This post was co-authored by Amanda Fernandes and Robert T. Muller, Ph.D.<\/p>\n
\u201cThings went poorly for this newborn with a complex congenital anomaly, and I felt entirely responsible due to my decision,\u201d says Steven Stylianos, professor and chief of the division of pediatric surgery and surgeon-in-chief of the Bristol-Myers Squibb Children\u2019s Hospital, in an interview with The Trauma<\/a> and Mental Health Report. Despite the tragic outcome, he remained personally involved in the infant\u2019s care, speaking with the parents daily until the baby passed away. <\/p>\n In 2000, the Institute of Medicine released To Err is Human: Building a Safer Health System<\/a>, a book that estimated as many as 98,000 preventable patient deaths each year in the United States due to medical errors. <\/p>\n The same year, Albert Wu, professor and general internist at Johns Hopkins Medicine, coined the term second victim syndrome<\/a> (SVS) to highlight the lasting effects of medical complications on healthcare professionals. He explains that the term \u201csecond victim\u201d reflected his belief that health workers can be \u201cinjured by the very same flaws in the healthcare system that cause patient harm.\u201d <\/p>\n The term SVS is used to describe the physical, psychological, and emotional impacts experienced by clinicians following their role in medical complications. While patients are recognized as the first victims in a medical complication, the concept of SVS acknowledges the suffering of healthcare providers, marked by shame<\/a>, trauma, and guilt<\/a> because of these incidents. <\/p>\n Those affected in this way may experience insomnia<\/a>, guilt, isolation, intense sadness, depression<\/a>, flashbacks, and persistent self-doubt. These intense characteristics can lead to burnout<\/a>, deeply impacting one\u2019s personal and professional trajectories for prolonged periods of time. In fact, a literature review<\/a> including over 27,000 surgeons revealed that burnout was associated with a 2.5-fold increased risk of medical error, furthering the cycle of pain and trauma.<\/p>\n Additionally, research<\/a> shows that 50% of healthcare professionals will experience “second victim” feelings at least once in their careers following involvement in an adverse event. This tends to be especially pronounced among surgeons, like Stylianos, whose roles carry higher levels of risk, stress<\/a>, and complexity. A 2024 study also revealed that, in the aftermath of a surgical error, some surgeons resort to maladaptive coping mechanisms, with 6.5%<\/a> reporting the use of alcohol<\/a> and other substances as a means of managing their distress.<\/p>\n Furthermore, the weight of a complication can be exacerbated by an internalized belief among surgeons that the error was entirely their fault. This sense of personal responsibility is often reified within healthcare systems, where such accidents are frequently met with investigations, punishments, or judgments of incompetence. As a result, second victims who suffer in silence often experience a steady decline in job satisfaction, questioning their abilities even to the point of stepping down or quitting medicine entirely.<\/p>\n Wu\u2019s work in describing the term SVS as a potential issue among healthcare professionals helped recognize the systemic factors that may contribute to medical errors or complications. Recent discussion around SVS is geared toward shifting the blame away from individual clinicians, while also working to reverse the deeply ingrained culture of perfectionism<\/a> that exists in healthcare systems today. <\/p>\n These emotions can be strong, for surgeons and others, and so it is important to address them soon after an adverse event to facilitate better outcomes for healthcare professionals. Stylianos states, \u201cThe most important act to begin healing right after a serious adverse event is speaking with a peer and venting emotions to someone who understands the visceral feelings, someone who is non-judgmental, supportive.\u201d<\/p>\n Peer support has emerged as one of the most effective interventions for helping second victims cope. In one assessment of a surgery-specific peer support program, 81%<\/a> of participants reported a positive impact on the culture of safety and support within their department. <\/p>\n