to constructively work through and resolve the predominant identity tensions that risk unbalancing their sense of self. Identity construction and development can be an important coping and adjustment response for sustained well-being and career satisfaction (Scholz & Trede, 2023) and helping people to do conscious, intentional identity work can assist in their adjustment and coping (Barnard & Flotman, 2020). Intentional identity work will enable veterinarians to reflect on self-inconsistencies, establish psychological boundaries and to more consciously identify the value choices that would most benefit their sense of authenticity and self-congruence.
Acknowledgements
The authors acknowledge the veterinarians who volunteered to participate in this study and the sharing of their personal experiences. We further acknowledge the data that was analysed in this article, were gathered as part of L.J.v.R.’s Masters research on veterinarians’ lived experiences. Her Masters dissertation focus on their well-being from a coping and adjustment perspective. Thus, this article is partially based on the author L.J.v.R.’s dissertation entitled ‘The coping and adjustment behaviour of veterinarians: A hermeneutic phenomenological inquiry’, toward the degree of Master of Commerce in Industrial and Organistional Psychology in the Department of Industrial and Organisational Psychology, University of South Africa, South Africa, with supervisor Prof. A. Barnard. This article however applies a unique identity theory perspective to veterinary well-being, with a distinct theoretical grounding and findings.
Competing interests
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
Authors’ contributions
Both researchers, A.B. and L.J.v.R., conceptualised and planned the research project. Both researchers were involved in the initial writing of the manuscript. A.B. steered the literature review, data analysis and findings and L.J.v.R. the methodology. L.J.v.R. managed the project and gathered data.
Funding information
This research received no specific grant from any funding agency. The publication fees of the manuscript were financially supported by the University of South Africa.
Data availability
The data that support the findings of this study are not openly available because of the personal nature of the information shared, small sample and possible identifiability of participants as a result.
Disclaimer
The views and opinions expressed in this article are those of the authors and are the product of professional research. The article does not necessarily reflect the official policy or position of any affiliated institution, funder, agency or that of the publisher. The authors are responsible for this article’s results, findings and content.
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