Defense Date


Graduation Date

Spring 5-13-2022


One-year Embargo

Submission Type


Degree Name





School of Nursing

Committee Chair

L. Kathleen Sekula

Committee Member

Mary Ellen Smith Glasgow

Committee Member

Richard Zoucha

Committee Member

Maria Van Pelt

Committee Member

Ann M. Mitchell


Second Victim Critical Event Self-Blame CRNAs


A second victim is a health care provider who has been involved in a critical event. A

critical event is a clinical situation in which an unforeseen clinical outcome occurs, or

the clinical deterioration of the patient takes place for many different reasons. The

patient and his/her family are the first victims. The health care provider(s) involved in

the event are second victims. After such an event, the healthcare provider may

experience a constellation of negative emotions, such as guilt, sadness, depression,

somatic symptoms, hypervigilance, and fear. Most second victims require support to

cope with the adverse clinical situation. Second victims, their need for support, and

methods of assistance are studied in this integrative review. Many of the studies

addressed in this integrative review, revealed that having a trusted colleague or staff

member with whom to discuss the critical event is therapeutic. Some organizations

have developed programs to support second victims in which specially trained staff

members are deployed to discuss critical events with those involved, if the

participant(s) desire the support. Other clinical facilities do not have established

support programs; however healthcare providers have expressed desire to discuss the event in order to gain perspective, understand why it happened, and sometimes just to ventilate about it.



Additional Citations

Neft, M., Sekula, LK., Glasgow, ME,. Zoucha, R., van Pelt, M., Mitchell, AM (In Press). Support Methods for Health Care Professionals who are Second Victims: An Integrative Review. AANA Journal