ISSUES IN NURSING: Don't abandon the “second victims” of medical errors
Judy Smetzer BSN, RN

February 2012 
Volume 42  Number 2
Pages 54 - 58
  PDF Version Available!

LAST YEAR, a veteran pediatric nurse took her own life seven months after making a mathematical error that led to a fatal overdose of an electrolyte. After investigating the event, hospital leaders had made the difficult decision to terminate the nurse's employment after 27 years of service for undisclosed reasons, including factors not directly associated with the event.To satisfy state licensing disciplinary actions, the nurse agreed to pay a fine and accepted a 4-year probation that included medication administration supervision at any future nursing job. Just before her death, she'd successfully completed an advanced cardiac life-support course to qualify for a flight nurse position. But this and countless other efforts produced no job offers, increasing her isolation. As a testament to her longstanding compassionate and competent nursing care, many patients and families who received care from the nurse attended her memorial service to honor her.Although we don't know all the details of the nurse's heartbreaking decision to take her own life, we recognize that the healthcare industry as a whole has not widely communicated or implemented effective support mechanisms to address the deeply personal, social, spiritual, and professional crisis often experienced by the "second victims" of fatal errors.1 The first victims of medical errors are the patients who are harmed and their families. The second victims are the caregivers and staff who sustain complex psychological harm when they've been involved in errors that injure patients in their care.1-4 We're all implicated in this nurse's death by our tacit acceptance of the way we currently treat-or fail to treat-these second victims.Not too long ago, we kept secrets about medical errors. Today, we may be making headway with improved reporting and transparency of medical errors. But too often, we remain silent and abandon the second victims of errors-our wounded healers-in their time of greatest need.5In the very best of

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