BMJ 2015;350:h2331 doi: 10.1136/bmj.h2331 (Published 7 May 2015)
Page 1 of 1
Letters
LETTERS SUPPORTING CLINICIANS AFTER MEDICAL ERROR
Must “second victims” always be in the wrong? 1
Christopher V Thompson specialty registrar colorectal surgery , Nigel Suggett consultant colorectal 1 2 surgeon , Jodie Fellows principal clinical psychologist University Hospital Birmingham, Birmingham B15 2GW, UK; 2Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
1
Edrees and Federico discuss the support of clinicians after medical error—the “second victims.”1 The concept of second victims seems to revolve around medical error and the psychological consequences of these events on the clinician.
increase our knowledge about the prevalence of PTSD/ASD-type symptoms in surgical trainees, current approaches to supporting trainees, and the uptake of such services.
Specialist training in surgery is known to be a stressful experience in which efficient and accurate learning are key to success.3 The symptoms of PTSD/ASD disrupt sleep, mood, and concentration.2 Clearly, PTSD/ASD among trainees is likely to be harmful to learning.
Competing interests: None declared.
A surgeon’s usual duties meet criterion A of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD).2 There is an expectation that surgeons will be entirely habituated to this “run of the mill trauma,” and that they will continue to deliver care in spite of preceding events.
We agree that future studies should focus on organisational culture as well as individual clinicians’ willingness to access support services. We would argue that waiting for error, rather than signs of stress, to trigger access to support may unintentionally give the impression that support is punitive or stigmatising. Using a validated scoring system,4 we aim to
This study uses a web based survey (www.surveymonkey.com/ s/traumasurg). The results so far have been fascinating. Of 120 respondents, 42% report that their training has suffered as a result of PTSD/ASD symptoms, but only 15% have received any support. We would be grateful if any surgical (pan-specialty) trainees reading this letter could participate in our survey.
1 2 3 4
Edrees H, Federico F. Supporting clinicians after medical error. BMJ 2015;350:h1982. (15 April.) American Psychiatric Association DTF. Diagnostic and statistical manual of mental disorders: DSM 5. 5 ed. American Psychiatric Association, 2013. Lazarus A. Traumatized by practice: PTSD in physicians. J Med Pract Manage 2014;30:131-4. Weiss D, Marmer C. The impact of event scale—revised. In: Wilson J, Keane T, eds. Assessing psychological trauma and PTSD: a practitioner’s handbook. Guilford Press, 1997:399-411.
Cite this as: BMJ 2015;350:h2331 © BMJ Publishing Group Ltd 2015
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Letters
LETTERS SUPPORTING CLINICIANS AFTER MEDICAL ERROR
Must “second victims” always be in the wrong? 1
Christopher V Thompson specialty registrar colorectal surgery , Nigel Suggett consultant colorectal 1 2 surgeon , Jodie Fellows principal clinical psychologist University Hospital Birmingham, Birmingham B15 2GW, UK; 2Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
1
Edrees and Federico discuss the support of clinicians after medical error—the “second victims.”1 The concept of second victims seems to revolve around medical error and the psychological consequences of these events on the clinician.
increase our knowledge about the prevalence of PTSD/ASD-type symptoms in surgical trainees, current approaches to supporting trainees, and the uptake of such services.
Specialist training in surgery is known to be a stressful experience in which efficient and accurate learning are key to success.3 The symptoms of PTSD/ASD disrupt sleep, mood, and concentration.2 Clearly, PTSD/ASD among trainees is likely to be harmful to learning.
Competing interests: None declared.
A surgeon’s usual duties meet criterion A of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD).2 There is an expectation that surgeons will be entirely habituated to this “run of the mill trauma,” and that they will continue to deliver care in spite of preceding events.
We agree that future studies should focus on organisational culture as well as individual clinicians’ willingness to access support services. We would argue that waiting for error, rather than signs of stress, to trigger access to support may unintentionally give the impression that support is punitive or stigmatising. Using a validated scoring system,4 we aim to
This study uses a web based survey (www.surveymonkey.com/ s/traumasurg). The results so far have been fascinating. Of 120 respondents, 42% report that their training has suffered as a result of PTSD/ASD symptoms, but only 15% have received any support. We would be grateful if any surgical (pan-specialty) trainees reading this letter could participate in our survey.
1 2 3 4
Edrees H, Federico F. Supporting clinicians after medical error. BMJ 2015;350:h1982. (15 April.) American Psychiatric Association DTF. Diagnostic and statistical manual of mental disorders: DSM 5. 5 ed. American Psychiatric Association, 2013. Lazarus A. Traumatized by practice: PTSD in physicians. J Med Pract Manage 2014;30:131-4. Weiss D, Marmer C. The impact of event scale—revised. In: Wilson J, Keane T, eds. Assessing psychological trauma and PTSD: a practitioner’s handbook. Guilford Press, 1997:399-411.
Cite this as: BMJ 2015;350:h2331 © BMJ Publishing Group Ltd 2015
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
