Adverse events: the second and third victims

Marjorie Stiegler


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.

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