Psychological responses, coping and supporting needs of healthcare professionals as second victims

Int Nurs Rev. 2017 Jun;64(2):242-262. doi: 10.1111/inr.12317. Epub 2016 Sep 28.


Aim: To provide an overview of healthcare professionals' psychological responses, coping strategies and supporting needs in the aftermath of an adverse event, thus informing health policy implications and future research in this aspect.

Background: Trauma experienced by healthcare professionals as second victims potentially provokes intense emotional distress, detrimental professional outcomes and imposes harsh long-term effects.

Methods: A systematic literature review was performed to synthesize the experiences and needs of second victims who are healthcare professionals being traumatized by an unanticipated adverse event, medical error or patient-related injury. CINAHL, Embase, PsycINFO, PubMed and Scopus databases were searched for relevant articles published in English from January 2000 to October 2015.

Results: Data extraction was performed for the 30 studies selected. Second victims experienced enduring intense negative psychological responses. They adopted multiple coping mechanisms and desired emotional and informational support.

Conclusion: Second victims experience substantial psychological impact which can be mitigated with supportive environments. It is imperative that subsequent research consider the potential factors affecting second victims' emotional experience, efficacy of coping strategies in facilitating recovery and obtain a comprehensive understanding of second victims' experience.

Implications for nursing and health policy: Nursing and health management's role in establishing organizational support structures is necessary to meet second victims' needs. This existing knowledge is significant to guide policy makers in developing a holistic and effective second victim support programme.

Keywords: Adverse Event; Coping Strategies; Psychological Responses; Second Victims; Supporting Needs.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adaptation, Psychological*
  • Emotions
  • Health Personnel / psychology*
  • Humans
  • Psychosocial Support Systems*
  • Stress, Psychological / etiology
  • Stress, Psychological / therapy*