Magnitude of the problem
The evidence shows that many healthcare workers have been involved in avoidable adverse events. 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.
- 92% surveyed physicians had been involved with a near miss, minor error, or serious error. 1
- 84% anaesthesiologists had been involved in at least 1 unanticipated death or serious injury over their career. 2
- 77% primary care professionals involved in safety incidents. (Newman 1996)
- 40% of physicians and nurses reported to have contributed to a severe adverse event in the last five years. (Mira et al 2016)
- 34% residents reported at least 1 major medical error between 2003 and 2005.3
- 14% physicians and 7.9% nurses reported to have contributed to a patient safety incident.4
From those who were involved in an incident, some will experience symptoms and become second victims. Common reactions can be emotional, cognitive, and behavioural. 5 As being a recent field of research, several studies tried to identify how many healthcare professionals become second victims. The following table summarizes some findings:
| Author | DAte | location | setting | finding | observations |
|---|---|---|---|---|---|
| Dumitrescu A | 2014 | Ireland | Department of Neonatology | 92% | Doctors and nurses. An I got Burnt Once (IGBO) – near-miss or actual clinical event, related to patient safety, that leaves a lasting impact on the health professional |
| O’Beirne M | 2012 | Canada | Primary care | 82% | Based on an incident reporting system. More frequent responses: frustration, embarrassment, anger and guilty |
| Mira JJ | 2015 | Spain | Primary care and hospitals | 62% PC 72% Hosp | Doctors and nurses. Reported having suffered the second-victim experience (themselves or through colleagues) in the previous 5 years |
| Edrees H | 2011 | United States | Tertiary care (hospital) | 60% | Can recall an adverse event in which they were a second victim |
| Edrees H | 2016 | United States | Department of Paediatrics | 58% | Experienced some problems, such as anxiety, depression, or concern about ability to perform job |
| Seys D | 2013 | United States | – | 10-43% | Systematic review |
The second victim phenomenon was also described on crisis situations as SARS pandemic in 2003. Tam and colleagues found that more than 50% of frontline healthcare workers had experienced psychological distress.6 More recently, the COVID-19 pandemic caused an unprecedent pressure on the healthcare systems and on the workers as well. 7 It was underlined that to respond to a crisis it is also crucial to take care of the healthcare workers wellbeing, who can easily become second victims in such stressful situations.
Van Slambrouck et. al found an 85% prevalence of second victim symptoms among nursing students, showing the importance of adequate education and training for the clinical experience. 8 In Germany, a survey of young physicians in training for internal medicine found that 59% of the respondents had already experienced second victim incidents in their career. 9
Gender-related differences should be addressed when tackling this problem: female workers tend to report more distress than male, but they are also more motivated to handle with the situation, discussing with colleagues and attending training programs. 5
- Waterman AD, Garbutt J, Hazel E, Dunagan WC, Levinson W, Fraser VJ, et al. The emotional impact of medical errors on practicing physicians in the United States and Canada. Jt Comm J Qual Patient Saf. 2007;33(8):467–76.
- Gazoni FM, Amato PE, Malik ZM, Durieux ME. The impact of perioperative catastrophes on anesthesiologists: Results of a national survey. Anesth Analg. 2012;114:596–603.
- West CP, Huschka MM, Novotny PJ, Sloan JA, Kolars JC, Habermann TM, et al. Association of perceived medical errors with resident distress and empathy: A prospective longitudinal study. J Am Med Assoc. 2006;296(9):1071–8.
- Van Gerven E, Vander Elst T, Vandenbroeck S, Dierickx S, Euwema M, Sermeus W, et al. Increased risk of burnout for physicians and nurses involved in a patient safety incident. Med Care. 2016;54(10):937–43.
- Seys D, Wu AW, Gerven E Van, Vleugels A, Euwema M, Panella M, et al. Health Care Professionals as Second Victims after Adverse Events: A Systematic Review. Eval Heal Prof. 2012;36(2):135–62.
- Tam CWC, Pang EPF, Lam LCW, Chiu HFK. Severe acute respiratory syndrome (SARS) in Hongkong in 2003: Stress and psychological impact among frontline healthcare workers. Psychol Med. 2004;34:1197–204.
- Wu AW, Connors C, Everly GS. COVID-19: Peer support and crisis communication strategies to promote institutional resilience. Ann Intern Med. 2020;172(12):822–3.
- Van Slambrouck L, Verschueren R, Seys D, Bruyneel L, Panella M, Vanhaecht K. Second victims among baccalaureate nursing students in the aftermath of a patient safety incident: An exploratory cross-sectional study. J Prof Nurs [Internet]. 2021;37(4):765–70. Available from: https://doi.org/10.1016/j.profnurs.2021.04.010
- Strametz R, Koch P, Vogelgesang A, Burbridge A, Rösner H, Abloescher M, et al. Prevalence of second victims , risk factors and support strategies among young German physicians in internal medicine ( SeViD-I survey ). 2021;8:1–11.
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