Table 5

Research team consensus for trajectory of recovery

Stage characteristicsCommon questions
Stage 1Error realized/event recognizedHow did that happen?
Chaos and accident responseTell someone → get helpWhy did that happen?
Stabilize/treat patient
May not be able to continue care of patient
Stage 2Re-evaluate scenarioWhat did I miss?
Intrusive reflectionsSelf isolateCould this have been prevented?
Haunted re-enactments of event
Feelings of internal inadequacy
Stage 3Acceptance among work/social structureWhat will others think?
Restoring personal integrityManaging gossip/grapevineWill I ever be trusted again?
Fear is prevalentHow much trouble am I in?
How come I can’t concentrate?
Stage 4Realization of level of seriousnessHow do I document?
enduring the inquisitionReiterate case scenarioWhat happens next?
Respond to multiple “why’s” about the eventWho can I talk to?
Interact with many different “event” respondersWill I lose my job/license?
Understanding event disclosure to patient/familyHow much trouble am I in?
Physical and psychosocial symptoms
Stage 5Seek personal/professional supportWhy did I respond in this manner?
Obtaining emotional first aidGetting/receiving help/supportWhat is wrong with me?
Litigation concerns emergeDo I need help?
Where can I turn for help?
Stage 6Dropping outIs this the profession I should be in?
Moving on (one of three trajectories chosen)Transfer to a different unit or facilityCan I handle this kind of work?
Consider quitting
Feelings of inadequacy
SurvivingHow could I have prevented this from happening?
Coping, but still have intrusive thoughtsWhy do I still feel so badly/guilty?
Persistent sadness, trying to learn from event
ThrivingWhat can I do to improve our patient safety?
Maintain life/work balanceWhat can I learn from this?
Gain insight/perspectiveWhat can I do to make it better?
Does not base practice/work on one event
Advocates for patient safety initiatives