Psychological aspects of patient safety
When care goes wrong, patients and carers may suffer extreme distress both from the care they receive and the way it is handled. Staff are also highly affected by the unintentional harm to, or even the death of, a patient. Distress may then be compounded by the patient safety, complaints or litigation processes that follow. Those individuals involved in medical accidents may face clinical, emotional and practical consequences. In recognition of this, over the past 10 years policy documents 1 have acknowledged the human suffering experienced by patients, carers and healthcare staff when something goes wrong. There has been a national drive to improve patient safety, with improved incident reporting, openness and fair blame policies and improved processes for handling complaints and litigation. It is notable, however, that whilst patient distress is readily acknowledged, policies focus on informing the patient after an adverse event and the need to communicate with the patient and carers, and there is little focus on the emotional aspects or how to deal with them psychologically. Similarly, whilst the healthcare professional involved, sometimes referred to as the second victim, is now routinely mentioned, policy has focussed on openness, fair blame and encouraging reporting. However, there has been little written on emotional impact and this may be the key to understanding why some staff are reluctant to fully engage with the patient safety initiatives.