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Secondary Trauma: Fostering Resilience, Decreasing Burnout and Reducing Medical Errors

December 8, 2022
December 8, 2022

This blog is taken from a recent HealthStream webinar entitled “Secondary Trauma: Fostering Resilience, Decreasing Burnout and Reducing Medical Errors.” The webinar featured

  • Jonathan Adler, M.S., M.D., Chief Medical Officer, CredibleMind
  • Scott Dahl, Senior Director, CredibleMind
  • Susan Gurzynski-Wells, Director, Product Management, HealthStream

The webinar focused on secondary trauma in healthcare workers, the importance of assessing individual risk, and interventions that can improve coping skills for secondary traumatization.


Secondary Traumatic Stress – What Is It?

Dr. Adler began by defining secondary traumatic stress (STS). It refers specifically to the emotional duress that is experienced when learning about someone else’s trauma. Secondary traumatic stress can lead to a variety of symptoms including those that can easily be mistaken for Post-Traumatic Stress Disorder (PTSD) and burnout. Further complicating the issue is the fact that healthcare providers may also experience both STS and direct trauma. Dr. Adler also shared that STS is further compounded by some fairly typical but difficult aspects of the healthcare workplace:

  • Long, inconsistent work hours
  • Disrupted sleep
  • Exposure to suffering, dying, and anguish
  • High stress levels resulting from high levels of job responsibility
  • Constant education requirements along with high capacity requirements
  • High productivity demands
  • High compliance and certification demands
  • COVID-19


STS and Burnout – What are the Consequences?

STS and burnout, when left untreated, have severe consequences for providers, patients and the nation’s healthcare organizations. Burnout is highly associated with unsafe care, unprofessional behaviors and low patient satisfaction, all of which can have a significant impact on bottom-line and reputation.

Sadly, the problem may also be contributing to the risk of suicide for doctors and nurses as 300-400 physicians die by suicide each year and medical students are three times more likely to die by suicide than the rest of the population in their age group. In addition, nurses die by suicide at a rate of 1.5 times the rate of the general population.

STS and burnout also come with an enormous financial cost. Dr. Adler shared that the cost of physician turnover and reduced physician hours amounts to $4.6 billion dollars each year or $7,600.00 per physician per year.


STS – Solutions

Dr. Adler went on to share some practical and effective solutions and encouraged leaders to think about two types of strategies – organizational transformation and individual transformation.

Dr. Adler began with organizational change and acknowledged that this is likely a slow process akin to turning a large ship. He had some specific recommendations on how leaders can begin transformation at the organizational level.

  1. Start by caring about STS and be intentional about communicating that care to employees.
  2. Increase resources to prevent and treat STS.
  3. Reduce stress by limiting caseloads and increase leave time.
  4. Create opportunities for part-time work, shared jobs and flexible hours.
  5. Compensate staff for the hours spent in training.
  6. Incorporate Continuous Quality Improvement (CQI) techniques into efforts to facilitate culture change.

Individual transformation is also important to maintain resilience. Dr. Adler stressed that these interventions can take place simultaneously with organizational change. He emphasized that being able to provide patient-centered care begins with caregivers taking good care of themselves, specifically focusing on their physical health including sleep, nutrition and exercise.

Dr. Adler also recommended focusing on emotional health and resiliency by embracing self-help and self-care techniques, mindfulness, counseling and coaching. 

Dahl encouraged healthcare leaders to remember that there can be barriers to accessing care for STS. Physicians may have concerns about licensure problems and may be conditioned to try to cope on their own. Another significant reason that physicians and other providers do not seek help is a lack of resources. Dahl mentioned a study that reported that 2 out of 3 respondents said that their employers had encouraged them to focus on their mental health and self-care during the pandemic, but the employers failed to provide any resources.


Interventions and Strategies to Combat STS

HealthStream has partnered with CredibleMind to provide courseware that can help providers implement real strategies to cope with STS. Dahl shared that there are actually three courses that are part of the “Essentials of Mental Health” series. The course includes assessments that help learners triage themselves into the appropriate level and type of care. Once the assessment is complete, learners can then see the courses and resources selected for them by CredibleMind based on their responses to the assessment.

Dahl also stressed that the course has different learning modalities depending on the type of learning preferred by the student. Students may choose to read material, listen to audio material, watch a video or choose interactive apps or online material.

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