In the event of an adverse event associated with care, attention rightfully focuses on the patient. However, the healthcare professional involved can also be deeply affected. This is referred to as the healthcare worker as a “second victim”.

This situation corresponds to emotional distress that can include guilt, anxiety, loss of confidence, fear of judgment from others, or medico-legal concerns. This reaction is frequent, normal, and documented. When it is not recognized or addressed, it can impair the professional's health, their clinical practice, and directly impact patient safety.

Identifying a Second Victim Situation in a Healthcare Worker

Support should be offered as soon as a serious adverse event occurs or when a professional exhibits unusual signs, such as:

• withdrawal or isolation,
• excessive guilt or rumination,
• persistent anxiety,
• marked medico-legal concern,
• changes in usual professional behavior.

The role of healthcare managers and colleagues is to identify these signs early and create a space for support.

This is not about analyzing the event, evaluating practices, or assigning blame.

What message should be given to a healthcare worker who is a second victim?

The first contact should be simple, clear, and non-judgmental. The key message is:

“What you are feeling is common after this type of event. You don’t have to deal with this alone.”

This message acknowledges the emotional impact, normalizes the reaction, and facilitates access to help, without delving into technical or organizational analysis.

Supporting a second victim: the role of the healthcare manager

The healthcare manager plays a central role in supporting second victims. When possible, the internal resources of the institution should be mobilized as a priority:

• institutional psychologist or support unit,
• occupational health service,
• psychology center,
• quality officer, risk management officer, or second victim liaison officer.

The goal is not only to inform, but to make seeking support legitimate, accessible, and non-stigmatizing. The framework facilitates networking and secures the process.

External Resources for Healthcare Professionals in Difficulty

If the professional does not wish to or cannot mobilize internal resources, it is essential to provide them with reliable external solutions that are immediately accessible.

• SPS Association – Healthcare Professional Support
  National Helpline: 0805 23 23 36
  24/7 support from trained professionals.
• National Council of the Order of Physicians (CNOM)
  Helpline: 0800 288 038
  Support and guidance system for physicians in difficulty.

In case of medico-legal concerns, reminding them of the existence of professional liability insurance or legal protection helps also to reduce anxiety and restore a sense of security.

Second Victim: Attitudes to Avoid

Certain reactions can worsen the professional's suffering and should be avoided:

• minimizing their feelings,
• analyzing the event immediately,
• looking for someone to blame,
• promising there will be no consequences,
• imposing an immediate return to risky activity while the emotional impact persists.

When to Strengthen Support for a Second Victim Healthcare Worker?

If the professional is experiencing intense distress, major disorganization, suicidal thoughts, or a risk to themselves or patients, management must act without delay:

• activate occupational health services,
• referral to specialized psychological support,
• temporary removal from clinical activity if necessary.

Second victim and patient safety: an inseparable issue

Supporting a second victim is neither incidental nor optional. It is an essential action for:

• patient safety,
• preventing psychosocial risks,
• developing a just and learning culture in healthcare facilities.

Supporting professionals after an adverse event directly contributes to the quality, reliability, and safety of care.

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