Editor’s Note (September 2026): This article was originally published in 2023 and reflects the research available at that time. It has been reviewed for medical accuracy, clarity, and formatting. Terminology surrounding vicarious trauma, compassion fatigue, burnout, and secondary traumatic stress has been clarified while preserving the article’s original context.
Key Takeaways
- Vicarious trauma can occur after repeated empathic engagement with people who have experienced trauma and may affect healthcare professionals and other helping professions.
- It can involve changes in a person’s emotions, beliefs, sense of safety, relationships, and view of themselves or the world.
- Vicarious trauma overlaps with compassion fatigue, secondary traumatic stress, and burnout, but these terms should not automatically be treated as interchangeable.
- Support may include professional mental health care, peer and workplace support, appropriate workloads, supervision, and strategies for managing occupational stress.
Nurses
Healthcare professionals routinely encounter people experiencing serious illness, injury, abuse, grief, and other forms of trauma. Repeatedly hearing about or witnessing the effects of these experiences can take a psychological toll.
One phenomenon associated with this type of work is known as vicarious trauma.
Vicarious trauma can develop through repeated empathic engagement with other people’s traumatic experiences. Research involving nurses and mental health professionals suggests that it can affect emotional well-being, beliefs, relationships, and perceptions of personal safety.
What Is Vicarious Trauma?
Vicarious trauma describes psychological changes that may occur when professionals repeatedly engage with people who have experienced trauma.
Healthcare professionals who regularly care for patients affected by violence, abuse, severe injury, loss, or other traumatic events may be particularly exposed.
A 2022 concept analysis of vicarious trauma in nursing described it as a psychological phenomenon involving changes in a nurse’s inner experience and worldview following prolonged empathic engagement with patients’ trauma.
These changes can affect how a healthcare professional views safety, trust, relationships, themselves, and the world around them.
Vicarious Trauma, Burnout, and Compassion Fatigue Are Not the Same
Several terms are used to describe the psychological effects of demanding healthcare work, including vicarious trauma, secondary traumatic stress, compassion fatigue, and burnout.
Although these concepts overlap, they are not necessarily the same.
Burnout is generally associated with prolonged occupational stress and may involve exhaustion, cynicism, reduced professional satisfaction, and difficulty functioning effectively at work.
Vicarious trauma is more specifically associated with repeated empathic engagement with the traumatic experiences of other people and may involve deeper changes in beliefs and worldview.
Secondary traumatic stress can produce symptoms resembling those seen after direct exposure to trauma, while compassion fatigue is commonly used to describe emotional and physical strain associated with repeatedly caring for people who are suffering.
Researchers have noted considerable inconsistency in how these terms are defined and measured. Healthcare professionals should therefore avoid self-diagnosing solely on the basis of a list of symptoms.
Possible Signs of Vicarious Trauma
The effects of repeated exposure to patients’ trauma can vary considerably between individuals.
Possible signs described in the literature include emotional distress, irritability, sadness, changes in a person’s sense of safety or trust, difficulty separating work from personal life, and persistent thoughts about patients’ traumatic experiences.
Some healthcare professionals may also experience sleep difficulties, fatigue, problems concentrating, social withdrawal, or changes in how they relate to patients, colleagues, friends, and family.
These symptoms are not specific to vicarious trauma. Similar experiences can occur with burnout, depression, anxiety, secondary traumatic stress, PTSD, sleep disorders, and other conditions.
Persistent or severe symptoms therefore warrant appropriate professional assessment rather than assuming vicarious trauma is necessarily the cause.
Why Healthcare Professionals May Be Vulnerable
Healthcare workers can be repeatedly exposed to severe illness, death, injury, violence, abuse, grief, and the distress of patients and their families.
Some roles involve particularly frequent exposure to traumatic experiences. These can include emergency care, mental healthcare, critical care, oncology, trauma services, and work with victims of violence or abuse.
The effects are not determined solely by an individual’s ability to cope.
Research has also examined organizational factors, including workload, workplace support, supervision, professional resources, and exposure to traumatic material. This means prevention should not place the entire responsibility on individual healthcare workers.
What Can Healthcare Professionals Do?
Recognizing changes in emotional well-being and functioning is an important first step.
Healthcare professionals experiencing persistent distress may benefit from speaking with a qualified mental health professional, particularly when symptoms interfere with work, sleep, relationships, or everyday functioning.
Peer support and appropriate professional supervision may also provide opportunities to discuss difficult clinical experiences.
At an organizational level, healthcare institutions can consider workload, staffing, access to mental health resources, trauma-informed education, supportive supervision, and opportunities for workers to recover after particularly difficult experiences.
Self-care practices such as adequate sleep, regular physical activity, maintaining relationships outside work, and taking appropriate breaks may support general well-being. However, self-care should not be presented as a substitute for professional treatment or necessary workplace changes.
What Does the Research Say About Treatment?
Research into interventions specifically targeting vicarious trauma remains limited.
A review of interventions for professionals working with people who have experienced trauma found that many approaches showed promising results for outcomes such as secondary traumatic stress, compassion fatigue, burnout, and other mental health measures.
However, researchers also identified limitations in the quality of the evidence and inconsistencies in how vicarious trauma was defined.
This means there is no single treatment that can be considered universally established for vicarious trauma.
The appropriate approach depends on a person’s symptoms and circumstances. A mental health professional can assess whether symptoms may be related to occupational trauma exposure or another condition and recommend appropriate care.
When to Seek Professional Help
Healthcare professionals should consider seeking help when distress persists, worsens, or begins interfering with their ability to work, sleep, maintain relationships, or function normally.
Professional help is particularly important when someone experiences severe anxiety or depression, intrusive thoughts, significant substance use, or thoughts of self-harm.
Seeking support for the psychological effects of healthcare work should be treated with the same seriousness as addressing other occupational health concerns.
Final Thoughts
Repeated exposure to other people’s trauma can affect healthcare professionals psychologically and emotionally. Research suggests that vicarious trauma can involve changes extending beyond ordinary workplace stress, including alterations in beliefs, relationships, and perceptions of safety.
However, vicarious trauma should not automatically be equated with burnout, compassion fatigue, secondary traumatic stress, or PTSD.
Healthcare organizations also have an important role to play. Supporting workers exposed to trauma requires more than encouraging individual resilience or self-care; appropriate staffing, supervision, workplace support, and access to professional mental health resources may all be important.
Healthcare professionals experiencing persistent psychological distress should seek appropriate assessment and support rather than attempting to manage serious symptoms alone.
References
Jimenez, R. R., Andersen, S., Song, H., & Townsend, C. (2021). Vicarious trauma in mental health care providers. Journal of Interprofessional Education & Practice, 24, 100451. https://doi.org/10.1016/j.xjep.2021.100451
Kennedy, S., & Booth, R. (2022). Vicarious trauma in nursing professionals: A concept analysis. Nursing Forum, 57(5), 893–897. https://doi.org/10.1111/nuf.12734
Kim, J., Chesworth, B., Franchino-Olsen, H., & Macy, R. J. (2022). A scoping review of vicarious trauma interventions for service providers working with people who have experienced traumatic events. Trauma, Violence, & Abuse, 23(5), 1437–1460. https://doi.org/10.1177/1524838021991310