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10. The Second Victim phenomenon

When an adverse event occurs, there is a domino effect with healthcare professionals (named second victims of these events) suffering from the knowledge of having harmed their patients (first victims).

A second victim has been defined as “a health care provider involved in an unanticipated adverse patient event, medical error and/or a patient related-injury who become victimised in the sense that the provider is traumatised by the event”.


Studies of the frequency of healthcare provider errors underline that more than 86% of healthcare professionals recognize an unintentional clinical error during their professional career, and 58% of them have reported serious adverse events; these emotional disturbances are usually more intense among providers females than males.

European studies indicate that around 72% of health care providers in hospitals and 62% in primary care reported having suffered the second victim experience in the previous five years. An alarming 86% of these professionals reported that they received no counselling and 56% no institutional support. Of these, 24% required time off work and 25% transferred to a different department/centre.

Frequently, second victims feel personally responsible for the unexpected patient outcomes and suffer doubts about their clinical skills and knowledge base. Also, they are afraid of the legal, economic, and professional consequences. The second victim phenomenon increases the likelihood of further errors and suboptimal care as consequences of emotional disturbances in the hours/days following the occurrence of an adverse event. Therefore, if not alleviated or treated, the second victim phenomenon can harm the emotional and physical health of care providers and subsequently compromise patient safety.


Evidence-based interventions to address the SV phenomenon increase patient safety by reducing AEs; promote staff and team wellbeing, engagement morale and retention, public engagement, and trust in healthcare; and reduce the costs of financial compensation.



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