FEATURE ARTICLE

Vicarious Trauma and Nursing Empathy

COVID-19 appears to be bringing the trauma nurses experience out of the shadows. Instead, words like ‘hero’ are bandied about, but for many, this title doesn’t sit comfortably. For many, our sense of duty, to provide equal healthcare to all that we can, and to extend our empathies means we reject the sometimes-hollow phrasing of being a ‘hero’. However, if we take a basic definition of hero being a person who is admired for their courage, outstanding achievements, or noble qualities, perhaps the disconnect with the term is deeper than at first glance.

Think about the last time something about your work scared you. Was it a dangerous patient, dangerous staffing levels, insufficient PPE, or even challenges in terms of what we can realistically achieve with the resources at hand? Many of these things are out of our control, but the one thing within our control, our empathy, in conjunction with our fears and distresses, can do us more harm than good if we do not recognise the warning signs of our response to accumulated trauma.

Vicarious Trauma

Vicarious trauma (VT) is ‘the negative transformation in the helper that results (across time) from empathic engagement with trauma survivors and their traumatic material, combined with a commitment or responsibility to help them’ (Pearlman and Caringi, 2009, 202-203).

As nurses, midwives, and care workers, we work within and alongside various challenging situations with those we care for. We learn of their traumas, their frustrations, their emotional distress. We bear witness to incredible difficulties and form therapeutic relationships with our patients. This however comes at a personal cost. We are often told about concepts of burnout, or compassion fatigue, however the Post Traumatic Stress Disorder symptoms of VT can also be very real and debilitating if intervention is not done in a timely manner.

Five common recurring factors have been identified as markers of VT:

Unmodulated affect in response to client’s trauma narratives e.g. intense emotional responses to a client’s trauma disclosures
Somatic complaints e.g. recurring headaches, aches and pain without apparent illness or injury
PTSD symptoms e.g. hyper-vigilance or re-experiencing aspects of disclosed traumatic events in intrusive images or symptoms such as dissociation
Impact on personal frame of reference e.g. clinicians may report pessimistic world and life views
Symptoms of acute stress disorder, depression and anxiety e.g. including insomnia, social withdrawal and patterns of work and social avoidance (Wilson &
Thomas, 2004).

A strong organisation which values its staff well-being provides interventions to manage any early signs of VT, and has a cohesive team approach with self-care, professional support and social support opportunities built into the working day. However, we are not always working within such a utopia, and can only control our own actions. Part of this is to prioritise our own self-care skills and devote the same energy and empathy we provide to others to ourselves – you cannot pour from an empty cup – and you deserve the commitment to yourself.

If you are struggling personally, the Nurse & Midwife Support service has further information on the signs and symptoms of VT and what you can do to protect your own mental health at https://www.nmsupport.org.au/workplace/vicarious-trauma or contact them for free, confidential 24/7 advice on 1800 667 877.

If you are experiencing issues in your workplace, please contact our Member Support Team on membersupport@anmftas.org.au

References:

Pearlman, L. A., & Caringi, J. (2009). Living and working self-reflectively to address vicarious trauma. In C. A. Courtois & J. D. Ford (Eds.), Treating Complex Traumatic Stress Disorders: An Evidence-Based Guide (pp. 202-224). Guilford Publications

Wilson, J. P., & Thomas, R. B. (2004). Empathy in the treatment of trauma and PTSD. New York: Brunner/Routledge.

Updates correct as at 23 July 2020.
Authorised by Emily Shepherd, ANMF Tasmanian Branch Secretary

ASSISTANCE & SUPPORT

Member Support Team: The ANMF Tasmanian Branch is 8000 plus members strong! Supporting nurses, midwives, and care workers as the only union in Tasmania employing nurses and care workers to represent members. This is why our Organisers and Member Support Team are uniquely positioned to understand your experiences, represent you in your workplace, and offer industrial advice that’s relevant to you. Please contact our Member Support Team if you need workplace support, would like to discuss any matters or raise a concern. Alternatively, you can send an email outlining your concerns to our team - membersupport@anmftas.org.au. Email is the preferred and fastest way of contacting the team, however if your matter is urgent, please phone (03) 6223 6777 or 1800 001 241 if you are outside of Hobart.

Member Support Team

Nurse and Midwife Support If you are seeking confidential support and advice, members have access to 24/7 phone support from Nurse and Midwife Support.

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