RESEARCH_FILE
Second-Victim Phenomenon
The second-victim phenomenon describes the predictable psychological injury clinicians sustain after being involved in an adverse patient event — guilt, intrusive replays, self-doubt, insomnia, and a questioning of clinical competence. Coined by Albert Wu in 2000 and quantified by multiple subsequent studies (SeViD-I found 12.4% prevalence; AHRQ estimates 10–43%), it is now a recognised occupational construct, not a verdict on character or competence.
How it sounds in your head
The inner script after a preventable death: 'I replayed the decision a hundred times. If I had caught it sooner, he would still be alive. I'm not fit to be here.' The research reads it differently: this replay, this guilt, this erosion of confidence is a documented occupational injury experienced by between 10% and 43% of clinicians in similar situations — not unique evidence of individual unfitness.