Identify Stress and Vicarious, Secondary, Indirect Trauma in Nurses
Published: 17 January 2017
Published: 17 January 2017
The relationship between a healthcare professional and their patient is often very close, and this proximity can expose staff to the distress and trauma experienced by patients. Nurse caseloads can often include patients who have been affected by trauma, violence, abuse, death, and fear, combined with a myriad of other physical and mental health issues.
The empathy and the desire to alleviate the pain and suffering of patients can dramatically enhance the connection between patient and nurse. Unfortunately, this connection can have a serious psychological impact on the nurse with long-term consequences if left untreated.
Empathic behaviour is associated with the mirroring of emotions and body movements between people (e.g. how laughing and yawning is considered to be contagious). In cases of trauma, the result is the mirroring of negative psychological issues in the nurse.
There is a great debate on the correct terminology for this type of trauma, with a range of descriptions that are often confused with each other. Vicarious trauma, post-traumatic stress disorder, compassion fatigue and secondary traumatic stress disorder are often used interchangeably.
Although there is some discrepancy in the definitions, most researchers agree that having a clear and distinct understanding of each term will help how we identify, respond and prevent the emotional impact of stress and trauma at work.
The human response to stress and trauma is autonomic, but the chemical and biological process that causes a person to experience vicarious or secondary trauma are the same. This stress response is not subject to cognitive or rational processing, and therefore two individuals will likely perceive and react in a different manner to the same event.
Nurses who are experiencing vicarious or secondary trauma will likely have several symptoms present. Common physical signs of vicarious and secondary trauma include: headaches, increased allergies, eating problems, bowel disorders, sleep disorders, burnout, and high blood pressure.
There are also a range of emotional behaviours and symptoms that are associated with vicarious and secondary trauma. Some common behaviours include: irritability, emotional volatility, social withdrawal, disrupted personal relationships, and addictive behaviours.
If left untreated, these symptoms can develop into feelings of helplessness, confusion, alienation, and paranoia. Together, these can be a prelude to the development of other mental health issues such as anxiety disorder, depression and dissociative episodes.
Exposure to stressful working conditions can have a direct influence on a nurse’s health and safety. Coping with these stresses requires protective measures that not only stem from the individual, but also from the professional organisation that they work for.
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James Graham is a freelance medical writer with a PhD in neuroscience. After 5 years of being a post-doctoral research scientist, James left the UK in 2014 and set up his own freelance medical writing business, Craftext, on the Gold Coast. James writes for a diverse stable of clients and has quickly accrued experience across a number of different medical and scientific topics as well as writing in a broad range of styles and formats.