Second victim phenomenon: a case study from Germany

The emotional toll of adverse events on health professionals is profound, and yet it's often overlooked in economic evaluations. This is what we refer to as the second victim phenomenon. The term was coined by Dr. Albert Wu, and later expanded in research by Susan Scott and many others, describing how clinicians, doctors, nurses, pharmacists, and others who are involved in patient harm events often experience guilt, anxiety, depression, and even post-traumatic stress disorder. But this doesn't just affect them personally. It also has ripple effects across the organization. Studies show that second victims are more likely to take sick leave, perform at reduced capacity, a phenomenon known as presenteeism, and ultimately leave their profession altogether. Defensive medicine, ordering unnecessary tests or avoiding high-risk patients is another costly consequence. And yet, many hospitals have no structured support systems in place. The silence and stigma surrounding these events only exacerbate the damage. It's not just a human tragedy; it's an economic one as well. The cost of replacing an experienced nurse or physician, the productivity loss to stress-related absence, and the decline in morale that affects the whole team. All of these add up. From an economic perspective, failing to support a staff after adverse events means absorbing avoidable costs. But there's another way: structured peer support programs, which we'll look at next. These programs not only help individuals recover, they help organizations retain talent, reduce error reoccurrence, and rebuild resilience and trust. So let's be clear, emotional safety is not a luxury; It's a necessity for sustainable, high-functioning health care, and it pays off.