The Impact of Vicarious Trauma on Nurses and How to Cope

In a recent episode of the Nurse Converse podcast, host Jeri Ford welcomes Danielle Palomares, a trauma, attachment, and sex therapist, for an open and compassionate conversation about the emotional toll of nursing. The discussion centers on vicarious trauma—also known as secondary trauma or compassion fatigue—and its pervasive impact on healthcare professionals, particularly nurses.

What Is Vicarious Trauma?

Vicarious trauma is the emotional residue that accumulates when nurses and other caregivers are routinely exposed to the suffering of others. Over time, this emotional weight can reshape one’s worldview, disrupt a sense of self, and lead to profound physical, psychological, and emotional distress. Nurses are especially vulnerable due to their proximity to patients during some of life’s most painful and vulnerable moments.

This type of trauma doesn’t stem from a single event but builds over time. Repeated exposure to crisis, grief, and emotional upheaval—combined with the pressure to remain composed and effective—can quietly erode resilience and lead to burnout if not recognized and addressed.

Recognizing Vicarious Trauma Symptoms

Vicarious trauma manifests in various ways, many of which can be subtle or easily dismissed as part of the job. Some of the most common symptoms include:

• Physical Symptoms: Chronic fatigue, sleep disturbances, changes in appetite, frequent illness, and a persistent feeling of being “wired but tired.”
• Cognitive Symptoms: Difficulty concentrating, memory lapses, dissociation (feeling disconnected from one’s environment or actions), and a tendency toward black-and-white thinking.
• Emotional Symptoms: Anxiety, irritability, emotional numbness, sadness, or feeling overwhelmed by minor events. Nurses may find it difficult to process their feelings or even to feel much at all.
• Behavioral Symptoms: Withdrawal from social interaction, reduced interest in previously enjoyable activities, and a reluctance to talk about work. Some may isolate themselves to conserve energy or avoid having to explain what they’re experiencing.
• Hypervigilance: A constant sense of alertness, as if anticipating the next emergency. This state can be exhausting and make it difficult to relax, even during downtime.

These symptoms can gradually lead to burnout—a state of emotional, physical, and mental exhaustion that can impair personal well-being and professional performance.

The Cost of Emotional Suppression

Nurses often feel pressure to “keep it together” and may suppress their emotional responses in the name of professionalism or resilience. However, avoiding or minimizing feelings can compound trauma and strip away the very qualities—empathy, connection, emotional presence—that make nurses effective caregivers.

Allowing space for emotional honesty is not a luxury; it’s a necessity. Recognizing one’s inner experience is the first step toward healing and sustainable caregiving.

Coping Strategies and Prevention

Addressing vicarious trauma involves both proactive and responsive strategies that support mental, emotional, and physical health. Some of the most effective approaches include:

1. Developing Healthy Habits

• Physical Activity: Engaging in movement that brings joy and energy—whether it’s walking, dancing, or stretching—can help regulate stress and reconnect with the body.
• Rest and Recovery: Prioritize genuine rest. Passive habits like endless scrolling may feel restful, but they often overstimulate the mind. Seek calming activities that actually replenish energy.
• Balanced Nutrition: Eat mindfully and stay hydrated. Small, intentional changes in nutrition can support mood stability and physical resilience.
• Awareness of Substances: Monitor the use of caffeine, alcohol, or other stimulants that may seem like quick fixes but can worsen emotional dysregulation over time.

2. Building Emotional Awareness

• Identify and Name Emotions: Learn to address your emotions rather than avoid them. This might include journaling, mindfulness practices, or simply taking a moment to check in with oneself during or after a shift.
• Create Space for Emotional Expression: You can achieve this through conversations with trusted individuals, creative outlets, or moments of quiet reflection.
• Give Yourself Compassion and Grace: Understand that emotional responses—grief, frustration, sadness—are not signs of failure but natural and valid reactions to difficult work.

3. Fostering Social and Community Support

• Relationship Building: Connection is a protective factor. Build relationships with colleagues who understand the unique stressors of nursing.
• Get Out of Your Work Environment: Maintain friendships and activities outside the healthcare world to gain perspective and recharge emotionally.
• Safe Spaces: Seek or cultivate safe spaces for sharing and mutual support, whether formal (support groups, therapy) or informal (a regular debrief with a friend or peer).

4. Practicing Mindfulness and Presence

• Mindfulness Practices: These exercises can help regulate emotions and reduce reactivity. Even brief moments of intentional breathing or grounding during a shift can create space between stimulus and response.
• Staying Present: This method also helps nurses avoid emotional numbing, preserving the ability to connect meaningfully with patients—and with themselves.

5. Seeking Professional Support

• Therapy or Counseling: Mental health professionals can provide a much-needed outlet and tools for managing emotional strain. A trained therapist can help identify patterns, develop coping strategies, and support long-term well-being.

Creating a Path Forward

Vicarious trauma is not a reflection of weakness; it is a reflection of care. Those who consistently show up for others in their moments of suffering will inevitably absorb some of that pain. Recognizing the signs and taking action to address them is essential, not just for individual health but for the future of the profession.

Healing requires intention, community, and a willingness to feel. With the right support and strategies, nurses can not only survive the emotional demands of their work but thrive within them—maintaining their compassion, their sense of purpose, and their own humanity.

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🤔Nurses, do you practice the methods shared in this article to cope with vicarious trauma? Is there anything you currently do that we didn’t mention? Share your thoughts in the forum below!