Following-up midwives after adverse incidents: How front-line management practices help second victims

Abstract

Objective: To describe how front-line managers of maternity wards provide support to midwives as second victims in the aftermath of an adverse incident.

Design: A qualitative study using critical incident technique and a content analytic approach of semi-structured in-depth interviews.

Setting: Maternity wards in 10 Norwegian hospitals with more than 200 registered births annually were included in the study.

Participants: A purposeful sample of 33 midwives with more than two years' working experience described 57 adverse incidents.

Findings: Maternity ward managers utilised four types of practices to support midwives after critical incidents: management, transformational leadership, distributed leadership and laissez-faire leadership.

Key conclusions and implications for practice: The study shows that proactive managers who planned for how to handle critical incidents provided midwives with needed individual support and learning. Proactive transformational leadership and delegating roles for individual support should be promoted when assisting second victims after critical incidents. Managers can limit the potential harm to second victims by preparing for the eventuality of a crisis and institute follow-up practices.

Keywords: Adverse incidents; Critical incident stress debriefing; Follow-up practices; Front-line management; Midwife; Second victim.