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a terrible error
Simon Carley
short
stay
wants
to go
home
RETURN return
feel
panic
radiology
path
experts
professional
self-image
personal
clinical
Radio
https://youtu.be/v3QD7Rrt2Ck
second victims
Medical Error: the secondVictim A.Wu. BMJ 2000
Second victims are healthcare providers who are involved in an
unanticipated adverse patient event, in a medical error and/or a patient
related injury and become victimized in the sense that the provider is
traumatized by the event.
Frequently, these individuals feel personally responsible for the patient
outcome. Many feel as though they have failed the patient, second
guessing their clinical skills and knowledge base.
Medical Error: the secondVictim A.Wu. BMJ 2000
Second victims are healthcare providers who are involved in an
unanticipated adverse patient event, in a medical error and/or a patient
related injury and become victimized in the sense that the provider is
traumatized by the event.
Frequently, these individuals feel personally responsible for the patient
outcome. Many feel as though they have failed the patient, second
guessing their clinical skills and knowledge base.
predictable course for second victims.
Chaos chaos
shame
denial
embarrassment
flashbacks
triggers
restoring
personal
integrity
obtaining
emotional
first aid
enduring
the inquisition
Williams 1999
are we
helpless?
what
works?
resilience
It is not the stressโ€ฆ
it is the state of mind,
that matters when one is
stressed
Hans Selye
http://www.robertsoncooper.com/gooddayatwork
Personal Organisational Culture
what happened?
be aware
prepare
support
Be Kind
thank you
Why bother?
Enduring the inquisition
The inquisition
GMC
HIPAA
Families
Coroner
ED days
In no relationship
is the physician
more often
derelict than in
his duty to
himself (herself).
monitor incidents
contact supervisors
Mentors
Parallel support for second victims
Other things -
develop emotional understanding
Schwartz rounds - build emotional and
psychological understanding of how people
feel not just what happens.
Organisations
Understanding	of	self	and	self	mastery	
Interactions	with	others	and	wider	world	
Meaning	beyond	self-	values-goals-focus	
Positive	approach-perspective	
Personal	growth	
Care	of	health	
Learning	from	overcoming	challenges	
understanding self
social interactions
meaning beyond self
health
learning from error
Organisations
Contact clinical sta๏ฌ€
Rea๏ฌƒrm your con๏ฌdence
Give time and space
Keep informed
Let them know you care
Be visible to all sta๏ฌ€ members.
Teach resilience
Guide donโ€™t dictate
Clinicians get harmed too
You may become a second victim
You will certainly meet second victims
There is a predictable course to recovery
You can personally prepare
You can organisationally prepare
You can personally support
You can organisationally support
FOR SUFFERERS
Be honest
Donโ€™t rationalise
Ask for help
Prepare
Personal impact Professional impact
Serious event
Chaos
Intrusive
re๏ฌ‚ections
Restoring
personal integrity
Enduring the
inquisition
Obtaining
emotional ๏ฌrst aid
Moving on
Dropping
out
Surviving
Thriving
โ€œa health care provider involved in an unanticipated adverse
patient event, medical error and/or a patient related-injury who
become victimised in the sense that the provider is
traumatised by the event.
โ€œa health care provider involved in an unanticipated adverse
patient event, medical error and/or a patient related-injury who
become victimised in the sense that the provider is
traumatised by the event. 

Frequently, second victims feel personally responsible for the
unexpected patient outcomes and feel as though they have
failed their patient, and feel doubts about their clinical skills
and knowledge base.โ€

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