The “Second Victim” – Nurses’ Coping with Medication Errors Comparison of Two Decades (2005-2018)

Background: Medication errors may be a critical event for the patients and caregivers involved. The performance of an erring worker, might be detrimental in the private and organizational life. This situation is known as the “secondary victim”. Objectives: To examine the affect of medication errors on the mental state and function of the caregiver who erred: a comparison between findings in 2005 versus its findings in 2018. Design: The research was conducted in the qualitative method. A semi-structured interviews were held with the participants. The data were processed by means of content analysis. Participants: 40 nurses from a general hospital in central Israel who had made an error in the administration of medication. Ethical considerations: The research was approved by the institutional Helsinki committee. Findings: severe emotional consequences commenced immediately after the incident and continued for several days. They were expressed by fear, anxiety, self-blame, shame etc. The participants’ reactions were grouped as: “Taking responsibility”, “Immediate stress response”, “Why did this happen to me”, “Dilemma - whether to tell the patient and his family”, “The staff’s response to the mistake”, “Fear of punishment” versus “In the past there was fear to tell, today there isn’t, anymore”, “The culture of learning and not punishing” and “The emotional impact over time”. Discussion: The ongoing emotional distress that characterized some of the participants was similar to PTSD. The main differences between the findings after more than a decade were the perception of the organization as investigative rather than blameful, which enabled better functioning. Conclusions: workplaces should plan in advance for such events and offer support mechanisms for the “second victim” regardless of the inquiries and examinations held by the risk management unit.