Second Victim in Nursing: I could have done more!

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Disclaimer: Although we are nurses by profession, we are not YOUR nurses. This article is for informational and educational purposes only, does not constitute medical advice, and does not establish any kind of nurse-patient or educator-student relationship with us. We are not liable or responsible for any damages resulting from or related to your use of this information.

Good morning everyone and happy new year! Thank you for joining us again! This is Sara and I wanted to discuss with you all a common topic that’s viewed as a taboo: Being a "second victim".

This is believed to be a professional who is involved in an incident that results in either potentially or actually harming someone. That would mean the individual being harmed is the first victim. Human error is to be expected, but what if your profession is to heal and a less than favorable outcome occurs? Stepping back from the anguish and guilt isn’t always as easy to do as it is to advise to someone. For some individuals, the trauma of harming another being is so severe that they aren’t able to return back to their profession. This trauma is not always experienced by novice nurses, the experienced nurse that has been doing this for years is not exempt, I assure you!

During my research, I was a bit devastated as I placed myself in some of these people’s shoes and felt how real this could be! Think about it, instead of giving 500 units of heparin subQ, you give it IV…it could happen! As someone who checks, and double checks, and sometimes triple checks, I still could very well make an error. I would blame myself but I would also analyze the situation. Was it my lack of knowledge? is it an opportunity to improve my process? Did I deviate from the standard and take a short cut? Sometimes things happen resulting in an adverse event. I provided this example because medication errors are the most common. I stress to everyone the importance of following the 6 rights of medication administration along with researching the medication you are administering to your patient. If medication requires a co-signature, it is there for a reason and do not override it as it is in place as a safety precaution.

I recently read about a nurse that administered the wrong dose to a patient. The nurse was known as a “healer” by all her colleagues and she made an error that would not only cost her the patient’s life, but also her own. No one goes into nursing with the intention of hurting the vulnerable. She mourned her patient along with the loss of her job, career, and identity. She was required to pay a fine and was unable to care for patients alone as part of her contract when she sought new nursing position. She found herself continuously and closely monitored and unable to practice with any autonomy. She knew this is the result of her actions. Her guilt and depression took over and she took her own life. Generally, we punish ourselves harshly as a result of mistakes, adverse events, and failure.

So what can you and I do about it? Let’s provide peer support! Situational awareness is imperative in nursing, so if you’re noticing your colleague is having anxiety or stress caring for their patients, reach out to them. Suggest seeking help as they may be suffering silently. If you yourself have experienced a traumatic event, please talk to someone about it. Most hospitals have employee assistance programs or maybe talk to your manager. Transparency and patient safety go hand in hand, and I for one believe that if we are able to talk about something that has been effecting us negatively, we can overcome it. Nursing is not always easy, nor will you always do every task perfectly.

I’d like to point out that my discussion today was not in anyway to frighten anyone but to bring awareness that mistakes happen and being a second victim is real. Here at ADPIE, David and I hope to provide you with as many tools to allow you to succeed. Sometimes topics like this one aren’t necessarily discussed in school and we would like to provide an educational space to talk about it. Follow this link for some recommendations by the Joint Commission if anyone is interested in reading them. We hope you tune in next week as we discuss another topic. So please continue to monitor...

*disclaimer: ADPIE is not an affiliate with the joint commission.*