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 In the Nurses Unit: Secondary Trauma From the Emotional Weight of Tragedy

Most nurses will tell you they’ve seen everything when it comes to gruesome injuries and tragic deaths.
 They’ve got thick skin and and an elastic heart. It’s a part of their survival and what it takes to focus on healing patients regardless of the calamity happening around them. 


However, our hearts can’t always be pain proof.


While nothing will compare to the pain that the victims of a tragedy and their loved ones may endure, things can take a toll on health professionals dealing with repeated exposure to the traumas, particularly when there are a massive number of victims such as 9/11, the Sandy Hook Elementary shootings, and most recently, the 49 people killed at the Orlando nightclub, Pulse.

An anonymous medical professional who was at the Orlando Regional Medical Center, which was just a few minutes away from the attack being called “the worst shooting in recent American history” spoke to about the hectic night. 

It seemed like any other weekend shift at the hospital when the first shooting victim was brought in during the early morning hours of June 12.

“...Then we heard multiple victims, and I knew that something worse had happened...Because we're so close, it was like everyone showed up all at once, and then more people kept coming," he said.

"There were literally hundreds of people, and family members were showing up, all panicked and hysterical."

The scene was frantic as patients with multiple gunshot wounds piled in with various injuries. Blood curdling screams from a mother could be heard as a doctor informed her her son didn’t survive.

The chaos was so loud the anonymous employee said he couldn’t hear himself think.

"I went into the staff room because I needed a minute, and there were two other nurses crying," he says. "I think everyone took a minute at some point last night and let out the emotions."

For many nurses, the stain of such tragic events won’t just wash away with one good cry.

It may trigger compassion fatigue, often used interchangeably with secondary trauma or Post Traumatic Stress Disorder (PTSD). It can affect the brain and  even cause neurological issues.

You can’t predict when it may hit, but when it does, you may feel disassociated with where you are and what you’re doing. You may feel physically sick before work, or you may start to feel what your patients feel, which could be due to learning about your patient’s horrible experience and subconsciously adopting them as your own.

Researcher Babette Rothschild calls it unconscious empathy.

This can lead to anger, anxiety, headaches, nausea, depression, dizziness, even nightmares and a host of other ailments.

The impact of trauma can stay with you for years, and may even be re-triggered.

Psychology Today reported that 1994 study found 86.7 percent of emergency personnel reported some form of PTSD following a highly distressing event with victims.

The symptoms can lead to serious health issues and the dreaded nurse burnout.

Thankfully, there are things you can do to avoid trauma and perhaps relief trauma if you’ve been dealing with it.

One of the biggest things nurses must implement to avoid secondary trauma is taking time for self care.

You must take the time to eat or take a break, more now than ever.

If you start to feel at any moment that you are not present in your body, that’s also a red flag that you need to take a break, and take a few deep breaths. You can also make small movements with your body to regulate your nervous system and decrease stress from the secondary trauma you’re experiencing.

It is also advised that nurses keep visual reminders aligned with their identity on hand, such as photos of their family and friends, or a playing with a wedding ring from time-to-time will remember your own life outside of work.

Take every opportunity to support work-life balance. Force yourself to use vacation days to actually book a vacation. Also remember that your sick days are good for mental health breaks..

Something nurses should also take advantage of in any difficult situation is the Employee Assistance Program available at many hospitals.

These resources typically provide supportive counseling for issues nurses may be facing, but even if your employee doesn’t offer this, a nurse struggling with compassion fatigue should seek out professional help for the sake of themselves, their families, their patients and their quality of work. For more information on how to prevent and treat secondary trauma, visit the American Nurses Association’s site primer page:

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