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High-risk Scenarios and Recovery Stages

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

Recovery Stages

Healing and recovery occurs in a predictable manner.

Six stages of second victim recovery have been identified as:

  1. Chaos and Accident Response
  2. Intrusive Reflections
  3. Restoring Personal Integrity
  4. Enduring the Inquisition
  5. Obtaining Emotional First Aid
  6. Moving On
    • Dropping out
    • Surviving
    • Thriving

Download a handout with more details (PDF).

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.

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