How Nurses Can Avoid Vicarious Trauma

Healthcare providers of all kinds exhibit empathy when dealing with patients who often have stories that contain intense, difficult experiences resulting from abuse. After listening to horrific stories repeatedly, counselors, nurses and other service providers might begin to suffer from vicarious trauma, otherwise known as compassion fatigue.

This condition has gone by many names over the years, from secondary traumatic stress to simply being referred to as “the cost of caring.” Vicarious trauma is defined by The Headington Institute, an organization dedicated to the well-being of humanitarian relief workers and emergency responders, as “the process of change that happens because you care about other people who have been hurt, and feel committed or responsible to help them.”

No matter how much training in maintaining professional boundaries a provider has under his or her belt, vicarious trauma can still seep in. Healthcare professionals should be aware of the signs, and hospital leadership must be proactive in implementing strategies to help staff avoid this problem.

Signs and symptoms list for vicarious Trauma

Prevention and Intervention

According to Heather Helm, PhD, LPC, RPT-S, “prevention and intervention efforts should occur across four dimensions: wellness, organizational, supervision, and education.”

Educating your staff on signs and symptoms of vicarious trauma is one way to be proactive in preventing it, and active supervision is important as well.

It is also essential to make sure your organization exhibits a company culture that lets healthcare providers seek out help if it’s needed. If someone needs help but is scared to ask for it, their vicarious trauma could get worse, affecting not only them, but also their patients or clients.

Additionally, the workload needs to be distributed in a way that the providers aren’t feeling overwhelmed, and the company should provide self-care resources.

Coping with Vicarious Trauma

Remind your staff of ways to cope with vicarious trauma if it does occur, such as:

  • Taking breaks. This may be a mental or physical break like reading a book or watching a TV series, or even taking off a week to recuperate.
  • Resting. This may involve discussing a funny story with a friend, getting a massage, taking a nap, or being creative.
  • Challenge the cynicism caused by vicarious trauma. Read some good news stories, or watch an uplifting movie.
  • Celebrate holidays and milestones with friends and family to find the joy in life.

Transforming Vicarious Trauma

Researchers say that coping with the vicarious trauma isn’t enough, one also needs to transform the trauma into something good that creates positive energy. Transforming vicarious trauma may include activities like:

  • Participate in personal growth activities like journaling or taking a course on something that interests you.
  • Get involved in community-building events where you can give back to those who need it, like Habitat for Humanity or a community garden.
  • Find meaning in something, whether it be religious in nature or through meditation. In a 1993 survey, 44% of counselors stated spirituality helped them work through the effects of vicarious trauma.

Constructivist Self-Development Theory

The idea of compassion fatigue comes from the constructivist self-development theory (CSDT). CSDT allows for the diagnosis of vicarious trauma and describes how constantly hearing stories of abuse can affect a counselor or healthcare provider. According to CDST, five components of the self can be affected by exposure to distressing material.

Those five components are:

  • Frame of reference
  • Self-capacity
  • Ego resources
  • Psychological needs and cognitive schemas
  • Memory and perception

CSDT proposes that symptoms from trauma are viewed as adjustments to those events, and thus vicarious trauma manifests itself in the same way. A psychologist, after hearing a victim’s story, begins to see the world as an unsafe place and will behave accordingly. These changes may affect every aspect of a person’s life. If you notice a staff member exhibiting signs of vicarious trauma, intervene quickly to prevent further issues.

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