Medicine is a stressful career, and health care provider wellness is sometimes neglected within the culture of medicine
Throughout our medical training we have had the opportunity to treat and learn from the patients every day. We are exposed to an extremely difficult working environment and are constantly witnessing terrifying traumatic events that most people never see in their lifetime.
During the past few months in our emergency department, we have recently seen multiple level 1 traumas, pediatric, and adult cardiac arrests. In this stressful environment it is very easy for medical errors or patient safety issues to occur. It is important that we take care of ourselves, support each other, and to utilize extra help if/when needed.
Today, I wanted to speak about second victim syndrome.
What is second victim syndrome?
· The second victim syndrome (SVS) is defined as the Health Care Providers (HCP) who commit an error and are traumatized by the event manifesting psychological (shame, guilt, anxiety, grief, and depression), cognitive (compassion dissatisfaction, burnout, secondary traumatic stress), and/or physical reactions that have a personal negative impact (similar to symptoms of acute stress disorder)
· Examples: incorrect medication dosages, missed diagnosis, incorrect medical management, accidental harm during a procedure, among several others.
· These types of cases are unforgettable and can leave lasting emotional scars on providers.
· After an adverse event, the prevalence of SVS varied from 10.4% up to 43.3%.
· Almost half of HCPs experience the impact as an SVS at least one time in their career
What are the impacts of second victim syndrome on providers?
· Anxiety, depression, guilt, sleep disturbances, loss of confidence in their practice, and decreased job satisfaction.
· Isolation, depression, and suicidality
· Numerous reports in the literature discuss providers (nurses, residents, attending physicians) who died by suicide following a significant event that led to patient harm.
RESIDENTS ARE AT VERY HIGH RISK!
· Residents are in the learning phase and are expected to make mistakes during their training given their relative levels of inexperience combined with high levels of clinical accountability.
· According to one study, the prevalence of fourth-year students involved in a medical error was 78% - compared to 98% of residents.
· A survey of more than 3100 physicians from the U.S. and Canada found that 81% of those who had been involved in a clinical event (serious error, minor error, or near miss) experienced some degree of emotional distress.
How can we identify this?
· May display similar emotions and behaviors to those experiencing burn out or acute stress disorder or burn out
What can we do to help each other?
· Peer supporters, patient safety, and risk management all play a critical role in ensuring the provider has a safe space to recover from the event.
· While support from friends, significant others and supervisors are important, most providers prefer support from a trusted colleague
· Receiving support from a colleague from within one’s own specialty offers a sense of shared understanding about the complex nature of patient care. It also normalizes the situation for the affected provider.
· Projects such as clinical event debriefing and help recognize systems errors, near misses, incidents, etc. They can also be used to help set up peer meetings and services if individuals are suffering.
References
https://omh.ny.gov/omhweb/bootstrap/crisis.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697646/
Second victims in health care: current perspectives
www.ncbi.nlm.nih.gov
Medical errors are a serious public health problem and the third-leading cause of death after heart disease and cancer. Every day, the health care professionals (HCPs) practice their skill and knowledge within excessively complex situations and meet unexpected ...
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