Second victim
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Background
- Second victims are healthcare providers in the midst of a medical mistake or error and become victimized because of their role.
- University of Missouri Health canter found almost 1 in 7 staff reported experiencing a patient safety event resulting in personal disturbed emotions.[1]
Clinical Features
- Immediate.
- Stress related psychological and physical reactions:
- Sadness, Fear, shame and anger
- Panicking, horrified and apprehensive.
- Sympathomimetic reaction with tachypnea, tachycardia, elevated blood pressure and difficulty concentrating.
- Lonliness and fear of being called names and losing job.
- Stress related psychological and physical reactions:
- Subsequent.
- Fear of returning to work.
- Loss of confidence.
- Self doubt, remorse.
- Hypervigilence, second guessing everything.
- Fear of returning to work.
- Ongoing till resolved.
- Characteristics of PTSD (inability to process the feeling of fear, sadness, guilt and shame).
- Resulting in:
- Insomnia, flashbacks and thoughts of suicide.
- Damaged self perception.
- Loss of self security.
Differential Diagnosis
- Anxiety neurosis
- Thyrotoxicosis
- PTSD
- Depression
Evaluation
- It is not easy to spot a second victim unless we specifically look for them.
- Second victims should be protected and shielded from public eye until the situation is properly studied.
- The second victim should be treated on urgent basis.
- Second victim code should be announced and a separate team should provide help to the person, besides the team evaluating the incidence.
Management
- Five rights of the second victim.[2]
- Treatment that is just.
- Respect.
- Understanding and compassion.
- Suppostive care.
- Transparency and opprtunity to contribute.
- Recovery process of the second victim.[3]
- Chaos and accident response.
- Intrusive reflections.
- Restoring personal integrety.
- Enduring the inquisition.
- Obtaining emotional first aid.
- Moving on. Which can lead to either of the three.
- Dropping out.
- Surviving.
- Thriving.
See Also
External Links
https://archive.ahrq.gov/news/newsroom/commentaries/second-victim-syndrome.html
References
- ↑ Scott SD. The "second victim" phenomenon: a harsh reality of health care professions. AHRQ; WebM&M Perspectives on Safety; May 2011.
- ↑ Denham CR.TRUST: the 5 rights of the second victim. J Patient Saf. 2007; 3: 107-119
- ↑ Scott SD, Hirschinger LE, Cox KR, et al. The natural history of recovery for the health care provider "second victim" after adverse patient events. Qual Saf Health Care 2009;18:325-30.