Psychological experience of nurses as second victims in nursing adverse events: A Meta-integration of qualitative studies

ABSTRACT Objective: More than 50% of nurses have experienced adverse nursing events. After such events, nurses often develop negative psychological reactions such as anxiety, self-blame, and depression, which can adversely affect their professional identity, quality of work, and even patient safety. Gaining an in-depth understanding of the psychological experiences of nurses as second victims in adverse events and exploring their inner perceptions is of great significance for establishing more precise and effective second-victim support systems. This study aimed to conduct a meta-synthesis to comprehensively analyze the developmental process of nurses’ psychological experiences as second victims after adverse events and to explore the underlying patterns, thereby providing more targeted interventions for nurses at different psychological stages.Methods: Domestic and international databases were searched for qualitative studies on the psychological experiences of nurses as second victims of adverse events, with the search period from database inception to October 2025. The methodological quality of the included studies was appraised using the 2016 Joanna Briggs Institute (JBI) Centre for Evidence-Based Health Care’s criteria for qualitative research. A meta-aggregation approach was employed to compare, analyze, summarize, interpret, and synthesize the findings of the included studies.Results: A total of 16 studies were included, comprising 7 Chinese and 9 English publications. One study was rated as level A in methodological quality, while the remaining 15 studies were rated as level B. Nine categories were identified and further synthesized into three integrated findings: the immediate impact of adverse events and crisis of professional identity; imbalance between individual coping strategies and support systems; and the process of recovery and growth in adverse events.Conclusion: Hospitals and nursing managers should pay close attention to the physical and psychological health and support needs of second victims, provide adequate support and guidance, help nurses actively cope with adverse events, and promote their timely recovery.