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

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

Identifying a Second Victim Situation in a Healthcare Worker

Support should be provided as soon as a serious adverse event occurs or when a healthcare professional exhibits unusual symptoms, such as:

• withdrawal or isolation,
• excessive guilt or rumination,
• persistent anxiety,
• a significant medical-legal concern,
• changes in normal professional behavior.

The role of healthcare managers and colleagues is to recognize these signs early on and create a supportive environment.

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

What message should be conveyed to a healthcare worker who is a secondary victim?

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

“What you’re feeling is common after this kind of event. You don’t have to go through this alone.”

This message acknowledges the emotional impact, validates the reaction, and makes it easier to get help, without getting into technical or organizational details.

Supporting a second victim: the role of the healthcare manager

The healthcare manager plays a central role in supporting secondary victims. Whenever possible, the institution’s internal resources should be prioritized:

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

The goal is not only to provide information, but also to make seeking support a legitimate, accessible, and non-stigmatizing process. The framework facilitates networking and ensures the process is secure.

External Resources for Healthcare Professionals in Need

If the professional is unable or unwilling to draw on internal resources, it is essential to provide them with reliable external solutions that are immediately available.

• 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 need.

In the event of medical-legal concerns, reminding them that professional liability insurance or legal protection is available can also help reduce anxiety and restore a sense of security.

Second Victim: Attitudes to Avoid

Certain reactions can exacerbate the professional's distress and should be avoided:

• downplaying their feelings,
• analyzing the event immediately,
• looking for someone to blame,
• promising that there will be no consequences,
• forcing a return to risky behavior while the emotional impact still lingers.

When Should We Increase Support for a Healthcare Worker Who Is a Secondary Victim?

If a healthcare professional is experiencing severe distress, significant disorganization, suicidal thoughts, or poses a risk to themselves or patients, management must act immediately:

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

Second victim and patient safety: an inseparable issue

Supporting a second victim is neither incidental nor optional. It is an essential step in:

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

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

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