Second and Third Victims Tip Sheet
When a patient is harmed, the impact extends beyond the clinical outcome. Patients and families may experience trauma as second victims, and clinicians and staff can suffer significant emotional distress as third victims. This tip sheet helps organizations respond with empathy, clarity, and structure to guide supportive actions after a serious safety event.
Who it’s for
- Patient safety, risk, and quality leaders
- Nurse leaders, physician leaders, and frontline managers
- Peer support teams, employee assistance, and HR partners
- Patient relations, experience teams, and social work
- Executive leaders overseeing safety culture initiatives
What it can be used for:
- Establishing or strengthening peer support and just culture practices
- Training leaders on how to respond to staff after difficult events
- Reducing burnout risk and supporting retention after traumatic events
- Informing policy, playbooks, and escalation pathways for event response
What’s inside:
- Situation: Signs a patient/family or staff member may need additional support
- Background: Why second/third victim experiences occur and how they show up
- Assessment: Risk factors, stress indicators, and points of vulnerability after events
- Recommendations: Practical steps for immediate response, follow-up, and resources
Access the Tip Sheet
A systematic review of 18 studies recognized the following symptoms of second victim syndrome: troubling memories, anxiety/concern, anger toward themselves, regret/remorse, distress, fear of future errors, embarrassment, guilt, and sleeping difficulties.
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