Second victim phenomenon among nurses in an adult critical care unit in Paraguay. 2025

Abstract

Introduction: The second victim phenomenon refers to the emotional, psychological, and professional consequences experienced by healthcare workers following an adverse event. This impact is particularly relevant in high-demand settings such as critical care units. Objective: To describe the frequency and characteristics of the second victim phenomenon among nursing professionals working in an adult critical care unit of a public university hospital in Paraguay in 2025. Materials and methods: Observational, descriptive, and cross-sectional study with a quantitative approach. A total of 88 nursing professionals were included through non-probabilistic convenience sampling. A structured, expert-validated instrument was used to collect sociodemographic data, experiences with adverse events, emotional impact, institutional support, and coping strategies. Data were analyzed using SPSS v.23.

Results: 55.7 % of participants reported having been involved in at least one adverse event in the past three years. The most frequently reported emotions were anxiety (38.7 %), sadness (38.7 %), fear (24.5 %), and guilt (22.4 %). All participants who experienced an adverse event reported some degree of impact on their professional performance-38.7 % mild and 26.5 % significant. While 55.1 % sought support from colleagues, only 22.4 % received formal institutional support. Additionally, 36.7 % stated that their institution lacked protocols to support second victims, and 34.7 % were unaware of their existence. Conclusion: The second victim phenomenon is highly prevalent among nurses working in critical care services. The findings highlight the need for emotional support and the strengthening of institutional strategies to address this issue.