FAQ

1.  What is meant by the term "second victim"?

The term "second victim" was coined by Albert Wu, MD, MPH in 2000 to acknowledge the phenomenon of emotional trauma in healthcare providers involved in patient care incidents with a negative patient outcome.  Dr. Wu is Professor of Health Policy and Management at the Johns Hopkins School of Public Health, and a leading expert on disclosure and the psychological impact of medical errors on both patients and caregivers. The term "second victim" was first used in a 2000 British Medical Journal.

2.  Who is affected?

Any healthcare provider who has been involved in an incident resulting in an adverse patient outcome can be affected by the second victim phenomenon.  In 2007 at  University of Missouri Health Care (MUHC) system,  almost one in seven staff members (175/1,160) reported they had experienced a patient safety event within the past year that caused personal problems such as anxiety, depression, or concerns about the ability to perform one's job.   Physicians, nurses, pharmacists, therapists and ancillary healthcare workers all have the potential to experience the second victim phenomenon.  Of course, each professional who has experienced or witnessed a traumatic event will experience it differently, and will exhibit an individual response.

3.  What kind of event can trigger the second victim response?

Although any untoward occurrence can precipitate a second victim response, the following types of events generally evoke the most severe reactions:

•  Unanticipated outcome for a child or young adult
•  Unexpected death of any patient
•  Error causing harm to a patient
•  Multiple adverse outcomes in a short time
•  Delay in identifying significant patient decline

4.  What kinds of reactions are possible?

Reactions run the gamut of human responses to any trauma. The literature describes a continuum from mild distractibility to suicidality.  Possible reactions are listed in this chart.

5.  Why is there a need for support for second victims?

While the second victim phenomenon is becoming more recognized, supports for second victims are currently lacking.  Few healthcare employers even give a second thought to the consequences of this phenomenon for both the victims and themselves.  In the MUHC study mentioned above, in which nearly one in seven clinicians experienced some of the effects of second victim phenomena, an alarming 68% of these clinicians reported they received no institutional support whatsoever.  If employing institutions do not provide support, or if the clinician no longer has an employing institution, non-affiliated support organizations must rise up and fill the gap.

6.  Why was this organization named Athena's Shield?

Athena is the ancient Greek goddess of wisdom.  She sprang, as a full-grown adult clad in armor, from the head of her father, Zeus.  She is known for her ability to strategize and for her strong sense of justice.  To me, Athena represents the warrior protectress, the strong advocate needed by the second victim for a full recovery.  Her archetype can be called upon to invoke personal strength, wisdom and fairness.