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RfR Trauma Care Program

Rituals for Recovery to Launch Employee Wellness Program to Address Emotional Stress and Burnout among Care Providers Who Are Considered "Second Victims" of Traumatic Events.

“The problem is not bad people working in healthcare, it is that good people are working in bad systems that need to be safer.” To Err is Human: Building a Safer Health System

Often the demands of caregivers deny them the time and resources necessary to process feelings or grieve losses when an adverse patient event or mistake happens. As a consequence, health care workers often suffer life-altering burdens of anxiety, depression, substance use disorder and shame after an adverse patient outcome. Dr. Albert Wu named this burden "second victim syndrome" in his pivitol publication in 2000.

Second victim symptoms are the result of a traumatic patient care event in the healthcare or caregiver setting. These events can include near misses, patient adverse events, deaths or provider mistakes but really encompass any event that leads to significant mental stress on the part of the provider (otherwise known as the "second victim") Each second victim will have unique perspectives, needs, and emotions related to the event, and symptoms can occur in various timelines after the event.

Almost all providers experience some symptoms of second victim syndrome over the course of their careers.

The publication by Sachs CJ, Wheaton N. states;

A recent review of 18 studies involving 11,649 healthcare providers suffering from SVS found the following symptom prevalence:

  • Troubling Memories 81%
  • Anxiety/concern 76%
  • Anger toward themselves 75%
  • Regreat/remorse 72%
  • Distress 70%
  • Fear of future errors 56%
  • Embarrassment 52%
  • Guilt 51%
  • Sleeping Difficulties 35%

In addition it was noted SVS impairs provider cognitive functioning with 79% reporting difficulty concentrating. 

Providers with SVS were twice as likely to report burnout and a desire to leave their jobs. 

However, it is important to note that these risks were decreased if they perceived that their organizations supported them through response.

Most concerning of all, left unchecked severe or long-lasting symptoms of SVS are associated subsequent depression, PTSD, and suicide.

It is imperative that systems identify high-risk events and support providers in recovering and processing the event. Since SVS is a direct result of work demands government, social service and healthcare organizations have a duty to offer effective resources and implement programs to identify high-risk events and reduce the consequences of second victim experiences.

Sachs CJ, Wheaton N. Second Victim Syndrome. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

Through RfR’s Trauma Care program, specially trained teams are established within community care organizations to provide peer-to-peer support, mental health expertise, and team-debriefing sessions to staff members following traumatic events. The program will be available to non-profits, the social service system and and all employees of Health + Hospitals. Our programs are tailored to the unique needs of the providers they serve.

Enhancing Health Care Team Outcomes

Program Summary

Stage 1: Emotional First Aid Training

The first tier is all staff being aware of second victim syndrome, being aware of the signs and symptoms, and being willing to talk about second victim cases and provide peer support to each other.

Stage 2: Support by Trained Peers

The second tier consists of the peer support champions, who receive additional training to become the “trauma responsive care responders” who can be dispatched to meet with staff suffering from second victim syndrome in 1:1’s.

Stage 3: Support by mental health professionals

The peer support champions can then triage second victims to tier 3 resources that include psychology, psychiatry, employee assistance program, chaplain, and social workers.

The ultimate goal of the peer support champions is to provide immediate and personalized support to traumatized staff to take those with the disposition of dropping out or simply surviving to staff who recover in a healthy way and end up thriving.

Research conducted by Albert Wu, MD, the physician who coined the term “Second Victim,” indicates similar emotional support programs elsewhere have been shown to increase the overall safety culture and quality of care, as well as provide cost savings to the health care systems that successfully utilize them.

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