Adverse events are events that cause harm to patients as a result of medical care. According to Dr. Albert Wu, the “second victims” of such events are the professionals that cared for the patient. Secondary victims experience cognitive and emotional distress—including guilt, fear, self-doubt, anxiety, apathy, and depression—as a result of their professional roles in an adverse patient event.
Second victims of adverse patient events are believed to be particularly vulnerable to developing compassion fatigue. Compassion fatigue can manifest as an inability to appreciate or care for patients, difficulty in maintaining relationships with fellow health care providers, increased time away from work or other duties, or an inability to focus on tasks. It is important for health care providers to be aware of the signs of compassion fatigue and seek help when needed.
Second victims of adverse events face significant ethical dilemmas. It is natural to want to protect oneself and one’s career when it appears that a bad outcome is the result of a medical mistake or misjudgment. Nonetheless, health care professionals face the ethical imperative to meet the patient’s “duty of care” and show loyalty to the patient in the face of an adverse event.
In addition to compassion fatigue, second victims of adverse events may also experience burnout syndrome, which is more serious and prolonged than compassion fatigue. Burnout syndrome is not caused by single bad events, but rather by long-term stressors such as difficult patient interactions, lack of control, and feeling trapped in a profession.
Not surprisingly, burnout syndrome can have severe mental and physical health consequences for healthcare providers, including a breakdown in their sense of professional identity, impaired morale, increased number of sick days, reduced energy, and even withdrawal or escape into behaviors such as substance use or recreational activities. Burnout syndrome is considered a disorder and may require professional help.
Finally, second victims of adverse events may experience vicarious trauma, or psychological distress as a result of being exposed to the traumatic experiences of their patients. This can cause disrupted sleep patterns, relationship difficulties, and poor performance at work.
In order to help second victims of adverse events, organizations must recognize the importance of providing psychological and emotional support. This can come in the form of peer-counseling programs, trainings, workshops, and conferences, or other types of support for healthcare workers who have been involved in an adverse patient event. Additionally, organizations should ensure that all team members have a clear understanding of their roles and responsibilities, and that the protocols for responding to adverse events are clearly defined. Organizations must also ensure that healthcare providers have the training and resources they need to be prepared to handle complex medical situations.
In conclusion, adverse events are an unfortunate reality of healthcare. Understanding the psychological and emotional consequences that second victims experience is necessary in caring for them. Organizations must provide resources to help healthcare providers in high-risk professions recognize, manage, and recover from their own patient experiences.