LK 101Adverse events: The second and third victims
Adverse events happen in medicine, and their impact is felt not only by the patient and the patient’s loved ones, but also by the physicians and other medical team members caring for the patient. These medical professionals who suffer after-effects are called “second victims”. Patients who are cared for subsequently, while the team is still impacted by the earlier adverse events, may be subject to distracted care and medical errors, and have been called “third victims”. Savvy patients have begun asking about caregivers’ mental state. Patients often ask if we are well-rested, where we trained, if we have a lot of experience with procedures and other team members. And people intuitively know that death or near-death experiences (even when vicarious) are impactful, even for seasoned professionals. Do our patients have the right to decide whether or not they wish to be on the receiving end of our best efforts after a catastrophe? Do we have an obligation to inform patients? How can we deliver best care to our patients, and best support ourselves and our colleagues? Medicine is losing many excellent doctors and nurses, either due to career change or even suicide, as a result of this unspoken epidemic.
Dr. Stiegler is an Associate Professor of Anesthesiology at the University of North Carolina at Chapel Hill. There, she is also the Director of the Consortium for Anesthesiology Patient Safety and Experiential Learning. Dr. Stiegler completed medical school at Emory University, did a medical internship at Georgetown University, and completed residency in anesthesiology at the Massachusetts General Hospital. Subsequently, she accepted a faculty position at the University of California Los Angeles, where she also completed a fellowship in medical education. She has received grant support from FAER and the AHRQ for research in simulation and decision-making, and currently serves on several national safety committees. She is speaks internationally on these same topics. Dr. Stiegler has recently been selected an both an examiner for the American Board of Anesthesiology and a member of the Academy of University Anesthesiologists. Marjorie lives in Raleigh, NC with her husband and two children.