Peer-to-peer support and the second victim syndrome

The COVID-19 pandemic has impacted everyone, especially those of us in health care.  Our way of practicing medicine has been changed; some would say forever. We find ourselves affected not only clinically but also emotionally.  As a result, clinicians are experiencing more stress and anxiety than ever before. These feelings are not new but have been heightened in the face of the pandemic.

Physicians are perceived as self-reliant, emotionally stoic, and pillars of the medical community. Society expects perfection from our health care system and turns to us in times of medical crisis. As clinicians, we need to recognize our humanity;  doctors are people too, with the same emotional needs as any other individual.  In fact, one could argue that medicine demands require an even greater level of emotional support than other professions.

So, what can we do?  It is important to acknowledge where the emotional stress comes from, so we can understand how to deal with it.  The term “second victim syndrome” was first coined by Dr. Albert Wu in 2000.  This refers to the phenomenon of a clinician becoming victimized by an unanticipated adverse medical event;  the patient is the primary victim, but the clinician is affected secondarily.  This syndrome can impact all health care team members, including doctors, nurses, therapists, pharmacists, and techs.  Examples include sudden death, missed diagnosis, medication error, complications of procedures, and malpractice lawsuits. These events trigger physical and emotional reactions, which in turn impact the clinician’s ability to perform at his/her optimal level.  In fact, Second victim syndrome has been associated with increased rates of burnout, substance abuse, and even suicide.

Now that we’ve identified what affects us, how do we address the issue?  This is where Peer-to-Peer Support becomes a vital part of the picture.  As the name implies, peer support is just that:  emotional support from colleagues to help the clinician navigate the signs and symptoms of second victim syndrome.  This assistance is provided through confidential, non-judgmental sessions wherein the clinician is afforded a “safe space” to discuss his/her feelings.  Peer supporters are trained individuals.  Techniques of active listening and open-ended questions allow the clinician to debrief, often gaining insight into their emotional state.  The goal is to buoy the clinician through the acute event, providing “emotional first-aid” as the initial step to recovery.

Where can we find peer-to-peer support?  Although some health care facilities are offering this service, many still do not. Acknowledging that we are not invincible superhumans is an important first step towards achieving the emotional fitness we all deserve.  Remember, our responses as “second victims” are the normal reactions of human beings and deserve compassion and support from our colleagues.

Susan Wilson is an emergency physician and physician coach.

Image credit: Shutterstock.com

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