The Second Victim Phenomenon: Perspective of Canadian Radiation Therapists

Abstract

Introduction: Clinical incidents are an unfortunate reality in the health care system. Patients and their families are the first victims of these incidents. The health care providers involved in the error are considered the second victims. This research aimed to evaluate the level of awareness of the second victim phenomenon (SVP) in Canadian radiation therapists, determine the post-incident emotional and physical reactions experienced, and determine the existing and/or recommended systems for support.

Methods: Mixed method design comprised two phases. In phase I, Canadian radiation therapists were invited to view an informational presentation about the SVP and complete an online survey. In phase II, participants partook in an online discussion forum.

Results: Survey results indicate that 31% of respondents were previously aware of the SVP and 86% of respondents report having been involved in a clinical incident. In addition, the results confirm that Canadian radiation therapists who have been involved in health care-related incidents do experience emotional and physical reactions. Most respondents indicated they lacked appropriate organizational support to help them recover from the clinical incident. Support from a colleague is the preferred method of support immediately after the incident. Finally, survey respondents indicated a clear desire for implementation of defined processes for postclinical incident supports.

Discussion: The reported level of awareness of the SVP surprised the authors as it was anticipated to be lower; however, there is an obvious need for greater knowledge of the subject. Reported frequency of involvement in a clinical incident as well as the post-clinical reactions experienced are comparable for other health care providers as indicated in the literature. Survey results revealed that emotional and physical reactions were experienced to a greater degree in those unfamiliar with the SVP, indicating potential value to adding an educational component to radiation therapist's training programs as well as on the job training for staff in the workforce. Most respondents requested specific methods of support for recovery after a clinical incident. In addition, an unexpected number of radiation therapists indicated the need for a "no-blame" work environment, which was an unanticipated finding.

Conclusion: This study highlights the lack of awareness of the SVP in Canadian radiation therapists. It identifies the gap between the needs of the second victims and the perceived lack of supports offered by their facilities. This issue is important for organizations wanting to positively manage clinical incidents and create a culture of safety for the patients and employees.

Keywords: Second Victim; adverse events; just culture; medical error; patient safety; radiation therapist; radiation therapy.