Evidence map›Paper›PMID 42533558›Full record

ReviewJournal of nursing management2026

Clinical Nurses as Second Victims After Patient Safety Incidents: A Meta-Synthesis of Experiences, Coping and Support Needs.

Wei Zeng, Yuxin Yang, Li Zhang, Qingyun Li

Abstract readReview
In one paragraph

Review in Journal of nursing management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Wei ZengSchool of Nursing, Nanjing University of Chinese Medicine, Nanjing, China, njucm.edu.cn.ORCID https://orcid.org/0009-0000-4199-7968
Yuxin YangSchool of Nursing, Nanjing University of Chinese Medicine, Nanjing, China, njucm.edu.cn.ORCID https://orcid.org/0009-0008-0699-7987
Li ZhangSchool of Nursing, Nanjing University of Chinese Medicine, Nanjing, China, njucm.edu.cn.ORCID https://orcid.org/0000-0001-7114-9572
Qingyun LiDepartment of Nursing, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China, njmu.edu.cn.ORCID https://orcid.org/0000-0002-3506-0914

Funding

Nanjing Medical Science and Technique Development Foundation GAX21281Nanjing Medical Science and Technique Development Foundation QRX17070
6 · The paper itself

Abstract

backgroundIn patient safety incidents (PSIs), nurses often act as 'second victims', experiencing multifaceted distress, including psychological, physiological and professional burdens. In recent years, qualitative studies on nurses as second victims have increased; however, the evidence remains fragmented. Existing qualitative meta-syntheses have limitations in terms of contextual diversity, coverage of incident types and exploration of support needs.

aimTo synthesise qualitative evidence on nurses as second victims after PSIs and provide implications for developing a multilevel support system.

methodsA qualitative meta-synthesis approach was employed. Twelve Chinese and English databases were systematically searched from inception to 10 February 2025, with an updated search conducted on 14 October 2025. The 2020 Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research was used to appraise methodological quality. Data were synthesised using the two-stage synthesis approach proposed by Sandelowski and Barroso.

resultsA total of 21 qualitative studies involving 272 nurses across seven countries were included. Three synthesised themes were identified: (1) a state of disequilibrium under multiple shocks; (2) support systems undermined by blame and silence; and (3) reconstructing the self in the aftermath of trauma: multipath coping and recovery mechanisms.

conclusionsNurses' second-victim experiences after PSIs are multidimensional, dynamic and shaped by incident severity, individual appraisal, organisational culture and accessibility of support. A just culture-based support system may help reduce blame and silence, promote psychological safety and facilitate recovery. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should recognise nurses' postincident disequilibrium as a second-victim response and embed structured support into PSI management. Strengthening just culture, psychological safety, peer support, confidential psychological care and protected recovery time may reduce blame, silence and help-seeking barriers, thereby facilitating nurses' recovery and safeguarding patient safety.

Indexed as

Adaptation, PsychologicalNursesPatient SafetyCoping SkillsHumansQualitative ResearchSocial Supportmeta-synthesisnursepatient safetyqualitative researchsecond victim

Identifiers

PMID42533558
PMCPMC13424605

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.