Caring for the caregiver following an adverse event

Abstract

In this article, we review the potential for adverse impacts on the clinician following a medical error or poor clinical outcome. Second victim syndrome, its symptoms, risk factors, natural history, and possible outcomes are described. We also discuss the important role of organizational leadership and culture and highlight possible programmatic interventions designed to support clinicians following an adverse event.

Building a critical incident peer response team: A full theatre team welfare intervention

“…Most anaesthetists will be involved in several critical incidents through their career, starting during their anaesthetic training, 1 with a cumulative deleterious effect on their mental health and clinical functioning. 1 –4…”

“…The impact of cumulative stressors in healthcare workers is evident, 4,7,9,10,12,13 with high rates of burnout and suicide especially among anaesthetists. 3 Absenteeism, substance use, and relationship breakdown have all been attributed to work stress in emergency service workers.…”

“…8,12 The authors, who have experience delivering group ‘debriefing’ conversations as an educational tool after simulated crises, were increasingly asked to offer psychological debriefs after real-life crises in the operating theatre, both by staff and by management. The frequency of these requests, and the growing evidence base reflecting harm to those involved in providing care during critical incidents (second victims) 4,5,10,11,13 made the need for a welfare intervention apparent. When the authors proposed a formal process for the support of teams after critical incidents, with appropriate training of facilitators, they received quick support from the relevant executive groups.…”

“…Most anaesthetists will be involved in several critical incidents through their career, starting during their anaesthetic training, 1 with a cumulative deleterious effect on their mental health and clinical functioning. [1][2][3][4] A critical incident is any significant event in the workplace that threatens to overwhelm the coping mechanisms of the staff members involved, with the potential to produce strong emotions, thoughts or behaviours that may result in the inability to function normally. 5,6 Critical incidents are not specific to healthcare, but many examples can be seen in the work of healthcare providers.…”

“…1,3,5,8 A support system that gives individuals autonomy and an active role in developing their own recovery pathway is thus fitting to reflect these differing responses. 11 The impact of cumulative stressors in healthcare workers is evident, 4,7,9,10,12,13 with high rates of burnout and suicide especially among anaesthetists. 3 Absenteeism, substance use, and relationship breakdown have all been attributed to work stress in emergency service workers.…”