There are several types of clinical events that can evoke a second victim response. Examples of high-risk situations that may induce a stress response include:
- Patient who “connects” to health care professional’s own family
- Unanticipated clinical event involving a pediatric patient
- Unexpected patient death
- Preventable harm to patient
- Multiple patients with bad outcomes within a short period of time within one clinical area
- Long-term care relationship with patient death
- Clinician experiencing his or her first patient death
- Failure to detect patient deterioration in timely manner
- Death in a young adult patient
- Notification of pending litigation plans
- Community high-profile patient or event
- Health care professional who experienced needle stick exposure with high-risk patient
- Death of a staff member or spouse of a staff member
Healing and recovery occurs in a predictable manner.
Six stages of second victim recovery have been identified as:
- Chaos and Accident Response
- Intrusive Reflections
- Restoring Personal Integrity
- Enduring the Inquisition
- Obtaining Emotional First Aid
- Moving On
- Dropping out
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Triggering has been defined as reliving the initial event when an external stimulus, such as a similar clinical situation, is presented. Triggering may occur at any time following the event by a random number of variables that the caregiver encounters.
Different factors have been described as triggering fresh memories of an old event. Examples of common triggers are taking care of a patient in the exact location of the original event, treating a patient with a similar name or similar diagnosis or treating of the original patient. When the memory is triggered, similar physical or psychological symptoms may return.