Oral Presentation The 26th International Nursing Philosophy Conference 2023

Nurses as Second Victims During the COVID-19 Pandemic: A Conceptual Model (#48)

Melissa Powell 1 , AnnMarie Walton 1
  1. Duke University, Durham, NC, United States

Background: During the COVID-19 pandemic, researchers have referred to healthcare workers as ‘second victims,’ who are “individuals working within an environment who are offering/providing care and are personally or professionally traumatized by exposure to a complex acute or chronic clinical case/event.”1,2,3,4 Registered Nurses (RNs) are at high risk for second victimhood, due to their amount of direct patient care compared to other professions.5,6 The purpose of this poster is to share concept analysis results and a conceptual model of second victimhood as it relates to RNs and the COVID-19 pandemic.

Methods: Rodger’s Evolutionary Method for Concept Analysis7 guided analysis and included definitions, attributes, antecedents, consequences, and related concepts from relevant literature. Foli’s Middle Range Theory of Nurses’ Psychological Trauma8 guided development of a conceptual model.

Results: During the COVID-19 pandemic, new and evolving antecedents, attributes, and consequences have been uncovered that contribute to second victimhood in RNs. RNs experience second victimhood from staffing shortages, increasing workloads, emotional and physical toll, ethical dilemmas, lack of supplies, and increasing safety risks.1,2,3 The consequences of RNs experiencing second victimhood include psychological symptoms like fear, physical symptoms like insomnia, mental health conditions, compassion fatigue, burnout, a desire to leave nursing, and increased staff shortages.1,2,3 The Nurses as Second Victims during the COVID-19 Pandemic Conceptual Model was developed.

Discussion: This analysis and conceptual model provide a foundational understanding of how second victimhood impacts RNs after the COVID-19 pandemic. Findings from this analysis deepen knowledge and aim to promote professional engagement from healthcare leaders and RNs to sustain the nursing profession and to shape a positive nursing identity. In alignment with The Future of Nursing Report9, continued research on RNs after the COVID-19 pandemic is necessary to fully understand their experiences and support needs to promote their well-being, reduce turnover, and create support programs and resources.

  1. 1 Moreno-Mulet, C., Sansó, N., Carrero-Planells, A., López-Deflory, C., Galiana, L., García-Pazo, P., Borràs-Mateu, M. M., & Miró-Bonet, M. (2021). The Impact of the COVID-19 Pandemic on ICU Healthcare Workers: A Mixed Methods Study. International journal of environmental research and public health, 18(17), 9243. https://doi-org.proxy.lib.duke.edu/10.3390/ijerph18179243
  2. 2 Bennett, P., Noble, S., Johnston, S., Jones, D., & Hunter, R. (2020). COVID-19 confessions: a qualitative exploration of healthcare workers experiences of working with COVID-19. BMJ open, 10(12), e043949.
  3. 3 Mira, J. J., Carrillo, I., Guilabert, M., Mula, A., Martin-Delgado, J., Pérez-Jover, M. V., Vicente, M. A., Fernández, C., & SARS-CoV-2 Second Victim Study Group (2020). Acute stress of the healthcare workforce during the COVID-19 pandemic evolution: a cross-sectional study in Spain. BMJ open, 10(11), e042555. https://doi-org.proxy.lib.duke.edu/10.1136/bmjopen-2020-042555
  4. 4 Scott, S. (2022, February 1). The second victim experience. University of Missouri – Kansas City School of Medicine. Kansas City, Missouri.
  5. 5 Institute of Medicine [IOM]. (2011). The Future of Nursing: Leading Change, Advancing Health. National Academies Press (US). https://doi.org/10.17226/12956
  6. 6 Maunder, R. G., Heeney, N. D., Strudwick, G., Danielle Shin, H., O’Neill, B., & Young, N. (2021). Burnout in hospital-based healthcare workers during COVID-19. Science Briefs of the Ontario COVID-19 Science Advisory Table, 2(46). https://doi.org/10.47326/ocsat.2021.
  7. 7 Rodgers, B.L. (1989). Concepts, analysis, and development of nursing knowledge: the evolutionary cycle. Journal of Advanced Nursing 14,330-335.
  8. 8 Foli, K. J. (2022). A Middle-Range Theory of Nurses' Psychological Trauma. ANS. Advances in nursing science, 45(1), 86–98. https://doi.org/10.1097/ANS.0000000000000388
  9. 9 National Academies of Sciences, Engineering, and Medicine. (2021). The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/25982.