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Altruism is one of the major driving forces in a caregiver’s decision to pursue a career in healthcare. The desire to help others in a time of need drives medical students to spend innumerable hours in the anatomy lab, in the medical school library, and in clinical wards. The Hippocratic Oath imparts the value of altruism and is built upon the dictum “do no harm.” However, inadvertent medical errors that result in patient harm are a reality. Current studies suggest that medical errors result in 210,000 to 440,000 deaths in the United States each year [1]. Albert Wu states “Physicians will always make mistakes. The decisive factor will be how [they] handle them” [2]. In 2000, Albert Wu coined the term “Second Victim” to describe the provider who is emotionally traumatized by a clinical situation resulting in an adverse patient outcome, and who is further harmed by a lack of institutional support to aid in the aftermath. Previous studies have found the prevalence of this phenomenon, known as “Second Victim Syndrome (SVS)” to be between 10.4% and 43.3% in caregivers who are involved in an adverse clinical event [3]. Most known risk factors for the development of SVS are directly related to the patient, or "first victim," rather than the provider. These patient-based risk factors include adverse outcomes relating to a young or healthy patient, multiple patients, or a devastating outcome of the error [4]. However, two potential risk factors directly relating to the medical provider rather than the patient have been identified: female sex and the degree of perceived personal responsibility [5, 6]. Other determined factors that impact the outcome of SVS are based on the medical institution’s response to the error [5]. The most common psychological manifestations of SVS include anxiety, guilt, and grief, and many second victims may suffer from chronic depression or PTSD as a direct result [5]. Furthermore, second victims can experience caregiver burnout, a topic that has gained much attention from the medical and lay communities [3]. External factors such as work overload, lack of control, breakdown of community, and conflicting values affect the development of burnout [7]. Family problems increase risk of physician burnout, whereas a supportive home life is protective [7, 8]. Therefore, external factors may have profound effects on how a healthcare provider copes with the stress of work. To the same degree, external

journal of wellness

The Crossroads of Wellness and Second Victim Syndrome: Identifying Factors that Alter the Pathway of Caregiver Recovery Following an Unanticipated Adverse Patient Outcome