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J Pediatr Intensive Care 2023; 12(02): 125-130
DOI: 10.1055/s-0041-1731666
Original Article

The Prevalence of Second Victim Syndrome and Emotional Distress in Pediatric Intensive Care Providers

Michael Wolf
1   Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States
2   Department of Physician Wellness, Children's Healthcare of Atlanta, Atlanta, Georgia, United States
,
Kathleen Smith
2   Department of Physician Wellness, Children's Healthcare of Atlanta, Atlanta, Georgia, United States
,
Mohua Basu 
2   Department of Physician Wellness, Children's Healthcare of Atlanta, Atlanta, Georgia, United States
,
Kurt Heiss
2   Department of Physician Wellness, Children's Healthcare of Atlanta, Atlanta, Georgia, United States
3   Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, United States
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Abstract

Pediatric critical care providers are at higher risk of second victim syndrome (SVS) and emotional distress after a poor patient outcome, unanticipated adverse event, medical error, or patient-related injury. We sought to determine the prevalence of SVS within our intensive care units (ICUs) and evaluate the adequacy of current institutional peer support. A validated survey tool, the second victim experience and support tool was sent electronically to all ICU providers in our pediatric health care system. Of 950 recipients, there were 266 respondents (28%). Sixty-one per cent of respondents were nurses; 19% were attending physicians, advanced practice providers, and fellows; 88% were females; 42% were aged 25 to 34 years; and 43% had worked in the ICU for 0 to 5 years. The most common emotion experienced was psychological distress (42%) and one-third of respondents questioned their self-efficacy as a provider after a second victim event. Support from colleagues, supervisors, and the institution was perceived as low. Support from a respected peer was the most desired type of support by 81% of respondents. Emotional distress and SVS are commonly found among pediatric ICU providers and the level of support is perceived as inadequate. Developing and deploying a peer support program are crucial to staff's well-being and resilience in the high-stress ICU environment.

Keywords

second victim syndrome - medical error - burnout - peer support - ICU - pediatric

Supplementary Material



Publication History

Received: 05 March 2021

Accepted: 10 May 2021

Article published online:
01 July 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Wu AW. Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ 2000; 320 (7237): 726-727
    CrossrefPubMedGoogle Scholar
  • 2 Seys D, Wu AW, Van Gerven E. et al. Health care professionals as second victims after adverse events: a systematic review. Eval Health Prof 2013; 36 (02) 135-162
    CrossrefPubMedGoogle Scholar
  • 3 Heiss K, Clifton M. The unmeasured quality metric: burn out and the second victim syndrome in healthcare. Semin Pediatr Surg 2019; 28 (03) 189-194
    CrossrefPubMedGoogle Scholar
  • 4 Ozeke O, Ozeke V, Coskun O, Budakoglu II. Second victims in health care: current perspectives. Adv Med Educ Pract 2019; 10: 593-603
    CrossrefPubMedGoogle Scholar
  • 5 Hirschinger LE, Scott SD, Hahn-Cover K. Clinician Support: Five Years of Lessons Learned. Patient Safety & Quality Healthcare; 2015
    PubMedGoogle Scholar
  • 6 Mitzman J, Jones C, McNamara S, Stobart-Gallagher M, King A. Curated collection for educators: five key papers about second victim syndrome. Cureus 2019; 11 (03) e4186
    PubMedGoogle Scholar
  • 7 Marmon LM, Heiss K. Improving surgeon wellness: the second victim syndrome and quality of care. Semin Pediatr Surg 2015; 24 (06) 315-318
    CrossrefPubMedGoogle Scholar
  • 8 Mira JJ, Carrillo I, Guilabert M. et al; Spanish Second Victim Research Team. The second victim phenomenon after a clinical error: the design and evaluation of a website to reduce caregivers' emotional responses after a clinical error. J Med Internet Res 2017; 19 (06) e203
    CrossrefPubMedGoogle Scholar
  • 9 Merandi J, Liao N, Lewe D. et al. Deployment of a second victim peer support program: a replication study. Pediatr Qual Saf 2017; 2 (04) e031
    CrossrefPubMedGoogle Scholar
  • 10 Mira JJ, Lorenzo S, Carrillo I. et al; RESEARCH GROUP ON SECOND AND THIRD VICTIMS. Lessons learned for reducing the negative impact of adverse events on patients, health professionals and healthcare organizations. Int J Qual Health Care 2017; 29 (04) 450-460
    CrossrefPubMedGoogle Scholar
  • 11 Stiegler MP. A piece of my mind. What I learned about adverse events from Captain Sully: it's not what you think. JAMA 2015; 313 (04) 361-362
    CrossrefPubMedGoogle Scholar
  • 12 Shanafelt TD, Balch CM, Bechamps G. et al. Burnout and medical errors among American surgeons. Ann Surg 2010; 251 (06) 995-1000
    CrossrefPubMedGoogle Scholar
  • 13 West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med 2018; 283 (06) 516-529
    Google Scholar
  • 14 West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association of resident fatigue and distress with perceived medical errors. JAMA 2009; 302 (12) 1294-1300
    CrossrefPubMedGoogle Scholar
  • 15 DeCaporale-Ryan L, Sakran JV, Grant SB. et al. The undiagnosed pandemic: burnout and depression within the surgical community. Curr Probl Surg 2017; 54 (09) 453-502
    CrossrefPubMedGoogle Scholar
  • 16 Hu YY, Fix ML, Hevelone ND. et al. Physicians' needs in coping with emotional stressors: the case for peer support. Arch Surg 2012; 147 (03) 212-217
    CrossrefPubMedGoogle Scholar
  • 17 West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet 2016; 388 (10057): 2272-2281
    CrossrefPubMedGoogle Scholar
  • 18 Zwack J, Schweitzer J. If every fifth physician is affected by burnout, what about the other four? Resilience strategies of experienced physicians. Acad Med 2013; 88 (03) 382-389
    CrossrefPubMedGoogle Scholar
  • 19 Shanafelt TD, Balch CM, Dyrbye L. et al. Special report: suicidal ideation among American surgeons. Arch Surg 2011; 146 (01) 54-62
    CrossrefPubMedGoogle Scholar
  • 20 Scott SD, Hirschinger LE, Cox KR. et al. Caring for our own: deploying a systemwide second victim rapid response team. Jt Comm J Qual Patient Saf 2010; 36 (05) 233-240
    CrossrefPubMedGoogle Scholar
  • 21 Dukhanin V, Edrees HH, Connors CA, Kang E, Norvell M, Wu AW. Case: a second victim support program in pediatrics: successes and challenges to implementation. J Pediatr Nurs 2018; 41: 54-59
    CrossrefPubMedGoogle Scholar
  • 22 Burlison JD, Scott SD, Browne EK, Thompson SG, Hoffman JM. The second victim experience and support tool: validation of an organizational resource for assessing second victim effects and the quality of support resources. J Patient Saf 2017; 13 (02) 93-102
    CrossrefPubMedGoogle Scholar
  • 23 Harris PA, Taylor R, Minor BL. et al; REDCap Consortium. The REDCap consortium: building an international community of software platform partners. J Biomed Inform 2019; 95: 103208
    CrossrefPubMedGoogle Scholar
  • 24 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research Electronic Data Capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
    Google Scholar
  • 25 Scott SD, Hirschinger LE, Cox KR. Sharing the load. Rescuing the healer after trauma. RN 2008; 71 (12) 38-40 , 42–43
    PubMedGoogle Scholar
  • 26 Clarkson MD, Haskell H, Hemmelgarn C, Skolnik PJ. Abandon the term “second victim”. BMJ 2019; 364: l1233
    CrossrefPubMedGoogle Scholar