Adverse Medical Events/Critical Incidents - How to Cope

Have you been involved in an adverse medical event?

​A Perioperative death or catastrophe can be devastating for the nurse anesthetist or student nurse anesthetist. The first step is awareness of the impact a critical incident or adverse event can have on your well-being and to understand the typical emotional and physical responses:

Health professionals recommend that you seek emotional support, such as peer support, self-help groups, or professional counseling. Even events that don't results in a bad patient outcome can still trigger the emotional trauma (see common reactions list). Does your workplace have an Employee Assistance Program (EAP)? If not, talk to your personal healthcare provider for recommendations on counseling and support and see the following resources.

You are not alone - adverse events support resources for individuals and organizations:

​AANA Professional Practice (847) 655-8870

Comments, concerns, or recommendations can be emailed to

Critical Incident Stress Management AANA Guidelines 
"The AANA recognizes that the physical and emotional wellbeing of CRNAs and Student Registered Nurse Anesthetists (SRNAs) is the foundation for practice excellence. Critical incidents are inevitable in healthcare, possibly causing significant, long term health issues patients and those who care for them." Link to the guidelines document.

Medically Induced Trauma Support Services (MITSS)

MITSS provides invaluable adverse event resources to both clinicians and 
patients, here are links to the online tools:


2013 MITSS HOPE Award Winner - Timothy B. McDonald, MD, JD for work on the Seven Pillars process, "linking effective and honest communication between patients and providers following patient harm events with improvements in patient safety, reduced medical liability risk, and improved timeliness of compensation for those who have been harmed."  Link to 2010 BMJ Quality & Safety article "Responding to Patient Safety Incidents: The "Seven Pillars" by TB McDonald et al.

January 2013 article in HealthLeaders Media, "Medical Error 'Second Victims' Get Some Help, Finally" cites two organized institutional structures to help clinicians following an event:

  • University of Missouri Health Care - forYOUTeam with 99 trained volunteers who provided "emotional first aid" peer support for 639 coworkers.
  • John Hopkins Hospital - RISE (Resiliency In Stressful Events) Team of 30 peer volunteers.

February 2013 article in Patient Safety Monitor, "After an Adverse Event, Staff Needs Support"

Institute for Healthcare Improvement (IHI) 2011 white paper "Respectful Management of Serious Clinical Adverse Events

The International Critical Incident Stress Foundation provides leadership, education, training, consultation, and support services in comprehensive crisis intervention and disaster behavioral health services to the emergency response professions, other organizations, and communities worldwide.

See also the Wellness Milestones index for these helpful articles:
  • The Personal Impact of Adverse Events
  • Change, Grief, and Healing - comfort in recovery and healing following an emotional situation 
  • Dealing with Litigation Stress Syndrome -  Sandy Tunajek, CRNA, DNP writes, "You are stunned, bewildered, and disoriented.  As with any traumatic event, the initial response of most people is disbelief and denial.  You cannot believe it is happening to you!  The experience of being sued is unexpected, overwhelming, and difficult to process.  And, it often cascades into reaction known as malpractice litigation stress syndrome."
Related AANA Health and Wellness links:  Wellness in the Workplace or Emotional and Mental Well-Being

Note: Links to external sites are provided as a convenience and do not imply endorsement.  AANA Health and Wellness is not responsible for any content on these websites but hopes they help support your well-being.


 Personal Impact


November 2013 Wellness Milestones article, "The Personal Impact of Adverse Events

More than 50% of survey respondents felt they had 
not been prepared to deal 
with a critical incident. 
See this and additional 
feedback: Critical Incidents and Adverse Events Open Forum Evaluation Results 

Questions or comments, email

 Resource Card


​Download the Adverse Events Resource Card to share and/or post in your workplace.

Or order quantities of the card online (member login required); card is free, shipping and handling costs will be incurred. For quantities over 25, email
to order. 


 Jan Stewart Speaker

The Jan Stewart Speaker at Annual Meeting On Monday, August 12 in Las Vegas was CRNA Maria van Pelt on "The Aftermath of Perioperative Catastrophes: Our Voices are Finally Heard!"