Mass Shootings and Secondary Trauma Add to Nursing Trauma

Nurse Beth, MSN

Nurses encounter first-hand trauma regularly, which can lead to post-traumatic stress disorder (PTSD).

Additionally, they are exposed to others' traumas at work and on the news, which can lead to secondary trauma. Secondary trauma occurs when we are exposed to horrific events or even someone else's PTSD, making us involuntary witnesses.

As a result of witnessing trauma vicariously, we're at risk of experiencing traumatic countertransference, where we experience various emotions, including helplessness and terror, as if we were there.

What are other terms for secondary trauma?

Other terms for secondary trauma include:

second-hand PTSD
secondary traumatic stress disorder
compassion fatigue
vicarious traumatization

Symptoms of PTSD and secondary trauma can overlap. They include:

anxiety.
difficulty coping, and feeling overwhelmed.
difficulty making decisions.
feeling helpless.
fear.
emotional numbing.
lack of tolerance, irritability.
flashbacks and dreams.
lack of empathy, feeling empty.
Other consequences of trauma

Trauma experienced in the present can trigger unresolved trauma from the past.

You may overreact to a slight loss, like losing or misplacing an item, because it unconsciously triggers memories of a more painful past loss.

Additionally, we can find ourselves in a constant state of arousal, waiting on edge for the next horrific event or mass shooting, wondering if our world really is safe.

Reduce exposure to news

Don't leave yourself open to a steady barrage of news at all times. Control your exposure. Things we can do to reduce our exposure and counter the negativity include:

taking a social media break. Disconnect from the news, even if it's for a brief time.
going for a walk and picking some flowers or leaves for a bouquet.
immersing yourself in a hobby, such as cooking or knitting, or something that requires singular concentration, like puzzles.

Process trauma at work

Process your thoughts and emotions. Take time to debrief and process traumatic events at work, such as a code.

Anecdote: Years ago, as a new nurse in ICU, I experienced my first patient death. At the time, I felt numb. I had never seen a dead person. I looked around the unit for someone to talk to or cues for what to do and how to act, but everyone was busy and acting normal. The head nurse was calmly chatting with a surgeon, both sipping coffee at the nurses' station, seemingly unaware of my personal trauma. I still remember looking at her and wondering how she could appear so unconcerned when a human being had just died within yards of her.

Within minutes the charge nurse came up and, without any preliminary conversation, briskly said, "Beth, we're floating you down to Tele since you're freed up. You can take a quick break, but they're expecting you!" I hurried down to Tele and can't recall the rest of that day.

That first death, an elderly no-code patient, seems routinely unremarkable to me now as I look back on it. Still, when weaving the story in during a lecture to new nurses 20 years later, my eyes welled up with tears. It was a sign that I had unresolved trauma around that death. At the time, I didn't know enough to ask for help or even know I needed help.

While tearing up during a lecture presentation was embarrassing, I pivoted and used my tears to highlight the importance of recognizing and processing trauma.

Practice self-awareness

Listen to your body. Be aware of symptoms that indicate you may be in a state of unintended arousal, such as having

nightmares.
difficulty falling asleep.
difficulty staying asleep.
panic attacks.

Realize your power

We have choices. You can always choose to make a positive impact within your sphere of influence. Even when you feel helpless in the face of horrific world events, you can reclaim your power by taking action.

Be a good human. Do good things for others. Doing good for others is doing good for yourself.

Call a friend you've lost touch with.
Spend some real quality time with your partner.
Leave a generous tip.
Give boxed leftover food to a homeless person.
Volunteer to take B/Ps or fingersticks at a health event.

Get help

When it's time for help, don't wait. If you wonder if you should get help, then you probably should. Getting therapeutic help for symptoms is crucial to your health and coping with trauma. There are many resources, including:

employee assistance program (EAP) at your place of work
seeing a counselor
seeing your spiritual provider

References

1. https://www.sciencedirect.com/topics/medicine-and-dentistry/compassion-fatigue
2. https://www.latimes.com/california/story/2023-01-23/secondary-trauma-mass-shootings