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a terrible error
Simon Carley
short
stay
wants
to go
home
RETURN return
feel
panic
radiology
path
experts
professional
self-image
personal
clinical
Radio
https://youtu.be/v3QD7Rrt2Ck
second victims
Medical Error: the secondVictim A.Wu. BMJ 2000
Second victims are healthcare providers who are involved in an
unanticipate...
Medical Error: the secondVictim A.Wu. BMJ 2000
Second victims are healthcare providers who are involved in an
unanticipate...
predictable course for second victims.
Chaos chaos
shame
denial
embarrassment
flashbacks
triggers
restoring
personal
integrity
obtaining
emotional
first aid
enduring
the inquisition
Williams 1999
are we
helpless?
what
works?
resilience
It is not the stress…
it is the state of mind,
that matters when one is
stressed
Hans Selye
http://www.robertsoncooper.com/gooddayatwork
Personal Organisational Culture
what happened?
be aware
prepare
support
Be Kind
thank you
Why bother?
Enduring the inquisition
The inquisition
GMC
HIPAA
Families
Coroner
ED days
In no relationship
is the physician
more often
derelict than in
his duty to
himself (herself).
monitor incidents
contact supervisors
Mentors
Parallel support for second victims
Other things -
develop emotional underst...
Understanding	of	self	and	self	mastery	
Interactions	with	others	and	wider	world	
Meaning	beyond	self-	values-goals-focus	...
Organisations
Contact clinical staff
Reaffirm your confidence
Give time and space
Keep informed
Let them know you care
Be visi...
Clinicians get harmed too
You may become a second victim
You will certainly meet second victims
There is a predictable cou...
FOR SUFFERERS
Be honest
Don’t rationalise
Ask for help
Prepare
Personal impact Professional impact
Serious event
Chaos
Intrusive
reflections
Restoring
personal integrity
Enduring the
inquisition
Obtaining
emotional first ai...
“a health care provider involved in an unanticipated adverse
patient event, medical error and/or a patient related-injury ...
“a health care provider involved in an unanticipated adverse
patient event, medical error and/or a patient related-injury ...
Coping with a Terrible Error by Simon Carley
Coping with a Terrible Error by Simon Carley
Coping with a Terrible Error by Simon Carley
Coping with a Terrible Error by Simon Carley
Coping with a Terrible Error by Simon Carley
Coping with a Terrible Error by Simon Carley
Coping with a Terrible Error by Simon Carley
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Coping with a Terrible Error by Simon Carley

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Error is almost inevitable in our clinical practice so we should be prepared to help and prepare those individuals involved for the benefit of them, our systems and our patients.

Do you remember that patient you saw last night?': A phrase the strikes terror into the hearts of all physicians. The prospect of a patient coming to harm as a result of a mistake is terrifying but it can and does happen.
The consequences for the patient and their family are often tragic but what of the clinicians who made the error? For many the result of making a terrible error is life changing.
Those permanently harmed by error are often referred to as second victims with the consequences of terrible events being life-long.
This talk explores the predictable course for clinicians who are involved in error and asks whether we can prepare and support such individuals through a difficult time.

Published in: Health & Medicine
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Coping with a Terrible Error by Simon Carley

  1. 1. a terrible error Simon Carley
  2. 2. short stay
  3. 3. wants to go home
  4. 4. RETURN return
  5. 5. feel
  6. 6. panic
  7. 7. radiology
  8. 8. path
  9. 9. experts
  10. 10. professional self-image
  11. 11. personal
  12. 12. clinical
  13. 13. Radio https://youtu.be/v3QD7Rrt2Ck
  14. 14. second victims
  15. 15. Medical Error: the secondVictim A.Wu. BMJ 2000 Second victims are healthcare 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.
  16. 16. Medical Error: the secondVictim A.Wu. BMJ 2000 Second victims are healthcare 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.
  17. 17. predictable course for second victims.
  18. 18. Chaos chaos
  19. 19. shame denial embarrassment
  20. 20. flashbacks triggers
  21. 21. restoring personal integrity
  22. 22. obtaining emotional first aid
  23. 23. enduring the inquisition
  24. 24. Williams 1999
  25. 25. are we helpless?
  26. 26. what works?
  27. 27. resilience
  28. 28. It is not the stress… it is the state of mind, that matters when one is stressed Hans Selye
  29. 29. http://www.robertsoncooper.com/gooddayatwork
  30. 30. Personal Organisational Culture
  31. 31. what happened?
  32. 32. be aware prepare support
  33. 33. Be Kind
  34. 34. thank you
  35. 35. Why bother?
  36. 36. Enduring the inquisition The inquisition GMC HIPAA Families Coroner
  37. 37. ED days
  38. 38. In no relationship is the physician more often derelict than in his duty to himself (herself).
  39. 39. monitor incidents contact supervisors Mentors Parallel support for second victims Other things - develop emotional understanding Schwartz rounds - build emotional and psychological understanding of how people feel not just what happens. Organisations
  40. 40. Understanding of self and self mastery Interactions with others and wider world Meaning beyond self- values-goals-focus Positive approach-perspective Personal growth Care of health Learning from overcoming challenges understanding self social interactions meaning beyond self health learning from error
  41. 41. Organisations Contact clinical staff Reaffirm your confidence Give time and space Keep informed Let them know you care Be visible to all staff members. Teach resilience Guide don’t dictate
  42. 42. Clinicians get harmed too You may become a second victim You will certainly meet second victims There is a predictable course to recovery You can personally prepare You can organisationally prepare You can personally support You can organisationally support
  43. 43. FOR SUFFERERS Be honest Don’t rationalise Ask for help Prepare
  44. 44. Personal impact Professional impact
  45. 45. Serious event Chaos Intrusive reflections Restoring personal integrity Enduring the inquisition Obtaining emotional first aid Moving on Dropping out Surviving Thriving
  46. 46. “a health care provider involved in an unanticipated adverse patient event, medical error and/or a patient related-injury who become victimised in the sense that the provider is traumatised by the event.
  47. 47. “a health care provider involved in an unanticipated adverse patient event, medical error and/or a patient related-injury who become victimised in the sense that the provider is traumatised by the event. Frequently, second victims feel personally responsible for the unexpected patient outcomes and feel as though they have failed their patient, and feel doubts about their clinical skills and knowledge base.”

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