What Is Second Victim Syndrome?
When an unexpected or traumatic clinical event happens, most healthcare providers have strong emotional defenses that carry them through and allow them to continue to get the job done. Yet sometimes, the emotional aftershock (or stress reaction) can be difficult and may last a few days, weeks, months or longer. This creates what is called the second victim syndrome, in which a healthcare provider is traumatized to the point where the provider may not be able to effectively do his or her work.
About the You Matter Program
At Children’s Healthcare of Atlanta, we want to care for those who care for others. The You Matter Program, our second victim peer supporter program, is an important component in doing just that. When an unanticipated adverse event happens, You Matter Program resources are available to help make sure our dedicated physicians receive the help and support that allow them to recover emotionally and remain a valued team member.
The You Matter Program includes the following components:
- Raising awareness: Children’s is working to raise awareness about second victim syndrome by presenting on the topic to medical staff in a variety of forums, including Grand Rounds and division meetings. After engaging in these tough conversations, attendees should have a better understanding of the syndrome and feel empowered to reach out to their peers. Attendees may also decide whether they are interested in becoming peer supporters, a more formalized way that Children’s staff members can volunteer to offer support to their colleagues.
- Peer supporter training: Peer supporters attend an additional one-hour training session, which prepares them to provide comfort and care to their colleagues when an event happens. If you are interested in becoming a peer supporter, contact firstname.lastname@example.org.
- Additional support: Understanding that physicians may need additional support beyond the peer supporter element of our program, the You Matter Program team has identified numerous internal and external support resources:
Want to learn more about second victim syndrome? There are a number of reports, white papers and other articles that have been compiled on the topic. We have included a selection of resources here:
Albert W. Wu, MD, MPH, a professor at Johns Hopkins Bloomberg School of Public Health and Director of the Center for Health Services and Outcomes Research, coined the term second victim in 2000.
- Follow him on Twitter: @withyouDrWu
- In Conversation With Albert W. Wu, MD, MPH
- Medical Error: The Second Victim. The Doctor Who Makes the Mistake Needs Help, Too.
- Healthcare Professionals as Second Victims After Adverse Events: A Systematic Review
Kurt F. Heiss, MD, a Pediatric Surgeon at Children’s, is passionate about second victims and has been a driver in establishing the You Matter Program. He has co-authored several articles on the topic, including:
- The Swiss Cheese Model of Adverse Event Occurrence—Closing the Holes
- Improving Surgeon Wellness: The Second Victim Syndrome and Quality of Care
- The Unmeasured Quality Metric: Burn Out and the Second Victim Syndrome in Healthcare
Susan D. Scott, PHD, RN, CPPS, a patient safety officer at the University of Missouri, has established a vibrant second victim program and has been an important advisor to the development and introduction of the You Matter Program at Children’s. She has published, or has been quoted in, a number of articles about the issue:
- The Second Victim Phenomenon: A Harsh Reality of Healthcare Professions
- Caring for Our Own: Deploying a Systemwide Second Victim Rapid Response Team by Scott, S.D., Hirschinger, L.E., Cox, K.R., McCoig, M., Hahn-Cover, K., Epperly, K.M., Phillips, E.C., & Hall, L.W.
- Too Many Abandon the "Second Victims" of Medical Errors by Matthew Grissinger, RPh, FASCP
- Alleviating Second Victim Syndrome: How We Should Handle Patient Harm by Carolyn M. Clancy, MD, Director of the Agency for Healthcare Research and Quality
Jo Shapiro, MD, FACS, an associate professor of otolaryngology, Head and Neck Surgery at Harvard Medical School, founded the Brigham and Women’s Hospital Center for Professionalism and Peer Support in 2008. Dr. Shapiro was influential in advising on our peer supporter training and has numerous published articles and research in this field as well.
- Hu, Y., Fix, M., Hevelone, N., Lipsitz, S., Greenberg, C., Weissman, J., & Shapiro, J. Physicians’ Needs in Coping With Emotional Stressors: The Case for Peer Support. JAMA Surg 2015;147(3):212-217.
- Harrison, R., Lawton, R., Perlo, J., Gardner, P., Armitage, G., & Shapiro, J. Emotion and Coping in the Aftermath of Medical Error: A Cross-Country Exploration. Online Jrl Patient Safety 2013.
- Gallagher, T.H., Mello, M.M., Levinson, W., Wynia, M.K., Sachdeva, A.K., Snyder Sulmasy, L., Truog, R.D., Conway, J., Mazor, K., Lembitz, A., Bell, S.K., Sokol-Hessner, L., Shapiro, J., Puopolo, A.L., & Arnold, R. Talking With Patients About Other Clinicians’ Errors. N Engl J Med. 2013;369(18):1752-7.
- Shapiro, J. (2015). Medical Ethics & Professionalism. Cochrane, T., Toy, E., & Raine, S. (Eds.). New York, NY: McGraw-Hill.
- Plews-Ogan, M., May, N., Owens, J., Ardelt, M., Shapiro, J., & Bell, S.K. Wisdom in Medicine: What Helps Physicians After a Medical Error? Acad Med. Sept. 4, 2015. [Epub ahead of print].
- Wu, A.W., Shapiro, J. (co-corresponding author), Harrison, R., Scott, S.D., Connors, C., Kenney, L., & Vanhaecht, K. The Impact of Adverse Events on Clinicians: What’s in a Name? J Patient Saf 2020 (in press).
- Shapiro, J., & Galowitz, P. Peer Support for Clinicians: A Programmatic Approach. Acad Med. 2016;91(9):1200-4.