Background: Second victims, defined as healthcare team members being traumatised by an unanticipated clinical event or outcome, are frequent in healthcare. Evidence of this phenomenon in Germany, however, is sparse. Recently, we reported the first construction and validation of a German questionnaire. This study aimed to understand this phenomenon better in a sample of young (<= 35 years) German physicians. Methods: The electronic questionnaire (SeViD-I survey) was administered for 6 weeks to a sample of young physicians in training for internal medicine or a subspecialty. All physicians were members of the German Society of Internal Medicine. The questionnaire had three domains - general experience, symptoms, and support strategies - comprising 46 items. Binary logistic regression models were applied to study the influence of various independent factors on the risk of becoming a second victim, the magnitude of symptoms and the time to self-perceived recovery. Results: The response rate was 18% (555/3047). 65% of the participants were female, the mean age was 32 years. 59% experienced second victim incidents in their career so far and 35% during the past 12 months. Events with patient harm and unexpected patient deaths or suicides were the most frequent key incidents. 12% of the participants reported that their self-perceived time to full recovery was more than 1 year or have never recovered. Being female was a risk factor for being a second victim (odds ratio (OR) 2.5) and experiencing a high symptom load (OR 2). Working in acute care was promoting a shorter duration to self-perceived recovery (OR 0.5). Support measures with an exceptionally high approval among second victims were the possibility to discuss emotional and ethical issues, prompt debriefing/crisis intervention after the incident and a safe opportunity to contribute insights to prevent similar events in the future. Conclusion: The second victim phenomenon is frequent among young German physicians in internal medicine. In general, these traumatic events have a potentially high impact on physician health and the care they deliver. A better understanding of second victim traumatisations in Germany and broad implementation of effective support programs are warranted.

Background: Second victim phenomena (SVP) are critical to workplace and patient safety, and epidemiological data are limited to investigate the causes and impact on German health care. We investigated SVP in German nurses regarding prevalence, causes, and predisposition compared to a preceding study on German physicians (Second Victims in Deutschland/SeViD-I). Methods: We conducted a nationwide anonymous cross-sectional online study in 2020 using a modified SeViD questionnaire including the BFI-10 (personality traits). Statistical analysis was conducted using chi² tests and binary logistic regression models. Results: Of 332 nurses, 60% reported to experience SVP at least once a working lifetime, with a 12-month prevalence among SVP of 49%. Of the nurses, 24% reported recovery times of more than 1 year. In contrast to physicians from SeViD-I, a main cause for becoming a second victim was aggressive behavior by patients. High neuroticism values, higher age, and medium work life experience, but neither gender nor workplace position, were predisposing for SVP. Like SeViD-I, nurses reported demand for an institutional response in cases of SVP. Conclusions: SVP is common among German nurses and comprises other causes and a different course than in physicians. Further research should concentrate on specific prevention strategies, e.g., profession- and workplace-based educational programs.

German hospitals are now confronted with major challenges from both shortages and fluctuations in the numbers of physicians and nurses. This makes it even more important that physicians and nurses do not prematurely leave patient care. The objective of the present study was to improve our understanding of the factors that trigger intentions to leave the profession. For this purpose, data from 1060 young physicians and nurses in hospital care were analysed. Intentions to leave the profession was assessed with the Copenhagen Psychosocial Questionnaire (COPSOQ). In the first step, the association was determined between intention to leave the profession and the factors of perceived quality of care and job satisfaction. In a second step, a mediation analysis was performed to determine the effect of perceived quality of care after correction for the possible mediator of job satisfaction. There were statistically significant negative associations between perceived quality of care and intention to leave the profession (beta: −2.9, 95% CI: −4.48–−1.39) and job satisfaction and intention to leave the profession (beta: −0.5, 95% CI: −0.64–−0.44). The effect of perceived quality of care on intention to leave the profession was partially mediated by job satisfaction. Thus, high perceived quality of care and high job satisfaction are both important factors that tend to prevent young physicians and nurses from leaving their professions.

Zusammenfassung: Hintergrund Die Zeit der ärztlichen Weiterbildung ist der Grundstein für die Karriereentwicklung junger Internisten und für die Aufrechthaltung einer hochwertigen ärztlichen Versorgung. Bereits 2014 haben die Nachwuchsgruppen der Deutschen Gesellschaft für Innere Medizin (DGIM) und des Berufsverbandes Deutscher Internisten (BDI) eine Befragung ihrer jungen Mitglieder durchgeführt und wesentliche Konfliktfelder beschrieben. Mit dieser überarbeiteten Folgeuntersuchung soll ein aktualisiertes Abbild der Konflikte im Arbeitsleben junger Ärzte erstellt und eine Verlaufsbeurteilung ermöglicht werden. Ein neuer Schwerpunkt ist das Spannungsfeld von Beruf und Familie. Methoden Ende 2016 wurde eine webbasierte Befragung aller bei DGIM und BDI organisierten Weiterbildungsassistenten durchgeführt. Dafür wurde der Fragebogen von 2014 modifiziert und um Items zur Untersuchung des Spannungsfeldes von Familie und Beruf ergänzt. Zusätzlich wurde erneut das Modell beruflicher Gratifikationskrisen eingesetzt. Ergebnisse Insgesamt konnten 1587 Fragebögen ausgewertet werden. Im Vergleich zu 2014 ergeben sich keine wesentlichen Änderungen. Die psychosoziale Arbeitsbelastung unter den Teilnehmern ist weiterhin sehr hoch. Ein strukturiertes Weiterbildungscurriculum und qualitativ hochwertige Weiterbildungsgespräche sind mit einer geringeren Ausprägung psychosozialer Arbeitsbelastung und einer höheren Zufriedenheit im Beruf assoziiert. Die Vereinbarkeit von Beruf und Familie wird von der Mehrheit der Teilnehmer mit Kind(ern) als unzureichend empfunden. Das betrifft insbesondere Frauen. Schlussfolgerung Auf Basis dieser Befragung bestehen weiterhin gravierende und System-relevante Belastungen im Arbeitsleben junger Ärzte in internistischer Weiterbildung, die Anpassungen der Arbeits- und Weiterbildungsbedingungen dringlich erfordern. Insbesondere das Potenzial von Frauen in der Medizin muss über eine bessere Vereinbarkeit von Familie und Beruf in Zukunft stärker genutzt werden.