Helping the Second Victim

Abdus Salam Khan, MD FACP
March, 2017


In my last blog we discussed the phenomenon of being second victim. Working in the medical field it is easy for all of us to understand that we are so vulnerable to become second victim anytime. It is because of dynamics of healthcare delivery which is prone to errors due to:

  • Complex clinical conditions.
  • Poorly designed processes
  • Inadequate communication pattern.

Thus a planned and well-thought-out intervention may have the potential to result in patients safety event. With each safety event there is a potential second victim. In order to prevent the second victim syndrome we have to work on preventing the safety event by actually promoting the safety culture in our institutions.By improving our care delivery process and communication we can avoid creating second victims. With the same token it is imperative that each one of us to develop and promote safety culture and also spot second victim in each safety event.

It is very well known that Pakistan is far behind in safety culture but it is giving me a sense of encouragement that we see signs of involvement of physicians in this field, so we are hopeful that our healthcare community will embark on this important aspect of delivery of care. Associated with that it is our hope that we become compassionate about our team players who get involved into safety events and become second victims.

Let me now delve into dealing with the second victim from management perspective.

People will become second victim frequency:

  • Feel personally responsible for the unexpected patient outcome.
  • Feel as though they have failed the patient second-guessing their clinical base.
  • Second-guess the knowledge base.

Research has shown that second victims develop their own way of coping. They also found that they went through similar stages described in the last blog. Let me go through them again for our memory refreshment:

  • Chaos and accident response.
  • Intrusive reflection.
  • Restoring of personal integrity.
  • Enduring the Inquisition.
  • Seeking emotional comfort.
  • Moving on.

The time taken to go through these stages vary and is dependent upon different variables. It includes the professional stage of the victim, organizational support system and other professional help available to the victim, among other variables. In any organization, the second victim should be supported so they could become meaningful part of the organization again. Denham has created five rights of second victim. These are:

  1. Treatment that is just.
  2. Respect.
  3. Understanding and compassion.
  4. Supportive care.
  5. Transparency an opportunity to contribute.

Hospitals have a responsibility to its employees to provide safe environment of care as a preventive strategy for second victim and also to care for the second victim. Early recognition of second victim and then formal program to assist healthcare professionals who becomes second victim and providing them with vocational, professional and emotional support are some of the ways adopted by organizations.

Although looking through the eyes of the society the healthcare workers are seen as strong with no chances of an error, so it becomes an uneasy concept to talk about victim-hood for healthcare professionals. This is one of the reasons that people don’t come forward willfully when they become second victims. Creating atmosphere of safety and preventing safety events help our first victim as well as the second victims.

It is my hope that we work on both ways of preventing safety events as well as supporting second victim in our healthcare systems to enhance our quality of care

I can be reached at

This entry was posted in Administrator's Post. Bookmark the permalink.