Second Victim?

March 26, 2017

“A tragic accident happened today on main street. A young child was killed when the car she was in collided with another car that was turning left at an intersection. A second victim, the driver of the other car, was not injured but feels traumatized by the event.”

 

This fictional news story is meant to draw attention to the use - or misuse - of the term "second victim." Can the person who caused the accident, or who feels responsible for the death of the child, be considered a victim? Would he or she want to be called a victim?


Much of the work I do in supporting health professionals is derived from the patient safety movement and inspired by the work of Albert Wu and Sydney Dekker. Wu coined the term "second victim" and Dekker adopted the term to describe a health professional who makes a serious mistake; the first victim is the patient who was harmed, while the second victim is the health professional who is traumatized by the event.

 

Dekker and Wu’s work on exploring the nature of the emotions and reactions of individuals who make mistakes has brought attention to the impact of mistakes on health professionals, and has made a significant contribution to our understanding of this situation. However, it is time to stop using the label “second victim” as it was never appropriate. Why?

  1. The label of “victim” does not resonate with health professionals: The word “victim” implies weakness, and is often associated with the word “hapless” which means pathetic or pitiable. Health professionals are not seeking to be pitied; they want to be seen as professional and competent.

  2. The label “victim” implies health professionals do not have a role to play in the incident: When a mistake is made, the health professional is part of something that happened to someone else – it did not happen to them. True, they can be traumatized by a mistake they made, but traumatized is not the same as victimized. The word victim implies that something has been done to someone that they had no control over.

  3. Calling the health professional a victim demeans the impact of the mistake on the patient: There is a danger in using the term “second victim” for the health professional, as it implies that the harm a patient receives is comparable to the harm a health professional receives.

I do not suggest a different term to describe health professionals who make mistakes; in fact, it is best not to create a term that risks pathologizing them and regards them as psychologically abnormal or unhealthy. Rather, let’s just talk about supporting health professionals after an adverse event and through the psychological trauma of coping with a mistake.

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©2016 by Diane Aubin, MSc, PhD. Proudly created with Wix.com