Practice Tip of the Week: Nurses Caring for Nurses - Supporting Second Victims
Tuesday, May 9, 2017
Posted by: Nadia Tamez-Robledo
By Ellen Martin, PhD, RN, CPHQ
Director of Practice
Texas Nurses Association
“To err is human; to forgive, divine.” – Alexander Pope
This year’s theme for National Nurses Week is Nursing: the Balance of Mind, Body, and Spirit. Nurses can encourage colleagues to practice compassion and respect for the inherent dignity and worth of every individual; not only with patients and families but with each other. This respect and compassion is vital when a nurse makes an error or the nurse’s practice is being reviewed.
Mistakes are a human inevitability. Healthcare providers work at the “sharp end” of healthcare. That is, they are in direct contact with patients where errors impact patient outcomes directly. When a patient experiences a negative outcome, nurses naturally express concern and sadness. If an error results in patient harm, the experience can be heart-wrenching for everyone involved. This is especially true for the person who made the error. The aftermath of serious errors includes investigation by the healthcare organization and often results in discipline by the employer and the licensing board.
The term second victim was coined in 2000 by Albert Wu, MD, a quality and patient safety leader, who described the negative impact of medical errors on healthcare providers. A serious medical error can be considered a double tragedy: first for the patient and family and secondly for the healthcare provider who must live with the aftermath of making the error. Second victims often experience stress and anxiety and may lose confidence in their clinical skills. Some may have intrusive repetitive thoughts about the error and others can become severely depressed. In April 2011 Kim Hiatt, a critical care nurse at Seattle Children’s Hospital with over 20 years experience, died by suicide 7 months after a medication miscalculation contributed to the death of an infant.
The University of Michigan Health System (UMHS) provides care for professional caregivers through a program called the ForYOU team. The Office of Clinical Effectiveness at UMHS also developed a reference guide that describes stages of the Second Victim Trajectory with common concerns at each stage and recommended actions. The second victim phenomenon is complicated. Not only is the second victim viewing him or herself as a problem, but colleagues may do the same and the organization may not support the second victim. All members of the health care team are susceptible to error and vulnerable to the after effects. We honor our profession, our patients, and the healthcare team when we support each other especially through difficult times.