The term “second victim syndrome” was first coined by Dr. Albert Wu in 2000. The definition is “the effect of an unanticipated adverse medical event on a clinician.” Certainly, the concept is pertinent to what health care professionals experience in their careers, but it comes with a very negative connotation. There has been discussion in the literature of the need to change the name, but so far, nothing has really stuck. In my evolution as a physician peer coach, I have had an epiphany: Our perception of this syndrome needs to change.
Indeed, the idea of “victim” suggests someone who is helpless, hurt, injured, and powerless to control the situation. This is a very judgmental and negative descriptor. Instead, this concept needs to be reframed; I propose the term “clinician distress syndrome” as a much more accurate portrayal of what is truly happening. By replacing the term “victim” with “distress,” the impact of these encounters is still conveyed, but in a much more discerning manner. Take the example of ARDS: We don’t call it “acute respiratory suffocating syndrome,” which implies helplessness. Instead, the word “distress” suggests significant pathology but doesn’t conjure thoughts that treatment is non-existent. Similarly, by eliminating the idea of being victimized by a situation, we effectively empower our clinicians to find solutions for the distress.
Taking control of distress is done by embracing the concept of “mental fitness.” Being mentally fit enables one to overcome the negative emotions that have traditionally sabotaged our lives, both personally and professionally. Similar to physical fitness optimizing our bodily strength, mental fitness promotes achievement in our performance, relationships, and sense of well-being. Much research has been done in neuroscience, cognitive and positive psychology, and performance science, showing the true benefit of mental fitness. In particular, the concept of neuroplasticity suggests that with the continued strengthening of certain neural pathways in the brain, modifications in brain architecture can be achieved. These changes have been shown with functional MRI, demonstrating increased density of grey matter in areas that correspond to certain thought processes.
The combination of traditional coaching insights with mental fitness allows for sustained change and will lead to the successful empowerment of clinicians in all areas of their practice. Pivoting from “second victim syndrome” to “clinician distress syndrome” does not minimize the trauma but suggests that health care professionals have the power to overcome the symptoms these scenarios cause. These adverse events often reveal underlying feelings of perfectionism and imposter syndrome, issues that in and of themselves can be modified with mental fitness.
The time has come to reframe these negative connotations; clinicians are a resourceful group and can control their responses to these challenging times with mental power, strength, and determination.
Susan Wilson is an emergency physician and physician coach.
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