What is second victim syndrome?
The concept of a second victim was proposed over 20 years ago to bring awareness to the health care professional providing care to a patient during a safety incident. The primary victim in these incidents is the patient or family/caregiver and deserves priority attention, having any ill-effects managed and mitigated. The second victim is/are the health care professional(s) engaged in the incident. In 2022, an international group of experts created a consensus definition.
A second victim is "any health care worker, directly or indirectly involved in an unanticipated adverse patient event, unintentional healthcare error, or patient injury, and who becomes victimized in the sense that they are also negatively impacted." Taking this further, second victim syndrome (SVS) is a phenomenon such as when a health care worker harbors feelings of personal responsibility for unexpected patient outcomes and feels that they have failed their patient, going so far as to discredit their own personal knowledge and clinical skills.
Medication errors are a leading cause of SVS
According to the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP), a medication error is defined as "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in control of the health care professional, patient, or consumer."
As the medication experts, pharmacists and pharmacy support personnel ensure that the right medication reaches the right patient at the right time at the right dose via the right route (commonly known as the five rights). Pharmacists employ principles of medication and patient safety to decrease the likelihood of patient safety incidents. The World Health Organization's Global Patient Safety Action Plan recognizes that patient safety incidents seldom result from an error of a single individual, but rather due to the complexity of poor design and operation of systems, and may occur throughout the entire medication-use system. A vast majority of patient safety incidents can be linked to flaws in systemic, strategic, or organizational conditions which are beyond the control or influence of the health care professional engaged in the incident. Health care systems are in a constant state of improvement to prevent patient safety incidents and potential second victims.
APhA supports pharmacists and pharmacy personnel suffering from SVS
APhA recognizes the impact that SVS has on individual pharmacists, pharmacy technicians, student pharmacists, pharmacy residents, and other pharmacy personnel.
Please keep checking this page regularly as APhA will be creating programs such as support groups where you can spend some time in a safe space with a community of like-minded pharmacy professionals. You can come to share your own personal story, or just listen. A mental health professional with experience in assisting second victims will be there to offer insights and resources.
We'll also offer materials to support the needs of pharmacy second victims as they move through the stages of second victim recovery.
Six stages of second victim recovery
- Chaos and accident response
- Intrusive reflections
- Restoring personal integrity
- Enduring the inquisition
- Obtaining emotional first aid
- Moving on