Supporting the Second Victim
14 Sep 2017
A patient dies a few hours after being reviewed and discharged by one of your colleagues. The patient's death is reported to the Coroner. The family complains to AHPRA about your colleague’s management.
Over the next few weeks you notice your colleague has become increasingly withdrawn and looks unwell. What can you do to help?
Doctors who are involved in a complaint, or other medico-legal investigation, can experience significant morbidity.
A recent survey found that:
- 16.9% of doctors with a current or recent complaint reported moderate to severe depression (compared to 9.5% of doctors with no complaints)
- 15% of doctors with a current or recent complaint reported moderate to severe anxiety (compared to 7.3% of doctors with no complaints)
- doctors with a current or recent complaint were 2.08 times more likely to report thoughts of self-harm or suicidal ideation.
Supporting the second victim: what can you do?
A second victim is a healthcare provider who is involved in an unanticipated adverse patient event, in a medical error and/or a patient related injury, and becomes victimised in the sense that the provider is traumatised by the event. The second victim frequently feels personally responsible for the patient outcome and may feel as though they have failed the patient, second guessing their clinical skills and knowledge base.
Research has shown that the most popular support system for doctors after an adverse patient event are healthcare peers.
To support a colleague, you can:
- encourage a description of what happened - begin by accepting this assessment and not minimising the importance of the event
- ask about and acknowledge the emotional impact of the event – “This must be very difficult for you. How are you doing?”
- identify other supports – a medical defence organisation, a treating GP or the Doctors’ Health Advisory Service
- consider sharing some of your own experiences with stressful situations, such as errors and complaints.
An AHPRA or Coronial investigation can take many months, and sometimes even years, to reach a conclusion. If a Coronial Inquest is held, the hearing will not take place until a few years after the death of the patient.
And so, remember to keep in touch with your colleague, and ask: “R U OK?”
More information about dealing with the stress of adverse events and medico-legal issues can be found here.
This blog contains general information only. We recommend you contact your medical defence organisation or insurer when you require specific advice in relation to medico-legal matters.
My Career Journey with Dr Nick Coatsworth
Dr Nick Coatsworth is an expert in health policy, public administration and a practising infectious diseases physician. He held a national role in the Australian response to COVID-19 as Deputy Chief Medical Officer of Australia, becoming one of the most recognised medical spokespeople during the pandemic. Nick engaged the Australian community through a variety of media platforms most notably as the spearhead of the national COVID-19 vaccination campaign. Dr Micheal Gannon, Obstetrician & Gynaecologist, sits down with Dr Nick Coatsworth to discuss Nick's medical career journey, and what insights and advice he has for junior doctors. MDA National would like to acknowledge the contributions of MDA National staff, Members, friends and colleagues in the production of the podcast and note that this work is copyright. Apart from any use permitted under applicable copyright law, you may not reproduce the content of this podcast without the permission of MDA National. This podcast contains generic information only, is intended to stimulate thought and discussion, and doesn’t account for requirements of any particular individual. The content may contain opinions which are not necessarily those of MDA National. We recommend that you always contact your indemnity provider when you require specific advice in relation to your insurance policy or medico-legal matters. MDA National Members need to contact us for specific medico-legal advice on freecall 1800 011 255 or email advice@mdanational.com.au. We may also refer you to other professional services.
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Career complications and contending with uncertainty
Among the many challenges of the COVID-19 pandemic for junior doctors is how to respond to medical training impacts and career uncertainty. In this podcast, Dr Caroline Elton (a psychologist who specialises in helping doctors)and Dr Benjamin Veness (a Psychiatry registrar) share advice for coping with medical training and career delays, disruptions and unknowns.
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