Vicarious trauma and the impact on healthcare professionals

Sophie is  a qualified midwife who has worked in an NHS trust for seven and a half years. She has been a clinical, high-risk labour ward midwife but currently sits in a specialist midwives role for a number of reasons; one being the fear of clinical midwifery and the impact it has on her mental health. Here, she shines a light on the problematic approach to trauma within healthcare, which has impacted her own decision not to have children.

As healthcare professionals, we are exposed to traumatic situations on a day in, day out basis and can become so immune to these experiences that we numb our emotions. This exposure can create an underlying, deep-rooted trauma that is potentially never addressed until we are in a similar position ourselves, for example during pregnancy. 

As a midwife who has provided care for women and birthing people, and experienced numerous traumatic experiences during this time, I can honestly say that these have had a significant impact on my life choices outside of work. On a daily basis, I see the impact trauma has on both women and birthing people but also healthcare professionals. 

Personally, I feel that my vicarious trauma presents itself in the absolute certainty that I do not want children (don’t get me wrong - there are other factors to take into account, but had I not gone through some of my professional experiences, I could have worked around these).

“On a daily basis, I see the impact trauma has on both women and birthing people but also healthcare professionals.”

The fear of falling pregnant

I have had numerous sessions of counselling, CBT and EMDR therapy to help work through these traumas, and although I have spent hours in therapy, I am still left with a trauma so deep that it makes me feel physically sick and gives me palpitations when I think about falling pregnant or having a baby. 

I know in some ways I am unique in that my aversion is so strong, however trauma presents in many ways for other healthcare professionals who have gone through difficult experiences. I often hear colleagues discussing their care and birth preferences including choosing to birth at home despite alternative recommendations or, on the flip side, avoiding altogether and having a planned caesarean birth. To me, the strength of these preferences speaks volumes and uncovers the deep-rooted trauma that, as healthcare professionals, we carry with us.

Addressing a systemic problem

In my opinion, the system is deeply flawed. I found that I did not receive the right support after experiencing traumatic events. I was pushed to return to work,carry on as though nothing had happened and just “get back on the horse”. I know from providing trauma-informed care to numerous women who have had previous traumatic births or life events that this approach simply doesn’t work. 

How trauma presents looks very different for everyone - trauma is in the eye of the beholder - and that person should be cared for and supported to help them through it in an individualised way. However, this appears not to apply to healthcare professionals. Being pushed to return to work and “get on with things” has compounded my trauma response; it almost made me leave a career in midwifery that I love and have worked so hard for. 

So how do we get this right? Ultimately, there is no best way or one size fits all. It needs to be led by the individual experiencing that traumatic event. Often these events are brushed off as being ‘normal’ because we are experiencing them so often in professional practice, however ensuring there is a robust system in place to provide support, trauma-informed debriefs and on-going options for counselling is key for every member of the team involved in any traumatic event.

“Being pushed to return to work and “get on with things” has compounded my trauma response.”

Left to support myself

To help with my vicarious trauma, I waited two years on an NHS talking therapies list for EMDR therapy - in which time I could have left the profession. I sought out charities that I could get support from as I was not in a financial position to pay for therapy myself, but these resources were limited and it can be a postcode lottery. I was fortunate that my employer provided six counselling sessions as part of the staff wellbeing package, but these didn't even scratch the surface (and once you’d used your six sessions, that was it - you were left to flounder and find your way through even muddier waters).

Finding an answer

It saddens me that I have been drawn to write this article, especially as a healthcare professional who is passionate about providing woman-centred, trauma-informed care, because I felt there was a lack of compassion and understanding when I was going through a work-based trauma. 

From this personal experience, I have gained insight into how things could be improved and have reached out to other members of staff who I know have been through difficult professional experiences to ensure they know where to seek help and to reassure them that it takes time to work through these incidents. 

In an ideal world, we would have a system where trauma therapy is compulsory after any incident in practice and staff would be supported to take time off to work through this. However, the NHS  is already faced with staff shortages and funding cuts, which makes this option more difficult than ever. 

I don’t know what the answer is given that every service and department in the NHS is stretched, however I do know that if we don’t care for our staff and support them through difficult and traumatic events then it will cause more people to leave the profession and contribute further to the shortage of midwives and healthcare professionals.

“In an ideal world, we would have a system where trauma therapy is compulsory after any incident in practice and staff would be supported to take time off to work through this.”

The Boy, the Mole, the Fox & the Horse by Charlie Mackesy