Episode 89 Second Victim Syndrome

Post by Spencer Willette, OMS-II

We all know that sickening feeling when a bad mistake has been made and there’s no chance to turn back time. The realization that a patient outcome could have been altered has the potential to lead to enduring agonization and mental stress.

At CORD 2020 in New York City, Andy and Drew met with Dr. Loice Swisher and Dr. Jennifer Kleven to talk about Second Victim Syndrome.

Patients can be victims of injury, disease, abuse, and addiction, but how could a health care provider be considered a victim? Practicing emergency medicine is an extremely rewarding field with the opportunity to positively impact patients lives, but that’s not to say it’s free of personal hardships. We are bound to go through a tough stretch of difficult cases, colleague interactions and personal obligations. Managing the balance of life’s variables can be a daunting task and sometimes lead us to a breaking point.

As first described in 2000 by Dr. Andrew Wu, Second Victim Syndrome is the suffering experienced by a health care professional due to a medical error impacting a patient, the obvious first victim. Doctors are negatively affected by the same errors leading to a downward spiral of second-guessing medical knowledge, clinical skills, and career choice. Doctors are human too. The downstream effects of a crucial error can impact not only professional interactions but providers’ social and private lives.

Recognizing and addressing the second victim syndrome phenomena is essential for the well being of our colleagues and the medical community as a whole. We experience life’s most intense moments on people’s worst days and it can take a toll.

Second Victim Syndrome Stages: as described by a 2009 research study

Chaos and Accident response – while battling negative emotions following a mistake, the provider must find a way to stabilize the patient.
Intrusive Thoughts – the error begins to affect other aspects of life, as self-reflection and doubt become overwhelming.
Restoring Personal Integrity – looking for support from a colleague or friend.
Enduring Inquisition – further reflection leads to questioning the potential professional and legal consequences.
Obtaining Emotional First Aid – using coping mechanisms to mediate the situation and seeking help.
Moving On – drop out, survive, or thrive. The goal is to ultimately thrive again and reobtain zeal in all areas of life. Using reflection to understand the error, but moving forward recovered, stronger and improved.

Healing in times of brokenness can largely be found through sharing with people. If we see a colleague going through a tough time, reach out to them. Prompting the conversation, showing that you care, asking how they are doing, can make a difference. It can be as simple as offering a listening ear and affirmation to someone in times of loneliness.

Listen in as Jennifer shares her heartfelt story, “Bouncing back from being broken” and how Loice offered her support and encouragement.