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The Impact of Adverse Events on Clinicians

What's in a Name?

Wu, Albert W. MD, MPH*; Shapiro, Jo MD; Harrison, Reema PhD; Scott, Susan D. PhD§; Connors, Cheryl RN, MS; Kenney, Linda; Vanhaecht, Kris PhD**

doi: 10.1097/PTS.0000000000000256
Review Article: PDF Only

Unanticipated patient adverse events can also have a serious negative impact on clinicians. The term second victim was coined to highlight the experience of health professionals with these events and the need to effectively support them. However, there is some controversy over use of the term second victim. This article explores terminology used to describe the professionals involved in adverse events and services to support them. There is a concern that use of the term victim may connote passivity or stigmatize involved clinicians. Some patient advocates are also offended by the term, believing that it deemphasizes the experience of patients and families. Despite this, the term is now coming into widespread use by clinicians and health care managers as well as policy makers. As the importance of emotional support for clinicians continues to gain visibility, the terminology surrounding it will undoubtedly change and evolve. At this time, it may be most appropriate to label this important phenomenon in a way that local leaders are comfortable with—in a way that promotes its recognition and adoption of solutions. For example, for policy makers and health care managers, the term second victim may have value because it is memorable and connotes urgency. For support programs that appeal directly to health care workers, different language may attract more users. Debate concerning the benefits and drawbacks to this terminology will enhance and further drive its evolution, while helping retain our industry's focus on the importance of developing and evaluating programs to support clinicians in need.

From the *Department of Health Policy Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; †Center of Professionalism and Peer Support, Brigham Women's Hospital, Harvard Medical School, Boston, Massachusetts; ‡School of Public Health, The University of Sydney, Sydney, Australia; §Patient Safety and Risk Management, University of Missouri Health Care, Columbia, Missouri; ∥The Johns Hopkins Hospital, Baltimore, Maryland; ¶Medically Induced Trauma Support Services (MITSS), Chestnut Hill, Massachusetts; and **KULeuven Institute for Healthcare Policy, Department of Public Health Primary Care, KULeuven, University of Leuven, Leuven, Belgium.

Correspondence: Albert W. Wu, MD, MPH, FACP, Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Room 653 Baltimore, MD 21205 (e-mail:

The authors disclose no conflict of interest.

A.W.W. and J.S. are co–first authors.

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