Antoine, J. Vicarious Trauma : It’s ok to not be ok, Don't Forget the Bubbles, 2019. Available at:
One afternoon my team broke the news to three different families that their children had a non survivable condition. That same week I was involved with a patient transitioning to a palliative pathway focused on comfort. I returned home to utter the words, “She is so sweet, I hope she dies soon.”
For many of us, days like these, occur commonly.
Being a doctor is a privilege, an honour, a calling. Our jobs are stressful, diagnostically challenging, involve managing team members, and effectively communicating and engaging with different families whom have different needs. We are reliant on our knowledge and skills. What sets our job apart from other high stress environments is that any given day can involve death and dying. We see distressing conditions. Our day includes the uncommon, the unlucky and the unfortunate events of life. To the public these events occur few and far between, but for us it may be a daily occurrence -a relentless barrage of traumatic events, poor outcomes and sad stories.
The intensive care environment is difficult to navigate. The rates of burnout, mental health issues and self medication are high amongst our peers. 70% of junior doctors feel burnt out following a neonatal rotation. Strikingly, their (our) rates of suicide are twice that of the general population. Most of us have heard the words compassion fatigue. Some of us may even be familiar with vicarious trauma – the negative experience of working directly with traumatised populations. Compassion fatigue and vicarious trauma are on a spectrum. We initially may feel overwhelmed by our interaction but this can develop into symptoms of post traumatic stress.
At DFTB18, I spoke about some of the things we can do to reduce this happening to us, and the events above reinforced that message;
- Seek the support of those around you.
- Reflect with your supervisor.
- Get together with your team to debrief.
- Seek professional psychological support.
- Foster a culture in your workplace that is supportive and open, whilst also taking time for yourself.
- Make a regular appointment to see you GP.
And remember, it’s ok not to be ok
For more on this topic of the difficulties of dealing with death and burn out hit up DFTB at:
Hauser N, Natalucci G, Ulrich H, Sabine K, Fauchere JC. Work related burden on physicians and nurses working in neonatal intensive care units: a survey, Journal of Neonatology and Clinical Pediatrics. 2015;2:2:0013.
Nimmo A, Huggard, P. A systematic review of the measurement of compassion fatigue, vicarious trauma and secondary traumatic stress in physicians. Australian Journal of Disaster and Trauma Studies. 2013;1:37-44.
Stress, burnout and vicarious trauma: looking after yourself. RACGP Webinar Series.