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Vicarious trauma
Distinct from burnout, traumatic stress and compassion fatigue, vicarious trauma among nurses needs to be better understood and studied.
Ravina Raidu interviewed by Dallas Bastian
Dealing with sensitive information when caring for distressed drug and alcohol clients, and the resulting emotional toll and exhaustion, leaves nurses at risk of a range of health issues, a clinical nurse specialist says.
Ravina Raidu, from Drug Health Services, South Western Sydney Local Health District and the University of Tasmania, says the vicarious trauma that nurses working within drug health experience needs to be better understood so it can be identified and treated before it becomes a problem.
Raidu describes vicarious trauma as the transformation that occurs within the self, in which perceptions, concepts and experiences are negatively transformed through continuous and controlled empathetic engagement with the trauma descriptions clients provide.
She adds that it is a natural consequence of detecting, connecting with and caring for clients affected by trauma and, as such, cannot be avoided.
“ It impacts the psychological, mental and physiological wellbeing of clinicians working with trauma clients,” she says.“ It cannot be avoided and is going to be present in their lives no matter what.”
Raidu presented a poster on the topic at the 2017 APSAD Scientific Alcohol and Drug Conference, for which she won the Early Career Poster Prize and the People’ s Choice Award.
The poster focused on Raidu’ s literature review, which aimed to identify, understand and determine the cause of vicarious trauma and its effect on nurses working with drug and alcohol clients.
“ The emotional toll and exhaustion sustained from dealing with sensitive information, with the potential of developing debilitating conditions like depression and anxiety, means that vicarious trauma could be very costly for nurses professionally and personally,” Raidu wrote.
Nursing Review spoke with Raidu about the signs of vicarious trauma, its impact on clinicians and how it can be managed.
NR: Tell us about vicarious trauma and why nurses, and in particular drug and alcohol nurses, may experience it. RR: Vicarious trauma is inevitable, I think, in trauma nursing, and drug and alcohol comes under trauma nursing. We listen to clients’ trauma stories and some of them are quite horrific, and we have to use suppressed emotions, so we don’ t really give into the normal exclamations that one would make when listening to something that is quite traumatic. And that suppressed emotion over time slowly changes nurses’ perceptions on how they look at themselves, how they look at people around them, how they look at their own self-esteem, and how they assess that.
What other impacts can vicarious trauma have on a nurse, both professionally and personally? Listening to the traumatic event increases an awareness of the range and reality of traumatic experiences around the nurse, and they just become more aware of their own vulnerability and safety and security, because most of the trauma stories the clients tell the nurses concern vulnerability, safety and security.
Eventually, this can cause a feeling of helplessness and loss of control, and it affects how we relate to family and friends. It alters the way nurses experience self-identity. It disrupts perception, self-intimacy, and this can lead to manifestations of physical, emotional, psychological signs and symptoms.
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