Clinical nurses as second victims after patient safety incidents: A meta-synthesis of experiences, coping and support needs (30 July 2026)

Summary

In patient safety incidents (PSIs), nurses often act as ‘second victims’, experiencing multifaceted distress, including psychological, physiological and professional burdens. In recent years, qualitative studies on nurses as second victims have increased; however, the evidence remains fragmented. The aim of this study was to synthesise qualitative evidence on nurses as second victims after PSIs and provide implications for developing a multilevel support system.

The study found that nurses’ second-victim experiences after PSIs are multidimensional, dynamic and shaped by incident severity, individual appraisal, organisational culture and accessibility of support. A just culture–based support system may help reduce blame and silence, promote psychological safety and facilitate recovery.

Nursing managers should recognise nurses’ postincident disequilibrium as a second-victim response and embed structured support into PSI management. Strengthening just culture, psychological safety, peer support, confidential psychological care and protected recovery time may reduce blame, silence and help-seeking barriers, thereby facilitating nurses’ recovery and safeguarding patient safety.