Second victims, organizational resilience and the role of hospital administration

Abstract

Second victims are practitioners involved in an incident that (potentially) harms or kills somebody else, and for which they feel personally responsible. Professional culture and the psychology of blame (and shame) influence how second victims are viewed and dealt with. This paper reviews the status of second victimhood in healthcare - both its symptomatology and organizational responses. Then it considers the problematic nature of "human error" in healthcare and sets this against the psychological backdrop of healthcare professions, seeking cultural-historical explanations in assumptions of actor autonomy and professional identity. It concludes by drawing links between the psychological resilience of the individual practitioners involved in an incident and the resilience of an organization's safety culture.