Delacroix Romuald
DNP Scholarly Project, The Catherine McAuley School of Nursing, Maryville University, St. Louis, Missouri.
J Am Assoc Nurse Pract. 2017 Jul;29(7):403-409. doi: 10.1002/2327-6924.12468. Epub 2017 Apr 27.
To explore the experience of committing medical error from the perspective of nurse practitioners (NPs). Overall, the purpose of the study is to discern NPs' behaviors, perceptions, and coping mechanisms in response to having made a medical error.
Qualitative research based on two face-to-face audio-recorded semistructured interviews with 10 NPs who had made medical errors in practice. The analysis was guided by concepts in phenomenology.
During iterative analyses, four overarching themes were identified: (a) The paradox of error victimization, (b) primacy of responsibility and mindfulness, (c) yearning for forgiveness and a supportive other, and (d) coping with a new reality is context dependent. The narratives strongly suggest that NPs who err experience "second victim" phenomena.
Reminiscing about the experience of living through an error, NPs shared meaningful insights into their need for a safe environment in which they could candidly share feelings, reflect on the experience, and ascertain the etiology of the mistake. Debriefing in a formal manner might prevent the development of permanent psychological injuries. Hence, inherent to the care of "second victims" is the notion of co-workers' fairness, compassion, and recognition of appropriate caring responses that contribute to effective coping and healing.
从执业护士（NP）的角度探讨医疗差错经历。总体而言，本研究的目的是了解NP在出现医疗差错后的行为、认知及应对机制。
基于对10名在实际工作中出现过医疗差错的NP进行的两次面对面录音半结构化访谈开展定性研究。分析以现象学概念为指导。
在反复分析过程中，确定了四个总体主题：（a）差错受害者的悖论，（b）责任与正念的首要性，（c）渴望得到宽恕和他人支持，（d）应对新现实取决于具体情境。这些叙述强烈表明，犯错的NP会经历“二次受害者”现象。
回忆经历差错的过程，NP们分享了对于自身需求的有意义见解，即需要一个安全的环境，在其中他们能够坦诚分享感受、反思经历并确定错误原因。以正式方式进行汇报可能会防止永久性心理创伤的形成。因此，照顾“二次受害者”的内在要求是同事的公平、同情以及认识到有助于有效应对和康复的恰当关怀反应。
