“Until we are able to love and take care of ourselves, we cannot be of much help to others.” – Thich Nhat Hahn
When a medical provider makes a mistake, they often silently suffer the consequences of that action. Most often, they become the “second victim” – a term used to describe a health care provider who has been traumatized as a result of their involvement in a medical error, adverse patient event, loss or negative outcome; or one who suffers emotionally from exposure to the work they do.
When this is the case, how does one truly care for the caregiver? This was the topic of discussion at the annual Interprofessional Education Workshop, hosted by the College of Health and Human Services at Fresno State and Valley Children’s Healthcare.
Nearly 100 CHHS students and faculty took part in the March 20th workshop, held at Valley Children’s. In addition, 40 pediatric professionals from Valley Children’s participated, including nurses, physicians, speech language pathologists, social workers, and more.
Of the CHHS students involved in the two-hour workshop, many are communicative sciences and deaf studies, nursing, physical therapy and social work education majors.
“The workshop was designed to provide an overview of the second victim concept, signs and symptoms, and the exploration and identification of interventions,” said Dr. Stephen Roberts, associate professor in the Department of Communicative Sciences and Deaf Studies and lead faculty on the interprofessional education collaborative.
“The CHHS/Valley Children’s Healthcare Interprofessional Education Consortium wanted to educate our students on the importance of identifying signs and symptoms of the second victim with the understanding that health care environment leaves us at risk; and more importantly to discuss potential interventions including self-care. “
Libby Chaney, formerly a pediatric intensive care unit nurse and now clinical educator in Valley Children’s PICU, was the first in a series of presenters to speak. She gave her own personal account of being the second victim.
According to Chaney, the instant patient harm occurs, the involved practitioner also becomes a patient of the organization – a patient who will often be neglected. Second victims suffer a medical emergency equivalent to post-traumatic stress disorder.
For students going into the health field, this topic serves an important reminder of the emotional and mental toll that comes with the job.
“Since they will be working as part of an interprofessional collaborative team, we want them to understand signs and symptoms, as well as potential interventions, as students and not wait until they are working in an environment that leaves them at-risk for work-related trauma,” said Roberts.
For second semester nursing student, Ericka Metz, hearing from Chaney was an eye-opening moment.
“I think that because I’m not a nurse yet I’ve never really thought about the impact that caring would take on me,” said Metz. “I am a fixer and that’s why I’m going into nursing, but I’ve found in the past that giving myself to family or friends, can cause me to feel depleted. And if that’s my nature, I need to know in this job that it’s important to take care of myself so I don’t become a second victim myself.”
Dr. Jana Price-Sharps, a licensed psychologist, presented next on vicarious trauma and compassion fatique – two common issues in health care professionals. She described vicarious trauma as “a trauma that occurs when someone is repeatedly exposed to the stories, life, or photos/videos, of people who have been or are currently being traumatized. The vicarious trauma is due to the shock, horror, or sadness about what has happened to someone else”.
Compassion fatigue differs in the fact that the individual is not traumatized, but just emotionally exhausted. It occurs when an individual, in a position of helping people, begins to feel exhaustion. It can stem from working too many hours or not investing enough time balancing between personal and professional life.
According to Price-Sharps, the factors that contribute to each of the two areas, can also lead to burnout – a depletion or exhaustion of a person’s mental and physical resources. To conclude her presentation, Price-Sharps provided helpful information on how health care professionals can instead focus on self-care because as she stated, “life should be enjoyed, not endured”.
Second-year Doctor of Physical Therapy student, Kurt Munoz, said the information is something he plans to utilize in his future profession as a physical therapist.
“Being a sounding board for my colleagues that could be going through an issue like this and being able to point them in the right direction is important in whatever setting I’m in,” said Munoz.
Following the presentations, the students and health care professionals discussed a couple of case studies together, as an interprofessional health care team. The workshop concluded with Patricia Bradley, respiratory care practitioner and clinical educator at Valley Children’s PICU, giving an overview of their Team HOPES program, which stands for Healing Our Professionals, Empathy and Support.
The free, confidential service is offered to Valley Children’s employees who are suffering from work-related trauma, with a focus on helping medical, clinical and nursing health professionals through the emotional trauma and stress so often experienced by hospital personnel.
The collaborative interprofessional education workshops have been taking place each semester since the fall of 2015 and incorporates the Core Competencies for Interprofessional Collaborative Practice – a learning process that prepares all health profession students to work together with the common goal of building a safer and better patient-centered U.S. health care system.
“Four core competencies of interprofessional education were included in each presentation, including values and ethics, roles and responsibilities, interprofessional communication, and teams and teamwork,” said Roberts.
The series of interactive workshops will continue into the fall semester. Munoz said this particular workshop and the impact of interprofessional education is essential.
“It’s incredibly important,” said Munoz. “One of the physicians made a point that it takes a village to harm a patient, but also to take care of one as well. Working with the physicians, nursing staff, occupational therapy, respiratory therapy – it’s all critical in terms of making sure the patient gets the appropriate care and support that they need whether its education or actual hands on care – it’s critical.”
To learn more the CHHS and Valley Children’s Interprofessional Education Collaborative, please contact Dr. Stephen Roberts at stroberts@csufresno.edu.
Fresno State College of Health and Human Services 