Erring Professionals as Second Victims: Grappling with Guilt and Identity in the Aftermath of Error

Abstract

Applying a grounded theory approach, we investigate how professionals cope with making errors that unintentionally harm others. We purposively sampled medical clinicians to study this phenomenon, as these professionals understand themselves as “enablers of patient health.” When unintentionally harming others, clinicians experienced initial feelings of guilt. Triggered by the error experience, these professionals engaged in a cognitive sensemaking process, aiming to determine the root causes of the error and evaluate their level of responsibility. In this process, clinicians considered aspects of themselves and their social environment (i.e., supervisors, organization, colleagues, and clients) as either sensemaking assets or liabilities. The self and others became sensemaking assets when helping to alleviate initial feelings of guilt, and sensemaking liabilities when aggravating them. Depending on the outcome of their sensemaking process, clinicians engaged in control-focused or escape-focused identity work. This identity work, in turn, influenced the thriving or deterioration of their future professional identity.