Am I Experiencing Vicarious Trauma?

Authors: Jennifer Hughes, PhD, and Alisha Bowker, LCSW, UMC Trauma Recovery Clinic Team

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At times it can feel nearly impossible to find the motivation to keep showing up to work, week after week, especially after working long hours or dealing with crises and looming deadlines. Working in the medical and helping fields, especially, we are often overwhelmed with horrific stories of violence, pain and trauma, which can dramatically alter the way in which we understand the world, ourselves and others.

The clinical term for this phenomena is Vicarious Trauma (VT).

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What is Vicarious Trauma (VT)?

Vicarious Trauma can be defined as a change in a helper’s inner experiences after working with people who have experienced traumatic events. Trauma can be defined as a deeply or distressing event that one directly witnesses or hears about. This can include natural disasters, interpersonal violence, war, divorce, childhood abuse and so on.

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Does Everyone Experience VT?

VT is a natural consequence of being an empathetic human, and being exposed to a population who has experienced trauma. Those often impacted by VT are social workers, case managers, doctors, nurses, first responders, etc. It is an inevitable hazard in these lines of work and, unfortunately, cannot be avoided, but definitely can be addressed and managed.

VT can also extend not only to helping professionals who work with this population, but also to the caregivers or loved ones of a survivor.

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How Does VT Impact My Life?

Vicarious Trauma is an ongoing process that slowly builds over time the longer we are exposed to the stories of trauma survivors. It generally begins to impact us in three different realms:

  1. Identity: It begins to impact our identity, which changes the way we see and define ourselves.
  2. Worldview: It impacts our worldview by skewing the ways in which we understand others or understand how to interact with those around us.
  3. Spirituality: It can impact our spirituality, and replace feelings of hope with feelings of cynicism and despair.

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VT Versus Burnout

Vicarious Trauma is different than burnout, as it truly only develops after being exposed to traumatic stories. Burnout is a state of chronic stress, particularly in a work environment, that leads to physical and emotional exhaustion, cynicism, detachment and feelings of worthlessness.

While the symptoms are similar, burnout is generally not rooted in trauma exposure.

Signs and Symptoms of VT

Some of the most common signs and symptoms of VT fall under these 5 areas:

  1. Cognitive: Intrusive thoughts, sounds or images about the traumas an individual has been exposed to, difficulty concentrating, constantly thinking about survivors outside of work, becoming more cynical or negative in one’s thinking patterns.
  2. Physiological: Ulcers, headaches, chronic pain, stomach aches, sweating or heart racing when reminded of a trauma
  3. Spiritual: Lose hope, see others as bad or evil and lose sight of the good in humanity, difficulty trusting our own beliefs
  4. Behavioral: Hair trigger temper, isolating, using unhelpful coping to manage big feelings (drinking, drugging, gambling), need to control everything and everyone
  5. Emotional: Lose touch with one’s own self-worth, isolate from loved ones, feeling overwhelmed or emotionally restricted

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So now that we have the language to define the symptoms we are experiencing, what can we do about it?

Thankfully there is an answer for this and it can be broken down into three phases:

Anticipate and Protect, Address and Transform

  1. Anticipate and Protect: Arrange things ahead of time to anticipate the stress of your work and its impact on you.
    • Become aware of VT and start to look out for signs and symptoms. Intentionally plan for a healthy balance between your work life and personal life.
    • Find a support system, particularly amongst colleagues who share this language and can support you as needed.
  2. Address: How you take care of yourself in and out of work
    • Engage in Self-care: Attending to yourself physically, spiritually, emotionally and psychologically
    • Self-nurture: Engaging in activities or things that provide comfort, relaxation and play
    • Escape: Getting away (whether literally or mentally)
  3. Transform: Transform the negative aspects of this work into positive connection and meaning
    • Create Meaning: Find ways to hold onto your values and identify even in the face of trauma
    • Infuse current activities with new meaning: Mindfulness, Connection to others
    • Challenge negative beliefs: Actively challenge negative thoughts or cynicism/ Re-frame your thinking

While vicarious trauma is a very common and inevitable consequence to the work that we do, the exciting news is that we have the tools to fight back. This is an ongoing process that will continue to look different at different stages of our careers, so it is a process we must continuously be engaging with.

Both individually and collaboratively, begin to identify the signs of VT in your own life and use the template above to make a plan for how to begin addressing and counteracting these symptoms.

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Remember, you are not alone with your vicarious trauma, and do not have to manage it alone either.  

Why You Won’t Want to “Feel the Burn” This New Year’s

Author: Angelle Bonura, BSN, RN, Nursing Director of UMC Burn Center

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Sparks fly every New Year’s Eve, and I don’t just mean romance during the annual midnight kiss. Fireworks are the staple tradition for ringing in the New Year, and for 2018, it will be no different.

While fireworks are fun to enjoy, they also pose hazards to those using or near them. On average, 250 people report to the emergency department every day with fireworks-related injuries in the month of July around Independence Day, according to the U.S. Consumer Product Safety Commission. For New Year’s, that number historically spikes again.

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In total, more than 50 percent of injuries involving fireworks happen to people under the age of 20.

At the UMC Burn Center, it is our job not only to treat and care for those who have suffered burn injuries, but to prevent them from happening in the first place.

Here are the do’s and don’ts when it comes to popping fireworks this year, compliments of the American Burn Association:

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DO

  • Consider safe alternatives, such as glow sticks and confetti poppers
  • Follow your local and state laws regarding fireworks
  • Have a designated SOBER adult light all fireworks
  • Light one firework at a time and move away quickly
  • Keep children and other observers at a safe distance
  • Keep a bucket of water close for disposal of fireworks

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DON’T

  • Allow children to handle fireworks
  • Attempt to alter, modify or relight fireworks
  • Point or throw lit fireworks at anyone
  • Ever hold lit fireworks in your hand
  • Consume alcohol or drugs when lighting fireworks

THE FACTS

  • Sparklers can reach 2,000 degrees Fahrenheit
  • Thousands of fireworks injuries were treated in the U.S. emergency rooms, often leaving permanent damage.

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IF A BURN INJURY DOES HAPPEN…

  • Cool the burn with COOL water.
  • Remove all clothing and jewelry from the burned area.
  • Cover the area with a dry clean sheet or loose bandages.
  • Seek medical attention immediately.

The UMC Burn Center will open in early 2018. It will be the only combined Burn-Trauma Center from Houston to Mobile, and will comprehensively treat thermal, inhalation and chemical burns.

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To learn more about the new Burn Center, visit: www.umcno.org/burncenter or click here.

To learn more about our Level 1 Trauma Center, visit: www.umcno.org/trauma. 

Be Mindful, B-WELL

Authors: Jennifer Hughes, Ph.D. (UMC Trauma Psychologist), Alisha Bowker (UMC Licensed Clinical Social Worker)iStock-639641818 (1).jpg

Mindfulness is defined as a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations.

Do you feel burnt out? Are you overworked? Do you feel as though you are at a crossroads in life? Are you happy?

Practicing mindfulness can help anyone who experiences stress, feels overwhelmed or battles with despair. It is proven to help many patients, too – especially those who have experienced trauma — learn how to cope with physical and emotional pain.

It also benefits healthcare professionals as they cope with stress after providing care to others, connect with patients, and work improve their quality of life.

For mental health professionals, this awareness helps reduce negative emotions and anxiety, and increases their positive emotions and feelings of self-compassion.

Research through Harvard University, the National Institutes of Health, and other leading healthcare agencies have shown that mindfulness can be effective, additionally, in reducing stress, symptoms of anxiety and depression, and improving sleep and pain management.
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Starting a mindfulness practice can be as simple as following these steps:

  • Choose a specific time: Set aside a time and space each day to practice mindfulness. It can be the same time everyday or different times, whatever is best for you. Find a quiet place with few distractions and take a comfortable seat in a chair or on a pillow on the floor.
  • Observe the here and now: The goal of a mindfulness practice is not to quiet the mind; in fact, our mind is made to wander, so why fight its natural instincts! Instead, set the intention of paying attention to the present, the here and now, without judgment.
  • Allow your judgments to come and go: When your mind inevitably begins to wander, some of those thoughts may be judging the current situation (for better or worse). When these thoughts arise, make a mental note of their presence and let them pass, and return back to the here and now. Don’t get bogged down in the power of judgment!
  • Be kind to your wandering mind: When we practice mindfulness, it can be helpful to begin by welcoming all of ourselves, including our pesky wandering mind. When your mind begins to drift away from the present moment, don’t judge it or yourself. Practice noticing those thoughts and returning to the here and now. Welcome your mind just as it is. iStock-584608574.jpg

 Mindfulness can also help with:

  • Physical Pain: One of the most effective mindfulness practices to help ease physical pain is the body scan, which allows us to identify and “dive into” different body sensations. By first focusing on specific body sensations and then widening our awareness to our body as a whole can help us to identify less with our pain.
  • Stress, Anxiety/Trauma, and Depression:
    • Stress: mindfulness can reduce stress in the moment and give you skills that will help decrease the impact of stress in the future
    • Anxiety and Trauma: Mindfulness can help the brain respond to traumatic memories in less painful and more helpful ways. This helps reduce the negative impact of traumatic events and improve overall functioning
    • Depression: Mindfulness can help ease the symptoms of depression by decreasing the cycle of negative thought patterns, feelings, and behaviors. It can even help to improve relationships with others through breaking these cycles

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At University Medical Center New Orleans, we are working to address burnout and compassion fatigue by focusing on mindfulness and other wellness initiatives through B-WELL: a new program that aims to give back to our employees and encourage them to remember to take care of themselves.

Our advice to you?: Be mindful to work toward B(ing)-WELL.

For more information on mindfulness, check out these resources:

Online

Books

  • Full Catastrophe Living by Jon Kabat-Zinn
  • A Mindfulness-Based Stress Reduction Workbook by Bob Stahl, Ph.D. and Elisha Goldstein, Ph.D.

Free Smartphone Apps

  • Stop, Breathe & Think
  • Insight Timer
  • PTSD Coach
  • Mindfulness Coach
  • Headspace (Paid)

 

Stop the Bleed, Save a Life

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Authors: Jen Avegno, MD (LSU Emergency Medicine Physician) & Rebecca Schroll, MD (Tulane University Trauma Surgeon)

A nightclub. A country music concert. A Congressional baseball field. These are normally places of leisure and entertainment, but in the past year, they have become scenes of unimaginable tragedy where innocent victims have been targeted for mass murder and injury.

As doctors at University Medical Center’s renowned Level 1 Trauma Center and Emergency Department, treating victims of violent injury is our job and something we do every day. With our fellow dedicated team members, we are proud to serve our fellow Louisianans on what is often the worst day of their lives.

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Although we are professionals who are trained to handle anything that comes our way, it affects us personally, too.

We are mothers, wives, neighbors, and citizens of this great city – and it’s hard not to put ourselves in the shoes of the grieving family members and friends we see after a violent trauma.

When we talk to others about high-profile tragedies like the recent Las Vegas concert shooting or the Washington, D.C. shooting of Representative Scalise and others, we often hear remarks like “I feel helpless” or “there’s nothing I can do to help.”

And yet … there is.

Anyone can save a life – and UMCNO is making it easy to learn how.

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Through partnerships with our two medical schools, we are proud to bring the national Stop the Bleed program to our community. New Orleans has long held the dubious distinction of having one of the highest rates of violent trauma from shootings and stabbings; now it’s our turn to lead the way in turning the tide. Stop the Bleed was developed by the Department of Homeland Security and American College of Surgeons to teach anyone – especially non-medical personnel – the basic skills needed to identify and control life-threatening bleeding in any emergency situation.

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Imagine you’re jogging in the park and you come across someone with a badly broken leg who is losing blood rapidly. With Stop the Bleed training, you can quickly and easily stabilize the victim while EMS is on the way.  It’s an empowering feeling to know that YOU can save someone’s life, and a natural way to prove we are a community that cares for each other.

The only thing more tragic than a death is a death that could have been prevented.

Because we believe so strongly in this program, UMCNO is hosting FREE community classes every two weeks – open to anyone. Or, if you’d prefer, UMCNO medical staff can come to you and give a free training in your school, business, church or other organization.

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We have also put together special Bleeding Control kits containing the supplies that can be used to help stop bleeding.

Our goal is to put a kit in every school, place of worship, large building, and public space in the city.

Since the program started, UMCNO has trained nearly 1,000 of our neighbors, colleagues and friends. We’ve given the training in schools, organizations, security agencies – to anyone who’s asked.

In partnership with Ceasefire New Orleans, we have set up a great community training kick-off event October 16 at Kermit Ruffin’s Mother-in-Law Lounge. Come eat some great food and second-line while you learn some valuable skills!

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To learn more about Stop the Bleed at University Medical Center New Orleans or sign up for a class, visit: www.umcno.org/stopthebleed.

We lead the nation in celebrating life in New Orleans … together, let’s lead it in saving lives, too!