Second Victim Syndrome

Health care workers often expect perfection from themselves, and societal opinions reinforce this expectation. However, perfection will always be an elusive goal, even for this group of hard-working, self-sacrificing, and altruistic humans. For decades, the system that trains and accredits medical providers, especially physicians, denied providers their own human imperfections and concomitant vulnerabilities. Mistakes in medicine were blamed on “bad” and/or imperfect physicians. Finally, in the 21 century, the Institute of Medicine admitted an undeniable truth in the oft quote publication, To Err is Human: Building a Safer Health System, when they asserted that “the problem is not bad people in health care--it is that good people are working in bad systems that need to be made safer.” Despite this acknowledgment, those indoctrinated by the medical system continue to expect perfection from themselves and are more often than not denied the time and resources necessary to process feelings and grieve losses when an adverse patient event or mistake occurs. As a consequence, health care workers often suffer life-altering burdens of anxiety, depression, and shame after an adverse patient outcome. Dr. Albert Wu named this burden “second victim syndrome” in his pivotal publication in 2000. In this framework, the first victim is the patient and the second victim is the health care provider(s). Though Wu initially discussed the second victim in relation to patient harm after a physician error, the term has since been expanded to include the burdens of anxiety, depression, and shame that any healthcare provider feels after any traumatic adverse and/or unexpected patient care experience.