NHS doctors who become second victims - an exploratory study

This study aimed to understand the lived experience of UK NHS doctors who encountered second victim phenomenon following an adverse event and the role that medical leadership played in their trajectory.

Semi-structured interviews were conducted with eight NHS doctors. Data were analysed using Interpretative Phenomenological Analysis (IPA).

There emerged three superordinate themes describing the impact on the doctor, the perceptions of colleagues and the leadership support received.

Although the small sample size is consistent with the chosen research methodology, it remains an acknowledged limitation. This study did not specifically aim to explore suicidality among NHS doctors; however, given the importance of this issue, further research is clearly warranted. While some protected characteristics were represented in the sample, they were not sufficiently prominent to influence the findings meaningfully. Consequently, there is scope to examine potential psychosocial differences among doctors. The first author's extensive NHS career may potentially introduce bias. Finally, future research should incorporate a longitudinal research design to assess the long-term impact of second victim phenomenon on doctors and the effectiveness of support interventions.

The paper makes three recommendations: (1) NHS organisations should establish locally led peer support or buddy programmes. Additionally, the organisation should strive to reduce psychological morbidity through candid and open discussions about prevalence. (2) When exhibiting signs of distress, burnout or other maladaptive coping strategies are observable, medical leaders should take compassionate and deliberate action. (3) Medical leaders must demonstrate collective responsibility for fostering cultures that learn from and support doctors in their darkest hour following an adverse event.

This study broadens the extant knowledge base regarding second victim phenomenon among doctors, particularly doctors in the NHS. A doctor's well-being and, consequently, patient safety are jeopardised by exposure to persistent, invisible distress. In the field of medicine, incivility, abusive supervision and poor organisational and team cultures exacerbate distress.