For Healthcare Providers, Healing Doesn’t End With the Patient

April 17, 2014

This week marks the first anniversary of the bombings at the 2013 Boston Marathon. While all of our thoughts are with the victims and their families, it is also a reminder of how far the implications of a large-scale tragedy can extend.

I recently read a Philadelphia Inquirer article by Dr. Leana Wen, who was working in the emergency room at Massachusetts General Hospital the day of the bombings. As Dr. Wen describes the extensive injuries sustained by her patients, she also discusses the strong emotional reactions she felt in the response to her experience: We were ready for trauma, but not for the volume of tragedy and the overwhelming emotions…as technically prepared as we were, nobody can ever be ready emotionally for such an event. Back in the ER the next day, I flinched every time I heard the loudspeaker. Every time sirens sounded, I wondered whether it was a loved one in the ambulance. I felt sorrow, then anger, then guilt: Who am I to have these emotions when so many others were suffering so much?”

Dr. Wen has touched upon an unfortunately common issue in healthcare-- the secondary traumatic stress experienced by those involved in patient care. Healthcare providers help patients and families through incredibly painful and stressful times. Although trained to provide medical care and support for their patients, providers are not always prepared to handle their own emotional reactions to particularly stressful situations. As the Director of Training for CHOP’s Violence Prevention Initiative, I provide trainings throughout the CHOP Network on trauma-informed care, which involves understanding a patient’s past and current trauma in order to best provide care. This approach can (and should) also be taken by providers when considering their own emotional response to a patient or situation at work. CHOP’s Healthcare Toolbox website provides actionable, evidence-based tips for providers to handle their own reactions.

  • Awareness: pay attention to your own emotional reactions and distress when confronting others’ traumatic experiences, and know what types of experiences may trigger your reactions
  • Support: Connect with others by talking about your emotional reactions with trusted colleagues or others who will listen
  • Balance: Maintain a balance between your professional and personal lives, with a focus on self-care (e.g., relaxation, exercise, stress management, etc.) to prevent, and lessen the effects of, workplace stress

It’s important to note that it’s not only “front line providers” such as doctors or nurses that can experience these traumatic stress reactions, but also support staff who witness a patient’s trauma. Although large-scale events like the Boston Marathon bombings can be a grim reminder of the emotional toll trauma can have on healthcare providers, these types of reactions can and do occur every day. All those involved in healthcare in a clinical setting, from an EMT to an emergency room doctor to a social worker, should remember that emotional reactions are experienced by many providers and are understandable. Addressing them head-on and helping colleagues to do the same is vital to a healthy professional and personal life.