Living Through the In-Between: Growth in Health Providers Following the Experience of a Serious Patient Safety Incident

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Hain, Abigail
second victim , patient safety incidents , post traumatic growth , relational ethics , Levinas , hermeneutic phenomenology , moral injury , moral resilience , growth
Patient safety incidents occur as a result of unanticipated failures in the processes of healthcare service and they severely affect patients and families. These kinds of events also deeply affect health providers. Much like patients and families who feel they have been abandoned in the aftermath of patient safety incidents, health providers can also feel they have no one to turn to for help while navigating blame, feelings of remorse and loss of confidence in their clinical abilities. To date, much of the research on the health provider experience of patient safety incidents investigates the negative effects and outcomes for providers with less focus on positive adaptive outcomes, such as health provider growth. In this hermeneutic phenomenological inquiry exploring the liminal journey toward growth for health providers involved in a serious patient safety incident; I was informed by the relational ethics of Emmanuel Levinas and posttraumatic growth theory. Common structures of experience are described and explored within six themes — Feeling Safe-Unsafe, Living Through It, A Kind Loving Hand, It’s Not About Me, Quiet Learnings and Having Good Come from Bad. Three important insights are gained through this inquiry: One, the participants mitigate feelings of self-blame with systems knowledge which in turn contributed to practice reintegration. Two, risk in clinical practice is managed as an embodied way of being. Three, an ethic of responsibility, lived by the participants through their incident, contributed to a moral resilience and reenforces what is most meaningful for them — caring for patients and families.
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