Editor’s Notebook
November/December 2011
Editor’s Notebook
‘Do No Harm’ to Clinicians, Too
In her work as president of MITSS (Medically Induced Trauma Support Services), Linda Kenney has always included clinicians among those who may need support following traumatic events in the course of medical care. She has steadily increased her efforts on behalf of clinicians in recent years, publishing a toolkit in 2010 to help organizations design and implement programs. This year, she invited experts in clinician support to present an afternoon workshop prior to the MITSS annual dinner and fundraising event on Nov. 1.
Kenney asked Doug Bonacum, vice president of safety management at Kaiser Permanente, to listen in and provide immediate feedback to the group at the end of the afternoon. His reflections included highlights of a lively, content-filled discussion.
Bonacum commented that when he first dedicated himself to patient safety, his commitment
…was almost exclusively focused on doing what I could do to prevent harm in the first place. I didn’t necessarily see it as my job to help my organization provide more support to the second victim.* That was someone else’s business. I think what we learned here today is that ensuring our organizations have effective clinician support programs is all our business.
Bonacum continued by highlighting points made during the workshop, including:
From an ethical perspective we share a responsibility to “do no harm”… not just to the patient but to all practitioners who make patient care their life’s work. And from a patient safety perspective, we have to do this because we all know that a practitioner who is aching emotionally, cognitively, and physically is not safe.
Those in attendance were clearly moved by Bonacum’s aspirational conclusion, in which he imagined what might come of these efforts and how the concluding paragraph to a journal article in the future might read:
While medical errors that harm patients continue to lessen each year, the attention given to the healthcare provider who experiences traumatic events while taking care of patients has never been better. Institutions everywhere are providing the right attention, the right resources, and the right support to practitioners we used to define as the 2nd victims of medical errors. Prompt debriefings, opportunities to discuss ethical concerns, access to counseling, psychological services, and formal emotional support have replaced the void that healthcare workers involved in adverse events previously experienced at a time when they needed us the most. By implementing clinician support programs following adverse events, we have enabled our healers to reconnect not only to the meaning of their work but more importantly, to the emotional pleasure, the feeling of success, and the joy that they and their families most certainly deserve.
For more information, visit www.MITSSTools.org.
*The term “second victim” was coined by Dr. Albert Wu, whose article in BMJ in 2000 raised awareness of the needs of clinicians. Dr. Wu keynoted the MITSS workshop and seemed to agree with the group that the word “victim” is problematic, whether we’re referring to patients or clinicians. It remains to be seen how the terminology will evolve in future discussions.