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Preventive Support Strategies for the Second Victim Phenomenon in Nurses: A Mixed-Method Study.

Hanseulgi Lee¹, Nam-Ju Lee^1,2

¹College of Nursing, Seoul National University, Seoul, South Korea.

International Nursing Review

|June 15, 2026

Summary

Nurses need enhanced support for the second victim phenomenon, which causes distress after patient safety incidents. Developing preventive strategies and integrating them into healthcare systems is crucial for supporting affected nurses.

Keywords:

mixed methods nurses nursing policy patient safety incident second victim work environment

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Area of Science:

Nursing
Healthcare Professional Well-being
Patient Safety

Background:

Patient safety incidents can lead to the second victim phenomenon, causing significant psychological distress among healthcare professionals.
While post-incident support has been explored, there's a recognized gap in preventive strategies, particularly for nurses.

Purpose of the Study:

To identify nurses' specific needs for preventive support concerning the second victim phenomenon.
To develop consensus-based strategies for mitigating the impact of the second victim phenomenon on nurses.

Main Methods:

A convergent mixed-methods approach was employed, integrating focus group interviews with nurses and a three-round Delphi survey involving experts.
Qualitative data from focus groups were thematically analyzed, while Delphi survey data assessed the necessity, feasibility, and validity of proposed strategies.

Main Results:

Nurses reported emotional distress, stigma, and turnover intentions due to inadequate formal support.
Identified key support components include incident prevention/response, understanding the phenomenon, post-incident care, and resource accessibility.
Recommended strategies include case-based education, empathy training, and anonymous digital support, validated by experts for integration into institutional frameworks.

Conclusions:

Findings support and expand international models for second victim support, highlighting the influence of blame-prone cultures and hierarchical structures.
Managerial engagement is identified as a critical enabler for effective support systems.
Systematic integration of preventive education, leadership commitment, and organizational preparedness is essential for sustainable support.