Why We Need to Talk About Medical Errors in Veterinary Medicine | Episode 91 | Reviving Vet Med

Medical error is one of the most challenging and least discussed realities in veterinary medicine, yet it has profound implications for the mental health and career longevity of the professionals involved. In this episode, Dr. Rochelle Low, veterinarian and Global VP of Quality and Patient Safety at Mars Veterinary Health, joins us to explore why patient safety is actually a vital pillar of team wellbeing.

Drawing from her research on the "Second Victim" experience and her 2025 global study of over 64,000 safety events, Rochelle shares how a systems-based approach can shift the focus from individual shame to collective learning. We discuss the emotional trajectory teams face after an adverse event, why errors are often rooted in system design rather than personal failure, and the specific types of support, like peer connection and psychological safety, that help professionals recover and stay in the field.

Rochelle also reflects on a personal medication error case and how an immediate, supportive leadership response shaped her own professional identity. This conversation offers a powerful and practical lens for anyone in veterinary medicine who wants to move past "blame and shame" to build a culture that truly protects both our patients and our people.

Watch the Video Version of this Episode
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Resources
Connect with Dr. Rochelle Low on LinkedIn: https://www.linkedin.com/in/rochelle-low-53ab0091/  

Read Dr. Low’s research papers:

Veterinary healthcare needs to talk more about error: For the wellbeing of our patients and medical teams: https://pmc.ncbi.nlm.nih.gov/articles/PMC9708451/ 

Patient safety events cause harm across a variety of veterinary care settings: a global retrospective analysis: https://avmajournals.avma.org/view/journals/javma/263/7/javma.24.08.0523.xml 

Personal resilience, good leadership, and a psychologically safe culture play a mitigating role on the impact of patient safety events: https://avmajournals.avma.org/view/journals/javma/263/3/javma.24.09.0620.xml 

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Transcript

Dr. Marie Holowaychuk - If you're staying late to finish notes, you need to hear this. There's now a free way to get help with your paperwork. Scribenote is an AI scribe built just for veterinarians and techs, helping you handle documentation so you can spend more time with patients and less time buried in medical records. Their free plan gives you access to core AI powered scribing features at no cost. Unlimited auto generated notes with ready made templates for soaps, dental charts, multi pet visits, callbacks, recaps, and more. You can lightly customize templates, collaborate with your team, and even get help from Otto, their AI chat assistant. Admin overload is real. Over 40% of vets have considered leaving the profession because of it. Scribenote exists to help you stay in the job you love and actually get home on time. Check out the free plan today at scribenote.com. Hey everyone. 

Dr. Marie - Welcome to another episode of Reviving Vet Med. Today's conversation is one I've been looking forward to for a long time. We're diving into something that is a daily reality in vet medicine, yet remains one of our greatest sources of silent trauma, medical error and patient safety. My guest today is Dr. Rochelle Low, a veterinary specialist and global leader in patient safety and quality. Rochelle serves as the Global VP of Quality and Patient Safety with Mars Veterinary Health, but her work goes far beyond protocols. She's at the forefront of researching how these events affect veterinary professionals and how we can move away from a culture of blame and shame toward one of healing and sustainability. 

Dr. Marie -  Rochelle has co-authored several landmark papers, including a powerful 2022 case study on a medication error, a 2024 study on the second victim experience, and a massive 2025 global analysis of over 64,000 patient safety events. In this episode, we explore what a true culture of safety actually feels like on the clinic floor and why the first few minutes after an error are so critical for a team's long term mental health. So let's dive in. Here's my conversation with Dr. Rochelle Low. This is the Reviving Vet Med podcast and I'm your host, Dr. Marie Holowaychuk and my mission is to improve the mental health and wellbeing of veterinary professionals around the world. 

Dr. Marie - Hi Rochelle, thank you so much for being here with me today. 

Dr. Rochelle Low - Oh, it's great to be here today. 

Dr. Marie - Yeah, I've been looking forward to this conversation for a really long time. Talking about medical errors is a real passion of mine and you're doing so much work in this area. I want to start by talking about one of the first papers I read from you on this topic, that was published in the Journal of Veterinary Internal Medicine back in 2022, and it was entitled Veterinary Healthcare Needs to talk More about Error. And that really struck a chord with me. In that paper, you talk about the case of Banks and how it affected the people involved, not just Banks and Banks family. I'm wondering, looking back on that experience, how did that impact you specifically around the way it was handled. How did that shape your own mental health and your decision to stay in this profession? 

Dr. Rochelle - Yeah. Thank you. It's a great question. So I'll just quickly kind of recap the case just so people have a little bit of background. So, essentially, I worked in emergency and critical care, and one day I was leading the ER. We had a very critical case come in, and this case actually had been hit by car. And unfortunately, there was a really emotional component to it because Banks had actually fallen asleep behind the back wheel of his owner's truck. And so that when he presented, he was a severe polytrauma case. And he was one of those cases where the owner said, just try to do everything. 

Dr. Rochelle - He's our whole family and our team have this amazing response where we, you know, did everything as far as stabilizing him, did blood transfusions, emergency surgery, so many different things over the next several days where Banks started to stabilize. And the family of Banks was amazing family, and they really appreciated everything we were doing. And I want to say it was probably about five or six days into Banks’ stay in our ICU, where I actually was writing his treatment sheet for the day, and I made a dosing error on a medication, and that medication was insulin. And banks received 10 times the dose of insulin that he was supposed to receive, and it immediately compromised him. 

Dr. Rochelle - And I just remember this, having that when I realized what happened, I just remember feeling a sinking feeling where I hadn't even thought about that happening, like, happening to me, happening to Banks. Because Banks had become sort of the favorite patient at the hospital. Everyone was rallying for him. And at the time, I remember, you know, trying to think through how do I respond and how do I make sure Banks is okay. And so you spend a lot of energy doing that. I also reached out to our medical director, and he right away came down, and I told him what happened, and he. He kind of put his arm around me, and he said, you know, Rochelle, this happens for the best of us. Let's just fix it. And essentially, he came into the icu. 

Dr. Rochelle - We worked through, you know, a plan for Banks, he also, I remember, coached me on how to talk to Banks's family, how to be very transparent and talk to Banks's family, talk about the financial side that we will cover, obviously all costs related to this. And then I remember him checking in with me later in that day and even throughout the next couple of weeks. And when you ask, like, how did that impact me at the time, I honestly was probably naive. I was probably in the first two years of my, you know, being out of school, I thought that was normal. I really did. And I think I had found myself in a strong team with strong leadership and in an environment that had a strong culture of safety, which we'll talk about more. But I didn't know what any of that was. 

Dr. Rochelle - I just knew like this was my team. Right. What I've realized since then is that's not the case for every team. Went into leadership roles with multiple teams. And so I think this case, in the end, had a profound impact on me. I might not have realized it early on, but it really did because that was. I knew that when things did happen that were stressful, I would be supported. 

Dr. Marie - I'm taken back to my first mistake that I made that sadly resulted in the death of one of my patients in the ICU when I was a resident. And just hearing what you're saying around the importance of the people that are with you during that time and the culture of the environment in which that mistake happens and therefore how it's handled, it has just a tremendous impact on everybody involved. And I think, yeah, when that's all we know, then it is maybe taken for granted until you talk to other folks who work in different environments and have had very different experiences. So thank you for sharing that. I want to dig into this culture of safety that you mentioned because I do think that this is, as you've identified, a core foundation for both patient outcomes and also team members. 

Dr. Marie - Wellbeing in the face of these errors. So in the day to day reality of the veterinary hospital, how does a culture of safety act as a protective barrier against experiences like moral injury and burnout that folks might have in the face of a mistake? 

Dr. Rochelle - Yeah, I think it's a great question. So when I think of a culture of safety, one of the core of it is recognizing that we are actually, healthcare is, we're in a high risk industry. So that means that the kind of care we provide sort of opens the door a little bit more for these kinds of things happening and what it actually does, what a culture of safety does like, what I felt when I was in the middle of the bank's case was that I could speak up, I could tell all details. I knew that I could be myself to try to figure out how to solve that solution. And I think when I think of a culture of safety, it really is about getting people's back. It's about making sure that people have a voice. 

Dr. Rochelle - And I think about when I used to work in the ICU and how many people would come up to me and say, hey, Rochelle, did you mean to write that particular dose or can you come check this patient? I'm worried about this patient. Or should we be doing that? Does that make sense? And it was so many of the amazing nurses that I worked with, other veterinarians that I worked with, that really protected all of our patients because people could speak up and really have a voice. And so when I think of a culture of safety, I think it really is about being able to be yourself in your work environment. And that right there, I think lends itself to certainly having more wellbeing because you aren't holding things aside, you're able to be yourself. 

Dr. Rochelle - And then definitely has been proven in human healthcare and definitely already in veterinary healthcare that it does improve patient outcomes because we find things, we see things, and everybody sees things from different perspectives. And that's what makes a culture CP so strong. 

Dr. Marie - Yeah. You know, as a fellow criticalist, I can relate to this so much. You know, I've worked in situations, especially as a locum, where the team didn't really know me. Right. We hadn't really established that rapport. You know, they maybe felt a little bit intimidated to come to me and share something. And that's something I've always really tried to emphasize at the beginning of working with any team, is that I'm going to make mistakes. And I am really looking to you to come to me, or if you happen to make a mistake, I want you to tell me as soon as possible. 

Dr. Marie - And know that there is not going to be any repercussions or you will not be shamed, blamed, you know, or reprimanded in any way that at the end of the day, we just want to be focused on the best care for the patients. And the best care for the patients means that safety is put above everything else. Which, like you said, if you're not in a culture that promotes that or embraces that, then it is going to be difficult for people to speak up and then that is going to have that downstream effect of impacting the patients. You published a global study in the Journal of the American Vet med association in 2025. This recent study looking at over 64,000 patient safety events. 

Dr. Marie - I'm wondering for those who might be listening, who feel alone or are questioning their skills because they made a mistake, what does the data from that study tell them about errors and mistakes in our profession? 

Dr. Rochelle - Yeah, so the reason we really wanted to publish a large amount of data was kind of, honestly, a little bit of a call to action to the field to say, hey, these things happen. But I think as you look deeper into them, we see some things. So these things happen across a variety of different hospital types, across a variety of different levels of experience. So this isn't all new vets or new nurses. This is absolutely everybody that works in a healthcare setting. It is across primary care, specialty, urgent care, it doesn't matter. It's also across, honestly, different countries. So the U.S. canada, Europe, Asia. And the other thing that we wanted to show was that actually we see the same things repeated. 

Dr. Rochelle - And when you start to see that within data like this, that means that there are opportunities to prevent them from happening. So when we think of safety, what we're saying is, hey, these things happen. We know they do. And trying to get every single person that is working today thinking about how could they potentially collect these events in the environment that they work in, wherever that setting is, and how could we share our data so we could learn more and more about them. And when I think about a mistake and I think about an individual feeling that it makes them look unskilled, I would say the number one thing I would say is if this happens to every single one of us, you've already mentioned it a couple of times. 

Dr. Rochelle - I can easily think of more than a handful of big mistakes I was involved in or errors. And that's simply because we're human. It's not because we're unskilled necessarily. It's not because we aren't intelligent at all. It is true, we are in this high risk environment with a lot of complexity, and that's where we see these kinds of things happen. And so I think for anybody that questions themselves, I think trying to develop support around you, trying to really think through what happened, and then I also think trying to proactively be involved in creating solutions for a safer environment is another thing to think about. But it is certainly not unique to you because I don't think I would hesitate to say there is not a person in veterinary medicine right now that hasn't made a mistake. 

Dr. Rochelle - And that may mistake, may or may not have directedly impacted a patient, but it also might have. And that's. That, I think is the healthiest way to think about this. 

Dr. Marie - Yeah, Echo everything you said. And I love that the intention was to just demonstrate the widespread nature of what's happening and that it isn't just in specific practices or by specific people. I mean, I've been practicing now for more than 20 years and I still make mistakes, especially on the days where I'm tired, we're short staffed, you name it. There's so many different situations that can create the right circumstances in which an error can happen. And we'll talk about what that means for prevention in just a moment. I think it's so important for people out there to not fall into a state of feeling like they're a bad veterinary professional. 

Dr. Marie - I think back to the mistake that I made and I talked about it on the podcast before, where the animal under our care in the ICU died because it was fed through a feeding tube that was placed into its airway that I misread on the radiograph. And obviously I felt really responsible, despite there being multiple factors at play there. And I really felt for months and months afterwards that I shouldn't be a vet, that I was waiting for somebody to kick me out or tell me, like, you know what, we've given this some thought and we don't think you should finish your residency. And it's just that feeling of shame that washes over you and just tells you that you're wrong, you're bad, you don't belong here. And of course, that perpetuates this culture of not talking about it. 

Dr. Marie - And I can remember not talking about my mistake with any of my resident mates or friends in other specialties that were training, because I was like, they're not going to want me to manage their cases in the icu. They're going to think I'm a terrible ECC resident. And it doesn't help the healing process. And it further perpetuates this culture of shame and blame. And that's one of the things I want to talk to you about next, because I think not in every circumstance, but in many practices, for many years, there has been this culture in vet med around an error happened and whose fault was it? Like, who made the mistake? And really focusing on that. And you really have emphasized this shift in thinking to systems level thinking. Right. And I know that this comes from researchers like Wu and Berwick. 

Dr. Marie - And I love this emphasis because as you shared, I think it can really lead to quicker self-forgiveness and moving on from the mistake and or learning from it, like you said. So I'd love for you to talk us through what that systems level thinking is around errors in vet medicine. 

Dr. Rochelle - Yeah, definitely. So if I think of a really sort of a very simple example, you think of two drugs that we use very similarly and we, they happen to be injectable drugs, they both happen to be in the fridge. So think of Convenia and Serena. For some reason we also tend to, I talk about this when I lecture about this, but we also tend to put them together in the fridge. And I don't really know why, but that is just a human nature thing that as I talk to people it's like, oh yeah, that's exactly right. So if I am asked to go and get a convenient injection for a patient or Cerenia injection and I say I'm asked to get Cerenia injection and I pull the other drug by mistake and I go to that patient, I give them the wrong drug. 

Dr. Rochelle - The last thing that is going to create any solution to you not doing the exact same thing the next day is blaming us. So if they blame me, we don't talk about it, we just bury it under the rug and we go about our day. Then this same mistake, and this is a very simple mistake that's not going to cause harm, but it is a very good example of this systems based solution. Because what we really need to do, and this is what we're actually doing right now across the groups that I work with, is looking at the way we organize our pharmacy and protect people within the system that they work by actually organizing drugs that look alike and sound alike and clearly labeling makes sure that those drugs are not beside each other. 

Dr. Rochelle - If you think about it, what do we do in our pharmacies? We often have them alphabetically labeled. And yet when you think of drugs like dopamine, dobutamine, of course we mix those up all the time, right? Because they're right beside each other on the shelf. I'm rushing, I'm getting 6 million questions as I'm trying to drop the drug. And so that's what we mean by system space is that actually we can be thoughtful about what we adjust in the different areas that we work in, whether that's with equipment, in surgery or anesthesia, whether that is with organization and the way that we do things that will protect us from making that simple mistake. And that's what's called a system solution. If we don't start to think about those things. And we just blame people. We aren't fixing anything. 

Dr. Rochelle - And that is the whole idea behind this sort of science of patient safety is that is where those solutions lie. And I would argue that probably in over 95% of patient safety cases, the solution is in the system. It's nothing to do with an individual person. 

Dr. Marie - Such a great point to emphasize. I can't tell you how many practice owners and practice managers who I've worked with in leadership trainings have lamented, you know, we've got this one team member and they just make mistake after mistake. And we keep talking to them and nothing's changing. And they're missing this really important piece, which I think is at James Clear. Even in his new book, which is of course about habit formation. But he talks about people not falling to the level of. I think he says, your habits, I'm totally going to butcher this. But falling to the level of their systems, right? And you can kind of think of medical errors as. As the same thing. People are going to fall to the level of whatever system is there to hold them up. And I can think back to my most recent mistake. 

Dr. Marie - I was doing a locum emergency shift in Seattle and it was super busy. It was the end of the day. This was an ER clinic where we also saw exotics which, please, nobody ever send me an exotic animal. I'm not the person to deal with it. And of course, it was a bird and they're so fragile and this bird has sustained trauma. Long story short, you know, I was so stressed about what to do with this bird and I finally settled on, okay, I think it's safe for this bird to have Metacam. And you know, I double checked the dose because the dose is so much higher and this, that and the other. And I ultimately decided it was going to get 01. Don't anybody quote me on this dose, okay? 

Dr. Marie - But let's just say it was a 0.1 mil dose that was supposed to be given, you know, IM or something like that to this bird. And I put it in the computer, but I accidentally put it in under the oral solution. So what ended up happening? Like, the dose was calculated, whatever dose I had used calculated it for the oral version, which of course is a lower, higher. This is a terrible story that I'm telling because I don't have all the facts sorted out. But the bottom line is that this bird ended up getting dosed for the injection at what it would have been given for the oral, which was three times overdose, because of course the concentration differs by about three times. So the bird got an overdose. And birds, of course, being very sensitive, this was a big deal. I was mortified. 

Dr. Marie - And all this to say, speaking of systems, is that there were clear system deficiencies here because this computer system allowed me to put a dose in. I am by the root. Everything was like this dose IM to this patient for an oral only administered drug. And so I verbalized that dose to the team member who drew up the drug and gave it without looking at it on the computer. So that was another system's mistake. Right? Not double checking, not looking. Not. Yeah. And so again, it was the end of a shift, everybody was tired and this happened. And needless to say, these owners were very upset, they were very angry and I immediately went into shame. And looking back now, I can completely see how many systems failed us in this particular situation. 

Dr. Marie - Well, I'm going to move on from there and that particular story just to normalize that for everybody who's experienced that. You have done some really great research with Dr. Lori Kogan as well. And one of those papers was published in JAVMA in 2024 where you talked a little bit about the second victim experience. And I'm wondering, for those who aren't familiar with this term, can you describe what is the emotional trajectory that a person goes through in the hours, days and weeks following an error in practice? 

Dr. Rochelle - Yeah. No. So the second victim concept is if you think of the patient and then you immediately think of the family with that patient, they technically are thought of as the first victim. The second victim is considered kind of the care team or individual that is related to the care of that patient. So related to the, say, the error, the mistake that happened. When I think of it and I think of it through the bank situation, I really think of the stages that you often go through. Now I will say that everybody's a little bit different. So it does depend on your support, it depends on your environment that you're in. But one of the first stages is very much sort of all about kind of figuring out the incident. So kind of accident response. 

Dr. Rochelle - I remember it feeling like kind of a chaotic time is like I don't really know exactly what I should be doing. But we need to recover from this incident if the patient, you know, is still. We're able to do that. And then I think there is a period of time where you start to. It sort of starts to hit you that, hey, this thing happened and you start to develop this phase that kind of is almost a fear of rejection of like, what are people going to think of me? Thinking about your teammates, like you mentioned your resident mates, thinking about the people that you interact with closely and really thinking, am I going to be rejected now from this team? 

Dr. Rochelle - I think beyond that, you really do start to think about kind of the thing like sort of it hits that, wow, this happened to me, this happened to Banks in this situation. And hopefully this is the direction that most people go is where you start to think about kind of creating solutions or going through figuring out like that phase of why did this happen? What could we potentially do? I do think though, as we looked at sort of responses from people and how these events affect us, it's very different. The things that we saw very clearly is that there are emotional components to this, there are physical things that can happen related to these events, and there certainly are psychological things. 

Dr. Rochelle - So one of the things that I notice pretty strongly is, especially if it is a severe event, is starting to question your own abilities, starting to kind of lack confidence potentially and definitely a fear of that happening again. So I have been in situations where say somebody has said to me, well, I don't do drugsticks anymore. And I at first didn't understand that. I was like, okay, that's fine, we'll figure out a different solution. What I realized is that it stemmed from something that happened that was dramatic. And so, yeah, I guess that's. Those are the kinds of things that we know. And I would encourage the field, like there are only a very few number of papers in this area. We need to explore this more. 

Dr. Rochelle - But we certainly know from human healthcare that this can cause a huge burden and can lead to people leaving the profession. And I suspect there's probably no difference in vet med. We just need to learn more about it. 

Dr. Marie - Yeah, absolutely, you're right. There's not very much research at all. I remember digging into this myself and there's a little bit of research looking at the difference in the emotional and psychological experience after a harmless hit versus a near miss versus an adverse event. So as you alluded to earlier, you might make a mistake and that mistake might have no impact. Cerenia, convenia, it doesn't matter. Like, there's no negative adverse event, so to speak, for that animal. And there still is going to be some experience on the part of the person who did that in terms of feeling like, oh my goodness, like, I can't believe I did that. And if I do something bigger in terms of a mistake, that could have the potential to have a really negative impact on a patient. 

Dr. Marie - And so yeah, I remember another paper as well looking at the different experiences that folks working in a high volume spay neuter practice were experiencing in terms of short term and long term repercussions. And it seems certainly that those events that are associated with adverse outcomes for the patients really do tend to take a more significant toll and as you said, can have anything ranging from physical, emotional to psychological ramifications. And you know, I, I go back to what you said about that feeling of judgment, you know, self-judgment and worrying about judgment from others. And I really feel like that's that shame piece coming up. Like we're so programmed to feel like we shouldn't be making mistakes in vet medicine. Like people aren't talking about this, not, they're still not normalizing this. 

Dr. Marie - And so we do still feel that, like, you know what are other people going to think? Because I don't hear anybody else talking about making mistakes. So I'm the unique one here and people are going to think poorly of me. So again, I'm just so glad that we're normalizing this conversation. If today's conversation about error, disclosure and psychological safety is resonating, I want to share something personal with you. In my book, A Compassionate what it really Means to Be a Veterinarian, I open up about my own experiences with mistakes, the hidden curriculum of vet medicine, and how silence and shame can undermine both wellbeing and care. This book is an honest, compassionate look at what our profession really asks of us and what we need to do better. A Compassionate Calling is available now wherever books are sold. Visit acompassionatecalling.com to learn more. 

Dr. Marie - That study that you did with Lori Kogan found that nearly 80% of veterinarians had a safety event in the last year. Again, just normalizing the frequency with which this happened. That's just over a year period, never mind a career's long period. What did the data from that study show more specifically? About the factors that helped some people to bounce back from those events while others, as you said, even sometimes choose to leave the profession. Their practice is impacted and sometimes so much that they don't even want to be in practice anymore. 

Dr. Rochelle - Right. So I think really what that study brought to light is that there were kind of three main components and they all to me seem very interwoven. So one is that the effect of sort of personal resilience. So how each, you know, people are going to respond individually. And resilience was a big tie. If you have a stronger level of resilience then it's less likely to have a big impact on you. But closely tied to that were the impact of leadership. So when I talked about Banks, I mentioned there were multiple examples around that event of good leadership. It wasn't just a single person, but that single person. There was a single person that was our overall leader. And because he became involved very early and quickly and was so supportive, I think that had made such a big difference. 

Dr. Rochelle - That also the third component that we found is that an environment with a strong psychological safety makes a huge difference on the impact of these events. If we're in an environment where we openly talk about these things and relatively routinely where we do eminem rounds, where we're really trying to make sure that we hear everybody's voice in situations that are stressful, then it becomes almost normalized to be that way. And I think that when you think of those three components, you can see why they would make such a difference to, you know, how these events impact people. And it's interesting because you mentioned the severity of the event in general. It's true that the more severe events that cause actual harm to patients will have more of an impact. 

Dr. Rochelle - But I've also seen, and this kind of surprised me initially, but even near misses or some of the more minor things like you mentioned having a big impact, and some of that might depend a little bit on the phase of your career. Like early on, even having a patient safety sort of event with an IV catheter placement might be something that literally affects you because you were trying so hard to place that catheter in that difficult patient. And something went wrong. And now nobody will ask you again to help them with a catheter like that could definitely change the trajectory of somebody's, you know, development and plan, even though it seems relatively minor. And so, yeah, I do think it really depends on the context from the situation, but that those are the three main things that we found in our study. 

Dr. Marie - Yeah, that's a really great point. Is that context matters so much. And I really, you know, I think of it as if this individual gives me an analogy to resilience and wellbeing in so many ways. I think this is such an important thing to talk about because it mirrors how we look at mental health, where we can look at the mental health of veterinary professionals and say, you know, that person needs to take better care of themselves. They just need to be more resilient. Or we can look at the environment in which that person is in and say, it doesn't matter how resilient. This person is, if they are not immersed in a culture with psychological safety or supportive leadership or normalization of these conversations, they are going to have negative consequences. 

Dr. Marie - And like you said, especially for those folks that might be early in their career or might be especially sensitive, yes, there is that individual component, and there's many tools and strategies people can use to build that resilience. But we cannot underestimate the impact of the environment on that individual's experience as well. So, so important to highlight that the Kogan study also highlighted that 71% of people want a respected peer to talk to, and 64% need a peaceful location to recover. And these were such practical and impactful things that I took away from this study. Why do you think these simple human needs are so often overlooked in veterinary practice settings? And how can leaders really take steps to prioritize them? 

Dr. Rochelle - Yeah, you know, these things seem so simple, but yet if you think about it, they're so human. Right. And if weren't in a hospital setting, or even if we are in a hospital setting, think of, you know, when something stressful happens, what do you want to do? You want to talk to somebody you trust? Do you want to just - I remember when the whole thing with Banks happened. I was in this very busy area. We called the treatment center, and there were multiple people on the phone. There was so much activity. And I literally was like, wow, I can't even process this. Like, I just need, like five minutes. And I remember when. When I did. The medical director did come down, went into this quiet space. And even just that made me feel better. 

Dr. Rochelle - And so I think, unfortunately, and this is where I think, when we really think of mental health and we think of taking care of people, we have to realize that there is a period of recovery needed. And even if that for somebody is 10 minutes, that could make such a big difference to, you know, thinking of all the time potentially wasted of them processing this or thinking about this on their own time. And so I do think that, you know, we almost sometimes pride ourselves on working all day and not even taking a break or, you know, all of these things that we do. And we think we're doing it for our patients, but it's harming us. And that's the kind of thing that we found in this is literally, it doesn't. 

Dr. Rochelle - It could just be me reaching out to you, and you don't even have to say anything. I'm just talking. And I have somebody that's. I trust that's listening to me, and that makes such a huge difference. So I think as a leader, understanding that and understanding that, you know what, we're in this field, that has an emotional burden to it. We are people that tend to go into the profession are emotional already. They definitely are very empathetic. And there are impacts that we have to be very open about. And this is, I think one of them is the more that we can normalize this kind of a discussion, I think the healthier it's going to be both for us and for our patients. 

Dr. Marie - Yeah, I love that. So, so important. Speaking of the immediate aftermath of the experience, when you had your experience with Banks, that leadership was just right there with you and calm, supportive, attentive. Based on the data from the research that you've done, how much of a team's long term mental health rests on that immediate period? What did you find there? 

Dr. Rochelle - Yeah, it's a great question. And again, I think we need more studies to know an actual timeframe. But what I do know in culture of safety, so if you think of culture of safety as kind of an emergent property of a group, so when you think of sort of psychological safety and the idea of feeling safe within a team, it really is about what people kind of in, within a group kind of think and say and how they react to each other. And so when you think of an event that happens, all of those feelings are already getting stirred up, right? We're like, wow, that's Banks. Everybody knows Banks. You know, everybody on the team does. People are already starting to form thoughts about what had happened. 

Dr. Rochelle - And so the longer you leave that, the stronger those thoughts are going to become without any sort of direction to really funnel a positive energy to really solve this thing. And I think that by having a relatively quick response, a strong response and a team based response where we were all surrounded, you know, Banks and like I remember this medical director talked through it to the group and said, hey, I, you know, this has happened to me a lot. And just the way that he did this very much kind of shaped the way we were going to work together to fix this challenge that we'd come up against. 

Dr. Rochelle - And so I do believe, I think it's a great question because I believe if that had waited 2, 3, 4, 5 hours now that team has kind of started to form their own ways of thinking around that. And there's nothing necessarily wrong with that, but I think the idea of a strong leadership response just really helps in these situations. 

Dr. Marie - Yeah, this is definitely some really impactful information that is going to inform the way that I handle errors, especially with other folks that I work with in practice. I've always looked at it through the lens of no judgment, no repercussions. Please tell me I am also making mistakes. I am fallible. I need you to let me know when I'm doing something wrong. Really bringing the entire team into the fold and making sure it's immediate and you're not waiting until the next shift or something to kind of circle back to that person. When I think about my experience during my residency, a little bit of a different experience, of course, being in academia, where I joke that, you know, things tend to move a little bit more slowly at times. 

Dr. Marie - I had the initial inkling after I found out that the dog had a cardiopulmonary arrest overnight. And weren't able to look at the X rays at that time because we were having an issue with the computer system. When I got the call on Monday from the radiologist, making sure that I knew that the last view taken on this patient showed the tube was in the airway, that was that immediate moment of like, oh, my gosh, I'm going to throw up, like, this is happening. And I remember telling my faculty member right away, and the focus from there just sort of like the shock. And we have to tell the hospital director, and then we'll have to talk to medicine because it was their case, and then somebody will have to call the owners. 

Dr. Marie - And I feel like from that moment, I was sort of just like, you know, okay, we'll take it from here. And that really caused my emotions to fester and my shame to build even. I find it's even still hard to talk about because it was months later that I was on rotation with another one of my mentors who had really picked up at this point on the fact that I was struggling and that I was really questioning myself and had lost a lot of my confidence. And similar to your experience, only months later, he put his arm around me and said, Marie, like, do you know how many patients I have killed in my career? And this is one of, like, the brightest people I knew. One of the most compassionate souls, double boarded, just an incredible human. And I was just blown away. 

Dr. Marie - And it was like this sigh, you know, and this burden was just lifted off of me. Like, really, like, up until this point, I didn't hear anybody tell me that they had also made a mistake. And I've been holding my breath, waiting to get kicked out of my residency program. And so, for everybody listening, please take this to heart and how important this initial Response is, especially when you are in that leadership role and you have the capacity to have such an impact on those whom you are working with. Well, you are doing such incredible work in this regard, Rochelle. I am just in awe of everything that you've accomplished and the work that you're continuing to do. In your role at Mars, you spend a lot of time looking at quality and safety at a massive scale. 

Dr. Marie - How are you building systems that aren't just going to help protect the pets, but also are going to proactively protect the mental health of veterinary professionals and help to do what I'm trying to do, which is to keep people in this profession for as long as possible? 

Dr. Rochelle - Yeah, that's a really good question. I think, I would say two things. One is, I really think as a profession, we need to measure culture, safety. So there are tools, surveys that measure this quite commonly in human healthcare. We have one validated tool in veterinary medicine, and it's a strong tool. It's just a little bit long for a global population. And so what we are working on now is we're working with Johns Hopkins to create a very simple, short tool that will get validated, that will be available for everybody. And what I'm really hoping is that people start to really assess how people feel in their hospital environments across our field. Because, you know, I can look back to that situation where I talk about banks and I realize, wow, I was in a strong team with a strong culture of safety. 

Dr. Rochelle - But how do we know? Like, how do we know how everybody feels? And one of the things that we do see is we see evidence whether it's strong or not come out when serious events happen. And all of a sudden you've got people yelling or throwing things, and then you're like, okay, wow, that's really clear. But it's not always that clear. It's sometimes very subtle. So one of the pieces is the measurement piece. The other thing that we have really been looking at. So about eight or nine years ago, Johns Hopkins actually started a voluntary response network. And they called this network rise. And this stands for resilience and stressful events. What they recognized was that, just as we did in our Kogan study, recognize that people often need support when these things happen. 

Dr. Rochelle - And it has actually, it started with patient safety events, but in human healthcare anyway, it has gone to any stressful event that happens. It could be losing a patient that you were really close to. It could be maybe it's a client complaint, something that, you know, just flared up a situation. But Essentially, what this network is there for is to respond when these stressful events happen 24, 7 to anybody that needs someone to listen. And what we have done is we have done training with Johns Hopkins in multiple kind of groups within MVH. We actually recently released a paper from Sweden, or we did it with a team in Sweden. 

Dr. Rochelle - And what they did is they looked at it through their lens, through their cultural and country lens, but also, you know, through the veterinary medicine lens and said where they thought it fit, where maybe didn't fit. And so, again, this is very early on and would love more people to look at this, but my goal with that is to get people to see that maybe this is something we could create here in North America. There are other examples of it in Europe. But I think recognizing again, that these things can harm our people and then trying to figure out what are the best solutions to try to eliminate or alleviate that harm. 

Dr. Marie - Well, it's incredible work and I can't wait to see how that all fleshes out. And so great to see something that is going to have such a dramatic impact on the profession, given again, how common these errors are in practice, these patient safety events. I'm going to ask you one more question. I feel like I could keep talking to you about this information, and I want you to get back to the incredible work that you're doing. The last question is one that we ask all of our guests on the podcast, and that is, what does the phrase reviving veterinary medicine mean to you? 

Dr. Rochelle - I love this question and I love the work that you do. I think when we talk about some of the struggles in veterinary medicine, I think lots of people have, you know, a number of different solutions. I really feel that what we have forgotten a little bit in Vet Med is that people, the people that work in this field, are at the heart of everything we do. And I think anybody right now that is working in the areas of health and wellbeing in recognizing that we're people and recognizing that this is such a rewarding profession, but it also brings some burden with it that we need to figure out good solutions for. And so I think when I think of reviving veterinary medicine, there are tons of different kinds of business solutions. 

Dr. Rochelle - But to be honest, like, if we could figure out really effective ways to support and take care of people, I think a lot of those other pieces will solve themselves. 

Dr. Marie - Beautiful. Well, thank you so much for sharing your sentiments, and I really appreciate all of your time and expertise and breaking down this research and sharing your personal experience with Banks. This is just tremendous work to do in our profession, and we're so grateful for you. So thank you again for all of your time today. Rochelle, it was great chatting with you. 

Dr. Rochelle - Oh, you're welcome. It's amazing to be here. 

Dr. Marie - So that's it for this episode of Reviving Vet Med. I'm so grateful to Dr. Rochelle Low for her honesty and for the research that she's doing in this field. Knowing that nearly 80% of our colleagues have navigated a safety event in just the last year is a sobering reminder that mistakes are a professional reality, not a personal failure. If you're listening to this and carrying the weight of a recent error, I hope Rochelle's words give you some room to breathe and the permission to forgive yourself and recover. If you'd like to read the research papers that we discussed today, we've linked them in the show notes. Please also follow Rochelle on LinkedIn to keep up with her work on transforming our professional culture. If this conversation resonated with you, please consider sharing it with a colleague or a friend who might benefit from it. 

Dr. Marie - These aren't always easy topics, but they are important ones, and the more we talk about them, the safer and more supportive our profession can become. A sincere thank you once again to Dr. Rochelle Low for joining me today to Bear Beat Productions for producing this episode, and to you, our listeners, for being here and part of this community. Until next time, take care of yourself. Bye for now.