What Is the Lived Experience for Doctors When They Are Involved in a Serious Incident? A Descriptive Phenomenological Analysis

Abstract

Within the National Health Service (NHS), when a serious incident (SI) occurs that harms a patient, understandably, the patient and their families are the primary focus. However, Wu (2000) recognised that the medical doctors involved in the SI, whom he termed “second victims”, can also experience psychological distress. This research aimed to explore the lived experiences of second victims, to better understand the second victim phenomenon, as given. The rationale for this research is highlighted through a critical review of the relevant existing literature, which revealed this to be predominately empirically driven, or otherwise interpreted or thematicised. Seven medical doctors were interviewed utilizing a semi-structured interview questionnaire. A Descriptive Phenomenological Analysis was undertaken to conduct an in-depth analysis of the data. The data were sectioned into meaning units and further scrutinised, to identify any psychologically sensitive elements. These were then transformed into nine constituents, which were synthesised to construct the general psychological second victim phenomenon. The findings indicate that doctors experience profound psychological distress at the moment they realise a SI has occurred, from which they never fully recover, concealing and suppressing the emotions the SI has provoked to their own psychological detriment. They feel changed, subsequently altering their work practices, becoming hypervigilant and avoidant. Their self-identities are damaged along with their sense of expertise as doctors, with symptoms indicative of post-traumatic stress disorder manifesting. Nonetheless, they do not consider seeking psychological support, as it is not a part of the clinical culture they have been socialised into since medical school. These findings provide a unique insight into the lived experience of doctors who have been involved in SIs. The clinical implications are discussed in the context of the current literature, leading to recommendations for training and psychological support for clinicians as crucial interventions to help alleviate the psychological distress of second victims.