Second Victim Syndrome (SVS)
Background
Medical errors are the third leading cause of death in the US
Poor outcomes can be due to a larger system failure or a human error
Examples include incorrect medication dosages, improper management, harm during a procedure, missed diagnoses, etc.
Second victim
Defined in 2000 by Albert Wu
In situations where medical errors are made or safety is compromised, the first victim is the patient and the second victim is the healthcare professional (EMT, nurse, physician) who can also be affected or traumatized by the event.
SVS
Aforementioned events can have a lasting impression on a provider
He/she tends to repeat the event over and over in his/her mind leading to emotional distress and scars
Immediate symptoms
Anxiety, guilt, shame, sadness, fear, anger
Can have sympathomimetic manifestations—tachycardic, elevated BP, etc
Later symptoms
Depression, loss of confidence, loss of job satisfaction, hypervigilance, poor decision making
Can develop PTSD like symptoms
Insomnia, flashbacks, SI, isolation
Identifying Second Victims
Symptoms and behavior can be similar to those who suffer from burn out
Different stages of SVS (see below)
Management
Support from colleagues is helpful
Provides a sense of shared understanding
M&Ms/patient safety conferences that are supportive instead of punitive
Culture change
Shift toward a “Just Culture”
Balancing accountability and support instead of perpetuating a blame/shame culture
TRUST mnemonic
Treatment that is Just
Respect
Understanding and compassion
Supportive care
Transparency and opportunity to contribute