Second Victims and Restorative Just Culture

The role of Restorative Just Culture on members of veterinary teams who are involved in unexpected outcomes

Understandably, the primary focus following veterinary incidents that result in harm are the patients and their families who are directly affected. Their needs—medical, emotional, and relational—must be acknowledged and addressed with honesty, compassion, and appropriate remediation.

It is vitally important also to recognise the veterinary professionals involved in or witnessing these events. Research shows that being involved in a serious incident can have profound and lasting impacts on the people within veterinary teams in terms of their wellbeing, confidence, ability to carry out professional tasks and even career continuation. Within the field of healthcare, professionals impacted in this way are known as second victims – who require support to process their experiences, to support learning and healing.  

Acknowledging second victims is not about diminishing the primacy of patient harm or creating equivalence between different types of suffering. Rather, it is about recognising that addressing both is essential for genuine healing, learning, and prevention. A veterinary professional drowning in unaddressed guilt and shame cannot fully engage in the reflective learning necessary to prevent future incidents. Similarly, organisations that fail to support second victims create cultures of fear and silence that ultimately compromise patient safety.

Restorative just culture enables the holding of both truths simultaneously: that patients and their families deserve our primary focus and concern, and that supporting the wellbeing of veterinary professionals is both ethically important and essential for maintaining safe, effective practice. This requires creating support structures that attend to both first and second victims, ensuring that neither is neglected in the aftermath of adverse events, and recognising that supporting one does not diminish our commitment to the other.

Veterinary professionals face unique ethical challenges when dealing with incidents and harm, which often lead to significant emotional distress, impacting their decision-making and overall wellbeing. Studies have also highlighted the significance role of work-related stressors and the prevalence of mental health challenges across the sector. Many of these were strongly linked to professional challenges, underscoring the need for targeted interventions within the profession, particularly when it comes to our response to adverse events. Taking steps to support a Restorative Just Culture within an organisation can go a long way to addressing many of these challenges.

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