What is Vicarious Trauma? A Look at an Important Yet Overlooked Concept

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Nursing leaders work with colleagues to prevent and manage vicarious trauma.

Nursing can provide great career meaning and gratification, but caring for others can also be emotionally taxing and stressful. Researchers report high rates of vicarious trauma in the emergency, mental health, pediatric, and oncology nursing professions, according to the article titled “Secondary Posttraumatic Stress and Nurses’ Emotional Responses to Patient’s Trauma,” published in the Journal of Trauma Nursing.

This vicarious trauma presents a challenge for nursing leaders. Registered nurses who wish to make a positive impact in health care through thoughtful leadership may want to pursue a doctoral level degree such as a Doctor of Nursing Practice (DNP). An online Bachelor of Science in Nursing (BSN) to DNP program can help prepare nursing students to combat vicarious trauma in a variety of settings from a valued leadership position.

What Is Vicarious Trauma?

Vicarious trauma, compassion fatigue, and secondary traumatic stress are all terms used to describe the “cost of caring” for trauma survivors. Specifically, vicarious trauma refers to the personal impacts of working with trauma patients.

Health care workers such as doctors, first responders, and nurses who are responsible for providing care to trauma patients are susceptible to developing symptoms of vicarious trauma. Nurses are vulnerable to this cost of care because of the nature of their interactions with patients. Typical nursing roles involve a direct relationship with a trauma patient throughout their recovery period. During this patient relationship nurses may become personally invested in the patient experience and recovery, feel empathy for the patient’s situation, and witness the impact of this trauma on the patient’s relatives and family.

Other professionals who may be impacted by vicarious trauma include lawyers, police officers, therapists, and support providers who work with homeless people or victims of domestic abuse.

How Vicarious Trauma Differs from Burnout

Vicarious trauma is often confused with burnout; however, the two terms describe different conditions. Vicarious trauma is more directly linked to working with trauma survivors, such as a nurse who has treated a patient with severe injuries from a car accident. In contrast, the primary causes of nursing burnout are stress and increasing workloads, according to the survey by RNnetwork titled “2018 Portrait of a Modern Nurse.” Burnout can stem from a variety of workplace factors, such as the high demands of caring for elderly Alzheimer’s patients in a senior care facility.

According to the American Counseling Association, burnout also typically builds up over time and can often be mitigated by modifying the responsibilities of a current job or taking on a new position in a different field. Vicarious trauma typically occurs more quickly and causes a state of tension that may require a more involved treatment program, such as therapy.

Symptoms of vicarious trauma and burnout can negatively impact the quality of care that is provided by a nurse practitioner. Nurses in leadership or management positions must be especially familiar with the signs and symptoms of burnout and vicarious trauma so they can identify when a staff member may be experiencing either condition.

Symptoms of nurse burnout include chronic fatigue, depression, and insomnia. Symptoms of vicarious trauma include anxiety, an aroused physiological state, difficulties managing emotions, and persistent flashbacks or nightmares of the traumatic event. These symptoms may result in withdrawing from family and friends, making odd decisions, or performing poorly at work.

How DNPs Can Combat Vicarious Trauma

A DNP degree prepares graduates to provide advanced primary and specialized care. With their leadership and interpersonal skills, DNPs may also take on clinical leadership positions, hospital administrative roles, and nursing instructor or educator positions.

Whether in a direct care position or clinical leadership role, DNPs can help prevent and watch for vicarious trauma symptoms in their peers and employees. DNPs can encourage their teams to develop healthy coping strategies that can help minimize the effect of the condition on providing quality care. These coping strategies include practicing regular self-care both during and outside of work such as eating regularly and getting enough sleep. Setting boundaries to prevent becoming too emotionally invested in a patient is another important coping strategy.

Nursing instructors and DNPs in administrative roles can look for opportunities to share knowledge and information about preventing and managing vicarious trauma. DNPs in administrative roles may seek out vicarious trauma training opportunities and courses that teach coping strategies and increase emotional resilience. Nurse instructors can focus on important skills such as emotional intelligence and self-awareness so the next generation of nurses is equipped to deal with the stress and demands of the job.

How Earning a BSN to DNP Degree Can Help Develop Key Skills

A BSN to DNP program enables registered nurses who hold a Bachelor of Science in Nursing (BSN) to pursue a doctoral-level degree. A DNP degree emphasizes evidence-based training.

Regis College offers an online BSN to DNP program that can help nurses gain knowledge of advanced clinical concepts and refine the skills needed to become effective leaders in their field. Students enrolled in the program are given the tools to develop emotional intelligence, leadership, and interpersonal and communication competencies:

  • Emotional intelligence: Courses such as Roles and Issues in APN help students understand the complex nature of advanced nurse practitioner roles and the value of emotional intelligence in nursing.
  • Leadership skills: With courses such as Concepts in Nursing Leadership, students learn about key theories and methods that support motivating and influencing others in a health care environment.
  • Interpersonal and communication skills: Courses such as Nursing Theory explore advanced nursing practice concepts and models, and help students develop a greater understanding of the importance of interpersonal and communication skills while working with patients and other health care professionals.

The advanced skills developed from a DNP degree can enable nurse leaders to help staff members cope with vicarious trauma before it negatively affects patient care.

Prepare to Advance Your Career with a DNP

Licensed RNs who wish to advance their careers would do well to explore the online BSN to DNP program offered by Regis College. The program is designed to empower graduates to make an impact in health care in various areas, including tackling important industry challenges such as vicarious trauma. If you’re looking to help make an impact, learn more about how Regis can help you achieve your goals.

Recommended reading

What Degree Does a Nurse Practitioner Need? Why Advanced Programs Are Critical
5 Benefits of Earning a DNP Degree
How Long Are BSN to DNP Programs?


American Association of Colleges of Nursing, DNP Education
American Counseling Association, Vicarious Trauma
International Society for Traumatic Stress Studies, Self-Care for Providers
Regis College, How Long are BSN to DNP Programs
Regis College, Online BSN to Doctor of Nursing Practice
RNnetwork, RNnetwork 2018 Portrait of a Modern Nurse Survey
Society of Trauma Nurses, “Secondary Posttraumatic Stress and Nurses’ Emotional Responses to Patient’s Trauma”
Taylor & Francis Online, “Emotional Resilience in the Helping Professionals and How it Can Be Enhanced”