Constructive intervention with respectful empathy can prevent future errors, salvage careers and self confidence, avoid burnouts and breakdowns, and create a much more functional system all around, Wu says.
What should always happen after such an incident is that the medical staff should make the incident widely known, so that everyone can benefit from the knowledge of what happened, instead of just one person, Wu says. "System flaws underlie the problem and allow it to happen."
"If people are consistently beaten up when there's a bad outcome, you create a climate in which no one talks about anything, and a conspiracy of silence leads to mistakes being repeated."
Most people in healthcare realize there's a problem with second victim psychological sequelae, but they think of it as a case-by-case thing. "There's been no organized recognition, no policy or support services for people with these problems."
Now, surveys that ask providers these questions are finding that as many as half of certain high acuity doctors and nurses "can think of an incident in which they would describe themselves as being the 'second victim,' " Wu says.
It's been more than a decade since Wu wrote his piece, but organized institutional structures are finally emerging to help providers grapple with the emotional turmoil they experience, whether or not their actions have caused a mistake.
Among the first such programs started in 2009, the forYOU Team, is the brainchild of University of Missouri Healthcare's patient safety officer Susan Scott, RN. Scott says she got the idea from Wu.