Secondary Trauma: Why Taking Care of the Caregiver is Paramount

Nov 13, 2018

Dr. Heather Farley shares her experience with burnout and coping with emotional distress after challenging cases

Heather Farley became a doctor to heal people who need help. As an emergency department physician, she saw people every day who were suffering as a result of illness, accidents and violence.  

After an especially difficult case, she felt anxious and guilty. After 16 years of practice, she questioned her decision to go into medicine.

Dr. Farley was experiencing secondary trauma. She is among the many doctors, nurses and other providers who face emotional distress following adverse outcomes or extremely challenging cases.

Burned Out

More than half of doctors reported feeling burned out in a Mayo Clinic survey. 

Furthermore, data suggests that burnout is slightly higher in female physicians than in male physicians. That could be because women doctors assume more responsibilities on the home front than their male counterparts.

Even in 21st century America, female physicians often face social challenges.  

“You are either too soft or not soft enough, never just quite right,” Dr. Farley says.  

Taking Care of the Caregiver

So who takes care of the caregiver?

To answer this question, Dr. Farley developed the Center for Provider Wellbeing at Christiana Care Health System in Delaware. She now directs the center, which is focused on creating a workplace that fosters provider wellbeing.

“How can we take care of you as a caregiver so you are best equipped to provide great care for our patients?” she asks.

The Center for Provider Wellbeing reaches out to doctors throughout their careers, starting when they are still in training.

Ice Cream Rounds, held quarterly, provides a safe place for residents to talk about stressful situations, learn coping skills and develop supportive relationships with their peers. Residents are encouraged to seek counseling through the center when they need help.

“Residency is a particularly high risk time,” she says. “There are a lot of demands, but not necessarily a lot of control. We want to normalize that it is a really rough time.”

A Culture of Compassion

When an adverse event occurs, there’s a culture of compassion and support instead of shame and isolation. Through the program Care for the Caregiver, the health system takes a proactive approach, contacting providers after an event and offering an empathetic ear from one of the health system’s 45 trained peer supporters. About 90 percent of providers accept help.

“It’s important to make space to process these events,” Dr. Farley says. “When Captain Sullenberger landed his plane on the Hudson River he didn’t have to pilot the next jet out. Physicians should not be expected to go on to the next case as if nothing happened.”

The OASIS project—Opportunity to Achieve Staff Inspiration and Strength Project—is dedicated to building resilience within care teams by bringing “bite-sized” evidence-based wellness interventions to help providers destress on the job. Topics might include dealing with change, healthy conflict, mindfulness and gratitude.

“Physicians are already some of the most resilient people around,” Dr. Farley says. “We want to help them flourish.”