Background: The second victim phenomenon is common among nurses in intensive care units. Apart from quantitative studies, little is known about individual cases among those high-risk groups. This study evaluates the natural history and cause of second victim traumatization in Western Austria for the first time to tailor specific intervention. Methods: A total of 20 guided interviews were conducted with intensive care nurses in Western Austria. All interviews were transcribed and analyzed with MAXQDA software. Evaluation followed the structuring qualitative content analysis scheme according to Kuckartz. Results: The most frequent symptoms of the second victim phenomenon reported were feelings of guilt and problems with falling asleep. Coping with the second victim phenomenon was accomplished by conversations in private as well as among work colleagues. Conclusions: Intensive care nurses are exposed to many exceptional situations which have a high likelihood of resulting in second victim traumatization. As proximal psychosocial support is considered to be a main source of coping, wide-spread implementation of effective psychosocial peer support programs ought to be applied by medical organizations. Patient safety measures such as proactive and reactive clinical risk management (e.g., CIRS) should be linked to second victim support.