Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jun;72(2):e70049.
doi: 10.1111/inr.70049.

The Silent Struggle: An Integrative Review of PTSD Symptoms in Second Victim Experiences Among Nurses

Shani Fisher  1   2 , Ayala Blau  1 , Yulia Gendler  1
Affiliations
Review

The Silent Struggle: An Integrative Review of PTSD Symptoms in Second Victim Experiences Among Nurses

Shani Fisher et al. Int Nurs Rev. 2025 Jun.

Abstract

Aim: This integrative review explores the parallels between second victim symptoms and post-traumatic stress disorder, emphasizing the need for a better understanding of their intersection.

Background: The second victim phenomenon refers to the emotional and psychological distress healthcare professionals experience following adverse events or medical errors. While the issue is gaining recognition, limited research has focused on its relationship with post-traumatic stress disorder.

Methods: A comprehensive integrative review was conducted, screening 758 titles and including 19 studies examining the second victim's emotional and psychological consequences. The studies were analyzed for post-traumatic stress disorder symptoms consistent with DSM-5 criteria, focusing on themes like changes in cognition, mood, and behavior. The review followed PRISMA guidelines, and the MMAT was used to assess the reliability and validity of the reviewed papers.

Results: The analysis found that the most frequently reported post-traumatic stress disorder-related symptoms were negative changes in cognition and mood, affecting 60% of healthcare professionals. These symptoms were largely related to guilt, shame, and self-doubt. Other significant symptoms included anxiety (35%), insomnia (30%), and intrusive memories (20%). These findings suggest that the emotional toll of adverse events often aligns with post-traumatic stress disorder symptoms.

Conclusions: The results underscore the significant emotional impact of second victim on healthcare professionals and highlight the need for healthcare institutions to address this issue.

Implications for nursing practice: Effective support systems, including targeted training, institutional policies, and integrated mental health programs, are essential to mitigate the impact of second victim experiences. Policymakers should prioritize the implementation of standardized peer support frameworks and resilience training within healthcare organizations. Further research is needed to refine these interventions and establish evidence-based policies that provide long-term psychological support for affected healthcare professionals.

Keywords: adverse events; post‐traumatic stress disorder; second victim.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Baas, M. A. M., K. W. F. Scheepstra, C. A. I. Stramrood, R. Evers, L. M. Dijksman, and M. G. van Pampus. 2018. “Work‐Related Adverse Events Leaving Their Mark: A Cross‐sectional Study Among Dutch Gynecologists.” BMC Psychiatry 18, no. 1:73. https://doi.org/10.1186/S12888‐018‐1659.
    1. Balogun, J. A., A. N. Bramall, and M. Bernstein. 2015. “How Surgical Trainees Handle Catastrophic Errors: a Qualitative Study.” Journal of Surgical Education 72, no. 6: 1179–1184. https://doi.org/10.1016/J.JSURG.2015.05.003.
    1. Busch, I. M., F. Moretti, I. Campagna, et al. 2021a. “Promoting the Psychological Well‐Being of Healthcare Providers Facing the Burden of Adverse Events: a Systematic Review of Second Victim Support Resources.” International Journal of Environmental Research and Public Health 18, no. 10: 5080. https://doi.org/10.3390/ijerph18105080.
    1. Busch, I. M., F. Moretti, I. Campagna, et al. 2021b. “Promoting the Psychological Well‐Being of Healthcare Providers Facing the Burden of Adverse Events: a Systematic Review of Second Victim Support Resources.” International Journal of Environmental Research and Public Health 18, no. 10: 5080. https://doi.org/10.3390/ijerph18105080.
    1. Chard, R. 2010. “How Perioperative Nurses Define, Attribute Causes of, and React to Intraoperative Nursing Errors.” AORN Journal 91, no. 1: 132–145. https://doi.org/10.1016/j.aorn.2009.06.028.

LinkOut - more resources