Abstract
ObjectiveTo describe how front-line managers of maternity wards provide support to midwives as second victims in the aftermath of an adverse incident. DesignA qualitative study using critical incident technique and a content analytic approach of semi-structured in-depth interviews. SettingMaternity wards in 10 Norwegian hospitals with more than 200 registered births annually were included in the study. ParticipantsA purposeful sample of 33 midwives with more than two years’ working experience described 57 adverse incidents. FindingsMaternity ward managers utilised four types of practices to support midwives after critical incidents: management, transformational leadership, distributed leadership and laissez-faire leadership. Key conclusions and implications for practiceThe study shows that proactive managers who planned for how to handle critical incidents provided midwives with needed individual support and learning. Proactive transformational leadership and delegating roles for individual support should be promoted when assisting second victims after critical incidents. Managers can limit the potential harm to second victims by preparing for the eventuality of a crisis and institute follow-up practices.
Highlights
Normal, healthy pregnancies are not entirely without risks of complications and death
Managers can limit the potential harm to second victims by preparing for the eventuality of a crisis and institute follow-up practices
A specific definition was posed by Scott et al, 2009 (p. 326) describing a second victim as “healthcare providers who are involved in an unanticipated adverse patient event, in a medical error and/or a patient related injury and become victimised in the sense that the provider is traumatised by the event
Summary
Healthy pregnancies are not entirely without risks of complications and death. Unforeseen and adverse clinical incidents might occur, even with women designated as low risk. The attending midwife may experience significant personal and professional distress after an adverse outcome; in that sense, he or she is a second victim, a term conceived by Wu in 2000. 326) describing a second victim as “healthcare providers who are involved in an unanticipated adverse patient event, in a medical error and/or a patient related injury and become victimised in the sense that the provider is traumatised by the event. 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.”
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