Are providers who make mistakes 'second victims'?

Even well-trained, competent clinicians can make mistakes. And when they do, the guilt and shame of causing adverse events can haunt them.

Known as "second-victim syndrome," the emotional and psychological toll errors have on providers can even destroy careers, ProPublica reported.

However, some members of the ProPublica's Patient Harm Community say family members are the real second victims and providers are the third, at best.

According to the Agency for Healthcare Research and Quality (AHRQ), most experienced nurses, physicians and other clinicians have been associated with healthcare-associated harm in some way. Adverse events among Medicare beneficiaries are related to medication (31 percent), patient care (28 percent), surgery and other procedures (26 percent), and infection (15 percent).

Albert Wu coined the term "second victim" in 2000 with his British Medical Journal study.

In the well-known tragic case of Kimberly Hiatt, the cardiac intensive care nurse at Seattle Children's Hospital in 2011 overdosed an eight-month-old patient, which led to the baby's death. Six months after the event, the nurse committed suicide.

More than a decade later since his study, Wu says the industry is just starting to make progress toward organizational structures to help with providers' emotional turmoil, he told HealthLeaders Media.

The University of Missouri Healthcare, Johns Hopkins, Brigham and Women's Hospital, Beth Israel Deaconess and Stanford University Hospital are working on employee assistance programs.

Second-victim syndrome doesn't only affect providers who commit patient harm, HealthLeaders noted. Hospital workers in high-risk units, such as intensive care, or employees who face colleagues' unexpected deaths also may suffer.

When a hospital helicopter crashed, giving two crew members "career-ending injuries," University of Missouri Healthcare's patient safety officer Susan Scott said there were grief-stricken staff left behind, including one who had traded his shift with one of the victims.

To deal with such events, the health system created ForYou Team, which offers a "rapid respond team for clinicians." The program has trained 99 volunteers who have helped 639 members of the staff cope with second victims with "emotional first aid."

For more information:
- see the ProPublica article
- read the HealthLeaders Media article
- check out the AHRQ information on second-victim syndrome

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