Another Look at the Terms “Second Victim” & “Third Victim”

Authors: Melissa D Clarkson, assistant professor, Division of Biomedical Informatics, University of Kentucky and Helen Haskell, President, Mothers Against Medical Error

The term “second victim” is frequently used to describe healthcare professionals who are involved in a medical error. This term has been disseminated by both academic researchers and programs to promote quality and safety in healthcare. To see how pervasive the term has become, type “victim of medical error” into a Google search—you will see that the majority of results are on the topic of the second victim.

If there is a second victim, why not a third? Healthcare organizations are now considered by some to be the third victim.

There is no doubt that physicians and nurses need compassion and support after a tragedy of patient harm, but using the term “victim” is not appropriate. By referring to themselves as victims, healthcare professionals and institutions signal that they believe much of patient harm is random, caused by bad luck, and simply not preventable. Patient safety programs are effective only if we confront the reality that healthcare systems, processes, and professionals can become unintentional agents of harm, and that much of this harm is preventable.

The victim mindset also affects individual and institutional responses to patient harm. Victims bear no responsibility. Where there is no responsibility, there is no accountability. With no accountability, we do not move toward the goal of zero preventable deaths in our hospitals.

Healthcare is an industry of change—new technologies, new procedures and treatments, new approaches to delivering care, and new perspectives about how providers and patients work together. The labels “second victim” and “third victim” move us away from the goal of a patient-centered environment, so terminology needs to change to. It’s time to abandon the terms “second victim” and “third victim”.

Read the full BMJ article at https://www.bmj.com/content/364/bmj.l1233