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September 2023Stages of Second Victim Syndrome
Just as there are stages to the process of grieving, a 2009 study published in Quality & Safety in Health Care (doi:10.1136/qshc.2009.032870) found that second victims went through their own process. Researchers interviewed 31 second victim volunteers representing different professional groups and found that they all essentially went through six stages.
1. Chaos and Accident Response. Second victims described situations being chaotic and confusing. They were frequently distracted and engrossed with self-reflection, while trying to manage their patient. They also chastised themselves for not being able to think clearly.
2. Intrusive Reflections. Second victims felt inadequate and frequently relived the situation, often isolating themselves from others. They also repeatedly asked themselves ‘‘what if’’ questions.
3. Restoring Personal Integrity. Many second victims sought support from someone they trusted, such as a colleague, supervisor, friend, or family. Many weren’t sure about their future professional career, wondering, ‘‘What will others think of me’’ and ‘‘Will I ever be trusted again?’’
4. Enduring the Inquisition. During this stage, the second victim isn’t sure how their institution will react and they begin to wonder about job security, their license, and possible future litigation.
5. Obtaining Emotional First Aid. Second victims reached out for support, but finding a safe person to confide in was sometimes difficult due to HIPAA concerns. Several received support from coworkers, supervisors, or department heads.
6. Dropping Out, Surviving, or Thriving. At this point, second victims either dropped out of healthcare altogether, functioned normally in their careers but were affected heavily by the event, or learned from the event and thrived in their careers.
—Amy E. Hamaker