coping with a terrible error by simon carley
TRANSCRIPT
a terrible errorSimon Carley
short stay
wants to go home
RETURN return
feel
panic
radiology
path
experts
professional self-image
personal
clinical
second victims
Medical Error: the second Victim A. Wu. BMJ 2000
Second victims are healthcare providers who are involved in an unanticipated adverse patient event, in a medical error and/or a patient related injury and become victimized in the sense that the provider is traumatized by the event.
Frequently, these individuals feel personally responsible for the patient outcome. Many feel as though they have failed the patient, second guessing their clinical skills and knowledge base.
Medical Error: the second Victim A. Wu. BMJ 2000
Second victims are healthcare providers who are involved in an unanticipated adverse patient event, in a medical error and/or a patient related injury and become victimized in the sense that the provider is traumatized by the event.
Frequently, these individuals feel personally responsible for the patient outcome. Many feel as though they have failed the patient, second guessing their clinical skills and knowledge base.
predictable course for second victims.
Chaos chaos
shame denial
embarrassment
flashbacks triggers
restoring personal integrity
obtaining emotional first aid
enduring the inquisition
Williams 1999
are we helpless?
what works?
resilience
It is not the stress… it is the state of mind,
that matters when one is stressed
Hans Selye
Personal Organisational Culture
what happened?
be aware prepare support
Be Kind
thank you
Why bother?
Enduring the inquisition
The inquisition
GMC
HIPAA
Families
Coroner
ED days
In no relationship is the physician
more often derelict than in
his duty to himself (herself).
monitor incidents contact supervisors
Mentors Parallel support for second victims
Other things - develop emotional understanding
Schwartz rounds - build emotional and psychological understanding of how people
feel not just what happens.Orga
nisa
tions
UnderstandingofselfandselfmasteryInteractionswithothersandwiderworldMeaningbeyondself-values-goals-focus
Positiveapproach-perspectivePersonalgrowthCareofhealth
Learningfromovercomingchallenges
understanding self social interactions
meaning beyond self health
learning from error
Orga
nisa
tions Contact clinical staff
Reaffirm your confidence Give time and space
Keep informed Let them know you care
Be visible to all staff members.Teach resilience
Guide don’t dictate
Clinicians get harmed tooYou may become a second victim
You will certainly meet second victimsThere is a predictable course to recovery
You can personally prepareYou can organisationally prepare
You can personally supportYou can organisationally support
FOR SUFFERERS
Be honestDon’t rationalise
Ask for help Prepare
Personal impact Professional impact
Serious event
Chaos
Intrusive reflections
Restoring personal integrity
Enduring the inquisition
Obtaining emotional first aid
Moving on
Dropping out
Surviving
Thriving
“a health care provider involved in an unanticipated adverse patient event, medical error and/or a patient related-injury who
become victimised in the sense that the provider is traumatised by the event.
“a health care provider involved in an unanticipated adverse patient event, medical error and/or a patient related-injury who
become victimised in the sense that the provider is traumatised by the event.
Frequently, second victims feel personally responsible for the unexpected patient outcomes and feel as though they have failed their patient, and feel doubts about their clinical skills
and knowledge base.”