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Healthcare workers as second victims

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).

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, SVs feel personally responsible for the unexpected patient outcomes, and suffer doubts about their clinical skills and knowledge base. 1 Also, they are afraid of the legal, economic, and professional consequences.2 This SV phenomenon increases the likelihood of further errors and suboptimal care as consequences of emotional disturbances in the hours/days following the occurrence of an AE. Therefore, if not alleviated or treated, the SV 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.3

  1. Heiss K, Clifton M. The unmeasured quality metric: Burn out and the second victim syndrome in healthcare. Semin Pediatr Surg [Internet]. 2019;28(3):189–94. Available from:
  2. Wu AW, Shapiro J, Harrison R, Scott SD, Connors C, Kenney L, et al. The impact of adverse events on clinicians: What’s in a name? J Patient Saf. 2017;65–72. 
  3. Schiess C, Schwappach D, Schwendimann R, Vanhaecht K, Burgstaller M, Senn B. A transactional “second-victim” model—experiences of affected healthcare professionals in acute-somatic inpatient settings: A qualitative metasynthesis. J Patient Saf. 2018;

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