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Health Care Providers are Second Victims of COVID-19

“Second victims are health care providers who are involved in an unanticipated adverse patient event, in a medical error and/or a patient related injury and become victimized in the sense that the provider is traumatized by the event. Frequently, 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.”(1)

The First Victims of COVID-19

The first victims of COVID-19 are the more than 400,000 individuals who have succumbed to the deadly virus in the United States of America. It was unimaginable that such an extraordinarily high number would ever be reached six months ago. To date, the pandemic has infected more than 96 million people worldwide. There have been over 2 million deaths related to COVID-19. Over 68 million people have recovered from COVID-19, many with lasting health related side-effects from the virus according to the Worldometer’s COVID-19 data.

The death of a loved one can take a tremendous toll on families and friends. The inability to be present at the bedside of the sick and dying is emotionally and psychologically traumatic. The process of mourning the dead is interrupted when family and friends cannot hold a “Homegoing” celebration or invite guests to a funeral to celebrate the life of the deceased, to say goodbye, and to honor them in death. Families have had to resort to holding virtual funerals and memorial services.

So, as I address the loss of life of individuals from the COVID-19 virus, it is imperative to acknowledge the millions of families and friends who are affected. Death has captured the tears of millions. Mourners’ cries echo and flow one after another creating a string of melancholic sadness that has blanketed the world as the unbearable losses are etched into our lives. As I write this today, my own heart is heavy as I received the news that a childhood friend of 55 years passed from COVID-19.

The Second Victims of COVID-19

The second victims of COVID-19 are all of the healthcare providers, including the clergy, nurses, nurse aides, doctors, respiratory therapists, physical therapists, custodial staff, dietary staff, maintenance staff, and others who are working in the various hospital settings to care for the sick. Second victims may experience symptoms such as anxiety, depression, guilt, self-doubt, loss of confidence, and feelings of incompetence. These feelings can become compounded when healthcare providers are reassigned to unfamiliar work environments to care for the ill during the COVID-19 pandemic. Those providing direct care often question their own ability to care for the sick. The healthcare staff may question their knowledge base, mental fortitude, stamina, and ability to endure long work hours while caring for the ill. It is emotionally and physically tough to address the daily needs of those who are sick with COVID-19. The emotional toll is unmeasurable and indescribable.

Under the strain of the pandemic, and often putting their own thoughts and feelings aside, healthcare workers are determined to do their best under the most horrible circumstances. They are our superheroes who have united to provide the best care to their patients. When overwhelmed by patients, they bond together while working long hours to ensure each patient receives the best care possible, even orienting and accepting unfamiliar assignments to ensure that all patients are provided care. When beds are limited, they open new areas, set up outdoor tents, and collaborate with other healthcare facilities to receive more of the same; the sick yearning for help.
As second victims of COVID-19, many healthcare providers do not take time to acknowledge their valiant efforts. They should not question their abilities or have doubts regarding their roles as healthcare providers. Every provider is appreciated for their efforts, and those on the front line are without a doubt, our unsung heroes of the COVID-19 pandemic. Many front-line nurses and other healthcare providers have succumbed while trying their best to fulfill their oath as a patient care advocate. These heroes should be honored and never forgotten. As nurses, these second victims took a pledge and have honorably upheld it.

The Nightingale Pledge

I solemnly pledge myself before God and in the presence of this assembly. To pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in this practice of my profession. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.
The profession of nursing is constantly evolving, and nurses and other healthcare providers must adapt to these changes to meet the challenges. Forever present in healthcare, nurses will always demonstrate their value in caring for the infirmed regardless of the presence of a pandemic. Even though they are the second victim, they are resilient, and with the support of peers, and the healthcare community they will continue to devote themselves to the welfare of others.

1) Scott SD, Hirschinger LE, Cox KR, McCoig M, Brandt J, Hall L. The natural history of recovery for the health care provider “second victim” after adverse patient events. Qual Saf Health Care. 2009; 18:325-330.

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