Risk For Secondary Traumatic Stress Research Articles

Exposure to secondary traumatic stress and its related factors among emergency nurses in Saudi Arabia: a mixed method study

BackgroundEmergency department (ED) nurses are exposed to the risk of secondary traumatic stress (STS), which poses a threat not only to nurses’ health and psychological well-being but also adversely affects the execution of their professional duties. The quality and outcome of their nursing services are negatively affected by STS.PurposeThe purpose of this study is to comprehensively investigate the prevalence and intensity of Secondary Traumatic Stress (STS) among Emergency Department (ED) nurses. It aims to identify and analyze the socio-demographic, occupational, and psychological factors that influence the severity and variation of STS experienced by these nurses.MethodsThe study utilized a sequential explanatory mixed methods approach, including two phases. Phase 1 employed a cross-sectional study design, utilizing a convenience sample of 181 nurses to explore the levels of STS and the factors associated with it. Following this, Phase 2 was structured as a qualitative descriptive study, which involved conducting semi-structured interviews with a purposefully selected group of ten ED nurses. Data collection took place at three major hospitals in Saudi Arabia during the period from January to June 2022.ResultsA total of 181 participants were included in the study. The mean STSS score reported by the nurses was 51 (SD = 13.23) out of the maximum possible score of 85, indicating severe STS among ED nurses. Factors associated with an increase in the levels of STS among ED nurses included being female, older in age, married, possessing higher education and experience, having a positive relationship with colleagues, receiving organisational support, and dealing with a higher number of trauma cases. Several themes emerged from the qualitative interviews including: ED Characteristics: Dual Impact on STS, Emotional Resonance and Vulnerability, Personal Life Stressors, The Ability to Cope, and Social Support.Conclusion and implications for practiceFuture strategies and interventions targeting STS should be prioritized to effectively manage its impact on ED nurses. It is crucial to develop targeted interventions that address the specific factors contributing to STS, as identified in this study. Additionally, these findings aim to enhance awareness among nursing administrators, managers, and supervisors about the critical factors associated with STS. This awareness is essential for accurately assessing and developing interventions that mitigate STS among nursing staff.

Exploring the relationships between self-care and well-being outcomes among child welfare professionals

ABSTRACT Child welfare workers experience increased risk of secondary traumatic stress (STS) and burnout. Despite encouragement to bolster self-care, little remains known about self-care and well-being outcomes. This study explored frequency of self-care and its relationship with STS, burnout, and compassion satisfaction by surveying 305 child welfare direct service and supervisor professionals. Participants completed the ProQol and reported frequency and types of self-care. Findings indicated frequency of self-care was associated with decreased STS and burnout, and increased compassion satisfaction. Given the prevalence of STS in child welfare, further exploration of self-care and its potential for strengthening well-being is necessary.

Who Will Save the Savior? The Relationship between Therapists' Secondary Traumatic Stress, Secondary Stress Self-Efficacy, and Attitudes toward Trauma-Informed Care.

Therapists who treat traumatized preschool children are vulnerable to secondary traumatic stress. This study investigates the relationship between therapists' attitudes toward trauma-informed care (TIC) and risk of secondary traumatic stress, with secondary traumatic self-efficacy as a mediating variable. Participants included Israeli social workers (N = 101) in preschool trauma frameworks, with 97.2% following trauma-informed care principles. The questionnaire combined three instruments: attitudes related to TIC (ARTIC), secondary traumatic stress (STS), and secondary traumatic stress efficacy (STSE). Therapists with less positive attitudes toward trauma-informed care showed higher levels of secondary traumatic stress (r[99] = -0.23, p = 0.019), while more positive attitudes predicted higher levels of secondary traumatic stress efficacy (r[99] = 40, p < 0.001). Secondary traumatic self-efficacy mediated the relationship between attitudes toward trauma-informed care and secondary traumatic stress (z = 2.72, p = 0.006). Therapists' secondary traumatic stress may be reduced by improving positive attitudes toward trauma-informed care and enhancing their secondary traumatic self-efficacy.

Exploring the delivery of community‐based trauma support by volunteer counsellors in a South African context

AbstractSouth Africa experiences high levels of violence and trauma in a context where formal mental healthcare is not widely accessible. Lay (non‐professional) trauma counselling services, staffed by volunteers, often fill this gap in provision. Extant research highlights the risk of secondary traumatic stress and burnout for volunteers, and although volunteering is often a collective activity, research typically focuses on the individual volunteer's characteristics, motivations and attitudes. Drawing on a case study with one organisation, this study explores lay counsellors' experiences of providing voluntary emotional support in a context of high trauma and low resources. Semi‐structured interviews with volunteers (n = 12) explored the nature of the work, reasons for volunteering and perceptions of the organisation. Thematic analysis generated two overarching themes, each with three subthemes: ‘We serve our community’ (sub‐themes: ‘Giving back to our community’, ‘Need outstrips resources’ and ‘Being there is powerful’) and ‘We are family’ (sub‐themes: ‘Being there for each other’, ‘Working through the work’ and ‘Being put in a safety net’). Findings illustrate how organisations with few resources can mitigate the psychological risks of trauma‐focused work by fostering strong bonds, collective identity and an ethos of care.

The mediating role of job satisfaction in the relationship between social support and the consequences of secondary exposure to trauma among medical providers working with trauma victims.

Medical providers working with trauma survivors are exposed to the negative and positive effects of secondary trauma, both of which are affected by social support and job satisfaction. The aim of this study was to determine the mediating role of job satisfaction in the relationship between social support and the negative and positive effects of secondary exposure to trauma among medical personnel. The negative indicator of such exposure was secondary traumatic stress (STS), while the positive indicator was secondary posttraumatic growth (SPTG). The analyses included 419 medical providers working with trauma victims (201 paramedics and 218 nurses). Data was collected with the Secondary Traumatic Stress Inventory, Secondary Posttraumatic Growth Inventory, Social Support Scale, Work Satisfaction Scale, and survey. Mediation analyses were applied to assess relationships between variables. The mediation analyses indicated that job satisfaction mediates (mainly partly) the relationship between social support and STS and SPTG. This may indicate that both social support and job satisfaction act as significant predictors of the negative and positive effects of secondary exposure to trauma. As a friendly and mutually-supportive environment can increase job satisfaction, reducing the risk of secondary traumatic stress and promoting positive posttraumatic changes, it is important to increase social support and job satisfaction among medical providers exposed to secondary trauma. Int J Occup Med Environ Health. 2023;36(4):505-16.

Assessment of Psychological Well-being Among Medical Professionals Working with Patients Who Suffer from Physical Trauma: An Observational Study from India.

Healthcare providers working with victims of physical trauma are exposed to significant human suffering at work. This may place them at risk of burnout, secondary traumatic stress (STS), and other psychological disturbances. This study aimed to evaluate the professional quality of life and psychological well-being among trauma professionals. This was a cross-sectional study conducted among 153 staff members (nursing officers, resident doctors, and faculty) of a Level 1 trauma center in North India. The Professional Quality of Life (ProQoL-5) and Depression, Anxiety, and Stress (DASS-21) Scales were used. More than 50% of the participants had a moderate risk of burnout and STS. In addition, 54% of participants reported having anxiety, 40% stress, and 36% depressive symptoms. Depression, anxiety, and stress were all strongly predicted by burnout and STS. Psychological distress symptoms were seen in a significant portion of professionals working in the trauma center. Workplace interventions for the promotion of psychological well-being among trauma professionals are recommended. Gupta S, Bhatia G, Sagar R, Sagar S. Assessment of Psychological Well-being Among Medical Professionals Working with Patients Who Suffer from Physical Trauma: An Observational Study from India. Indian J Crit Care Med 2023;27(7):493-502.

BUILDING PSYCHOLOGICAL RESILIENCY WITHIN MULTIDISCIPLINARY TEAMS: ADDRESSING SECONDARY TRAUMATIC STRESS AMONG HIGH-RISK CHILD-SERVING PROFESSIONALS AND THE ROLE OF THE CHILD AND ADOLESCENT PSYCHIATRIST TEAM MEMBER

Children who experience child abuse and other forms of trauma often receive services across systems led by multidisciplinary teams (MDTs) that include child and adolescent psychiatrists. MDT members are at high risk for secondary traumatic stress (STS) that can impair personal and overall team function. Child and adolescent psychiatrists are often seen as de facto support for the mental well-being of the team, and this dual role, when not recognized, can be a challenge. This Clinical Perspectives highlights common experiences and reactions of STS seen on child protection, foster care, and integrated care teams, and provides strategies for child and adolescent psychiatrists to effectively manage this dual role.

A Systematic Review of Secondary Traumatic Stress and Compassion Fatigue in Teachers.

When teachers care for children with trauma histories, they are at risk of developing compassion fatigue (CF), or a reduced empathic capacity (Hupe and Stevenson in J Child Custody Res Issues Pract 16(4):364–386, 2019. https://doi.org/10.1080/15379418.2019.1663334). They may also develop secondary traumatic stress (STS), a secondary condition resulting from a person learning about details of a traumatic event experienced by someone in their care (Essary et al. in Kappa Delta Pi Record 56(3):116–121, 2020). While CF and STS have been studied widely in healthcare and mental health professionals (Baird and Kracen in Couns Psychol Q 19(2):181–188, 2006; Caringi et al. in Adv Sch Ment Health Promot 8(4):244–256, 2015. https://doi.org/10.1080/1754730X.2015.1080123; Cieslak et al. in Psychol Serv 11(1):75–86, 2014), STS and CF have been understudied in the teaching profession (Caringi et al., 2015; Christian-Brandt et al. in Child Abuse Neglect 110(3):104437, 2020; Hupe & Stevenson, 2019). As such, we sought to complete a systematic review of the literature to answer two questions: (1) To what extent are CF and STS being studied in teachers?; and (2) How have CF and STS been studied in teachers? Qualitative data analysis led to the emergence of four themes across all included studies: (1) conceptualization of CF and STS; (2) teachers are at risk of developing CF and STS; (3) varying approaches can mitigate the risk of CF and STS in teachers; and (4) there is limited research on CF and STS in teachers. Limitations and directions for future research and practice are described.

Secondary Traumatic Stress and Vicarious Posttraumatic Growth among nurses during three COVID-19 lockdowns in Greece

IntroductionSince the onset of the pandemic, nurses have been repeatedly exposed to their patients’ COVID-19-related traumatic experiences. Therefore, they are at high risk for Secondary Traumatic Stress (STS), the stress syndrome resulting from helping others who are suffering. Positive psychological outcomes following this vicarious exposure are also likely. Vicarious posttraumatic growth (VPTG) refers to the positive changes from working with patients who themselves have coped with traumatic experiences.ObjectivesThis study aims to examine STS and VPTG among 429 nurses during three lockdowns of the COVID-19 pandemic in Greece.MethodsA repeated cross-sectional survey with a convenience and snowball sampling procedure was conducted. The Secondary Traumatic Stress Scale (STSS), the Post-Traumatic Growth Inventory (PTGI), the Brief Resilience Scale, and the Brief Cope (BC) were used to measure STS, VPTG, resilience, and coping strategies, respectively.ResultsNurses in Greece demonstrated high levels of STS at the first lockdown, significantly lower in the second one, which raised again -but not significantly- in the third lockdown. Resilience significantly decreased, whereas VPTG significantly increased across the three lockdowns. Following the escalation of the pandemic nurses in general used significantly more adaptive and less maladaptive coping strategies to deal with the crisis.ConclusionsFurther research is needed to clarify the longitudinal course of the negative and positive psychological effects of the pandemic on healthcare staff. Conclusions can guide the development of interventions to safeguard nurses from the deleterious impacts of the COVID-19 and support them in their process of growth.DisclosureNo significant relationships.

What is known about the secondary traumatization of staff working with offending populations? A review of the literature.

Being secondarily exposed to trauma through working with traumatized clients can be challenging for professionals, sometimes leading to them developing secondary traumatic stress (STS) and/or vicarious trauma (VT). Experiences of VT and STS have primarily been researched in relation to staff working with trauma survivors. Perpetrators of offenses have also often experienced traumatic events in their lives and may be traumatized by the offense they have committed. This review aims to summarize what is known about the prevalence and development of VT and STS in populations of any staff working with adult offenders. Relevant literature was identified by searching appropriate databases, and hand searching was conducted to identify any gray literature or omitted articles. A total of 11 studies were identified, critically reviewed, and synthesized. All of these studies found VT or STS to be present within their samples. Staff were largely categorized as being at low-to-moderate risk for STS. No studies attempted to clarify the level of VT within their sample. Factors associated with VT and STS are discussed. This literature base was challenging to synthesize owing to a lack of conceptual clarity and methodological issues within the included studies. The findings suggest that staff working with offending populations do experience VT and STS and that support could be improved to assist in mitigating the effects. Keywords: vicarious trauma, secondary traumatic stress, compassion fatigue, offenders, staff

THE EFFECT OF A RESİLİENCE TRAİNİNG TO PROMOTE THE MENTAL WELL-BEİNG OF FRONTLİNE WORKERS: A BRİEF REPORT OF A SEMİ-EXPERİMENTAL STUDY ON THE COMMUNİTY RESİLİENCE MODEL

Problem of the Study: Frontline workers (FLW) are at risk for secondary traumatic stress, burnout, and related psychiatric sequelae. These; depression, anxiety, suicidality, post-traumatic stress disorder, sleep and substance use disorders. Frontline workers (FLW) need self-care programs to support their mental health. The research problem of the study is handled in this context. Methods: A quasi-experimental study was conducted to evaluate the effect of a simple training on mental well-being and emotional regulation, using an appropriate example of the Community Resilience Model (CRM), FLW (Front line workers). Baseline scores on mental health and stress measures are compared with follow-up scores at three time points. Outcomes, psychological well-being (World Health Organization-5 Well-Being Index); endurance (Connor-Davidson Endurance Scale-10); traumatic stress (Secondary Traumatic Stress Scale); physical symptoms (Somatic Symptom Scale-8) were evaluated within the scope of concepts. Results: 73 (70.2%) of the 104 participants enrolled and participated in the CRM training completed at least 1 post-test. Well-being scores increased at 1 year with a small-medium effect size. (Cohen d=0.32). Resilience scores increased by 1 year with a small-medium effect size (Cohen d=0.36). Although secondary traumatic stress scores showed the greatest effect in 1 week (Cohen d=0.49), reductions were found in the scores obtained. Somatic symptoms decreased at each posttest and the greatest change occurred from baseline to 1 week (Cohen d=0.39). Participants reported that awareness of their body sensations helped them when they were very bored as a way to calm themselves. Conclusions: After three hours of Community Resilience Model (CRM) training, participants report improved mental health and reduced secondary traumatic stress and somatic symptoms. This simple body awareness intervention can be cited as a good resource during the COVID-19 pandemic.

Compassion Fatigue, Compassion Satisfaction, Burnout and its Associated Factors among Nurses Working in Critical Care area of Tertiary Care Hospital, Karachi, Pakistan

Background: Compassion satisfaction and compassion fatigue is the element of professional quality of life which plays an integral role in compassionate care. Compassion fatigue can lead to poor job performance, high turnover rate, absenteeism, lack of interest in patients, and poor patient outcome. Objective: This study aimed to determine the burden of compassion fatigue and compassion satisfaction and burnout among nurses working in specialty-based critical care areas. Materials and Methods: A cross-sectional analytical study was accomplished at Dow University Hospital. A structured, and validated tool, ProQol was utilized for data collection. Data were entered and analyzed in SPSS version 24.0. Binary logistic regression was applied to establish the association between the variables. The level of significance was considered with a p-value ≤0.05. Results: A total of 140 nurses working in critical areas were approached and responded to this survey. The average means score was 40.77 ± 6.26 for compassion satisfaction, 22.47 ± 5.46 for burnout, and 26.14 ±6.20 for secondary traumatic stress was found. On multivariable regression analysis, the likelihood of average compassion satisfaction was significantly higher among nurses who had BSN degrees. Nurses with work experience of 6 months to &lt;1 year, 1-3 years, and 4-6 years had higher average compassion satisfaction. None of the participants’ characteristics was associated with a burnout on univariate analysis. The risk of secondary traumatic stress was reported higher in single participants. Conclusion: The study findings indicated an average to a higher level of compassion satisfaction and a low to average level of compassion fatigue which is burnout and secondary traumatic stress among critical care nurses.

The impact of the alterations in caring for COVID-19 patients on Compassion Satisfaction and Compassion Fatigue in Italian nurses: a multi method study.

Background and aim of the work:During COVID-19 first wave, healthcare professionals were exposed to a major psychological pressure related to uncertainty, a lack of therapies or a vaccine and shortages of healthcare resources. They developed higher levels of Burnout and Compassion Fatigue, and similar levels of Compassion Satisfaction. Aim is evaluating in Italian nurses Compassion Satisfaction and Compassion Fatigue and impacting individual and relational variables.Methods:A multi-methods approach was used. Qualitative data were collected through 2 focus group. Quantitative data were collected through a web survey composed by an ad hoc questionnaire developed from the focus group results, the Professional Quality of Life Scale-5 and the Resilience Scale .Results:In the qualitative phase 6 categories emerged. From the quantitative analysis the sample reported a moderate level of Compassion Satisfaction, a low level of Burnout and a moderate level of Secondary Traumatic Stress. Compassion Satisfaction had as predictors resilience (β = .501), followed by feeling part of the team (β = .406) and collaboration with colleagues (β = .386). Secondary Traumatic Stress had as predictors the impact of PPE (β = .269), and feeling Covid-related individual sufferance (β = .212). The only predictor of Burnout was resilience (β = -2195).Conclusions:During COVID-19 first wave Italian nurses were exposed to a higher risk of Secondary Traumatic Stress, mainly impacted by frustration, loss of control, loss of possibility to properly care for patients, and personal threat. Relational and team support had a crucial role in sustaining Compassion Satisfaction. (www.actabiomedica.it)

Promoting Professional Quality of Life and Resiliency in Sexual Assault Nurse Examiners.

Sexual assault nurse examiners (SANEs) have received specialized education and clinical training in providing forensic care for sexual assault and abuse victims. SANEs provide compassionate and competent care that promotes emotional recovery for their patients; however, caring for this population puts SANEs at risk for secondary traumatic stress, professional burnout, and compassion fatigue. The research regarding SANEs indicates that there may be multiple personal and organizational factors that affect their development of negative outcomes related to professional quality of life. This study explored challenges SANEs experience in their work and what resources are utilized to promote their resiliency and professional quality of life. SANEs were recruited to complete an anonymous online survey through the International Association of Forensic Nurses community; 69 SANEs completed the survey. Eight of the SANEs also participated in follow-up focus groups. The participants reported many gratifying aspects of their work. They also described challenges related to personal, professional, organizational, and community factors. Many of the reported negative effects align with secondary traumatic stress and professional burnout. The SANEs identified multiple ways to support their resiliency in the context of this difficult work. The nature of this work puts SANEs at risk for developing adverse symptoms related to professional quality of life. SANEs need better support and resources to cope with the demands of their work. Findings of this study will be used to design SANE Well, a support application to promote SANE wellness and resiliency.

Indirect exposure to trauma: Does resilience explain the link between optimism and secondary traumatic stress among in-patient carers?

This study examined the relationship between optimism and secondary traumatic stress (STS), including the mediating role of resilience on the association. Family carers (n = 194; female = 64.95%; married = 50%; age range = 15 to 70, mean age = 31.5 years, SD = 8.9 years) of in-patients in a Nigerian orthopaedic hospital participated in the study. The participants completed measures of secondary traumatic stress, resilience, and optimism. Path analyses results showed lower levels of secondary traumatic stress, with high optimism and resilience mediating the relationship between optimism and secondary traumatic stress, while lowering the risk for secondary traumatic stress. Resilience mediated the relationship between optimism and secondary traumatic stress, lowering the risk for secondary traumatic stress. Psychological interventions that target optimism and resilience of informal caregivers during in-patient care in hospital settings could reduce their risk for secondary traumatic stress with exposure to indirect trauma.

Impact of a Resiliency Training to Support the Mental Well-being of Front-line Workers: Brief Report of a Quasi-experimental Study of the Community Resiliency Model.

Background:Front-line workers (FLW) are at risk for secondary traumatic stress, burnout, and related psychiatric sequelae: depression, anxiety, suicidality, posttraumatic stress disorder, and sleep and substance use disorders. FLW are in need of self-care programs to support their mental health.Methods:Quasi-experimental study to assess the impact of a simple mental well-being and emotional regulation training, the Community Resiliency Model (CRM), using a convenience sample of FLW. Baseline scores of mental well-being and stress measures were compared with follow-up scores at 3 time points. Outcomes were psychological wellness (World Health Organization-5 Well-being Index); resilience (Connor-Davidson Resilience Scale-10); traumatic stress (Secondary Traumatic Stress Scale); physical symptoms (Somatic Symptom Scale-8).Results:Of the 104 participants who enrolled and attended the CRM training, 73 (70.2%) completed at least 1 posttest. Well-being scores increased at 1 year with a small-moderate effect size (Cohen d=0.32). Resilience scores increased with a small-moderate effect size by 1 year (Cohen d=0.36). Secondary traumatic stress scores declined, with the largest effect at 1 week (Cohen d=0.49). Somatic symptoms decreased at each posttest, with the largest change occurring from baseline to 1 week (d=0.39). Participants reported an awareness of body sensations helped them when overwhelmed as a means of calming themselves.Conclusions:After a 3-hour CRM training, participants reported improved mental well-being and decreased secondary traumatic stress and somatic symptoms. This simple body awareness intervention may be a good resource during the COVID-19 pandemic.

Secondary Traumatic Stress and Burnout in Healthcare Workers during COVID-19 Outbreak.

(1) Background: The present study aims to assess the level of professional burnout and secondary traumatic stress (STS), and to identify potential risk or protective factors among health care workers (HCWs) during the coronavirus disease 2019 (COVID-19) outbreak.; (2) Methods: This cross-sectional study, based on an online survey, collected demographic data and mental distress outcomes from 184 HCWs from 1 May 2020, to 15 June 2020, from 45 different countries. The degree of STS, perceived stress and burnout was assessed using the Secondary Traumatic Stress Scale (STSS), the Perceived Stress Scale (PSS) and Maslach Burnout Inventory Human Service Survey (MBI-HSS) respectively. Stepwise multiple regression analysis was performed to identify potential risk and protective factors for STS; (3) Results: 184 HCWs (M = 90; Age mean: 46.45; SD: 11.02) completed the survey. A considerable proportion of HCWs had symptoms of STS (41.3%), emotional exhaustion (56.0%), and depersonalization (48.9%). The prevalence of STS was 47.5% in frontline HCWs while in HCWs working in other units it was 30.3% (p < 0.023); 67.1% for the HCWs exposed to patients’ death and 32.9% for those HCWs which were not exposed to the same condition (p < 0.001). In stepwise multiple regression analysis, perceived stress, emotional exhaustion, and exposure to patients’ death remained as significant predictors in the final model for STS (adjusted R2 = 0.537, p < 0.001); (4) Conclusions: During the current COVID-19 pandemic, HCWs facing patients’ physical pain, psychological suffering, and death are more likely to develop STS.

Secondary traumatic stress, burnout and compassion satisfaction among Flemish foster care workers during the COVID-19 lockdown

This study examines secondary traumatic stress (STS), burnout and compassion satisfaction (CS) in Flemish foster care workers (FCW) during the COVID-19 lockdown. Even though child welfare workers are at increased risk for STS and burnout, these constructs have not been studied in FCW so far. Additionally, the COVID-19 measures severely impacted Flemish FCW’s work, personal and client environment, possibly stimulating the onset of STS and burnout and weakening CS. Moreover, this study aims to identify the work, client and personal factors determining high levels of STS and burnout and low levels of CS among FCW during the lockdown. STS, burnout and CS levels from 434 Flemish FCW were inquired with the Professional Quality of Life Scale. Low mean levels of STS and moderate mean levels of burnout and CS were reported during the lockdown. FCW who experienced a negative impact of COVID-19 measures on their work, had a high amount of worrisome placements due to birth parents in their caseload and low emotional stability are an at-risk group for both STS and burnout during the lockdown. CS was strongly determined by the impact of the COVID-19 measures on work and personality traits. Emotional stability determined the three outcome variables, making this a key characteristics for FCW during the lockdown. Consequently, during adverse circumstances, foster care agencies should pay extra attention and offer additional support to those FCW they estimate emotionally less stable and who struggle with the birth parents in their caseload.

Caring for Patients From a School Shooting: A Qualitative Case Series in Emergency Nursing

IntroductionEmergency nurses are at risk for secondary traumatic stress, compassion fatigue, and burnout as a result of witnessing the trauma and suffering of patients. The traumatic events perceived as being most stressful for emergency nurses involve sudden death, children, and adolescents. Multicasualty, school-associated shooting events are, therefore, likely to affect emergency nurses, and recent reports indicate an increase in multicasualty, school-associated shootings. This research is necessary to learn of emergency nurses’ experiences of caring for patients from a school shooting event in an effort to benefit future preparedness, response, and recovery. This manuscript describes these experiences and provides opportunities for nurses, peers, and leaders to promote mental health and resilience among emergency nurses who may provide care to patients after such events. MethodsA qualitative case series approach, a theory of secondary traumatic stress, and the compassion fatigue resilience model guided the research. The emergency nurses who provided care to patients who were injured during a 2018 multicasualty, school-associated shooting in the Southeastern United States were invited to participate. ResultsThe themes identified by this research with 7 participants were preparation and preparedness, coping and support mechanisms, and reflections and closure. DiscussionThe results identified through this research may be translated to policies and practice to improve emergency nurses’ welfare, coping, resilience, and retention. Patient outcomes may also be improved through planning and preparedness.

Exploration of factors associated with secondary traumatic stress in foster parents

The role of caring for traumatized individuals has been widely recognized as having inherent risks for secondary exposure to trauma and associated distress. Child welfare work in particular has been found to be an occupation where indirect exposure to trauma is especially prevalent as are related experiences of secondary traumatic stress (STS) and burnout (Bride, Jones, & Macmaster, 2007; Nelson-Gardell & Harris, 2003). Given that rates of trauma exposure for children in foster care range from 80 to 93 percent and repeated or chronic exposures are common, it is assumed that foster parents are also at significant risk for STS (Lipschitz, Winegar, Hartnick, Foote, & Southwick, 1999; Stein et al., 2001; U.S. Department for Health and Human Services, 2013). As child welfare and foster care systems move toward implementation of trauma informed care, the potential for secondary traumatic stress (STS) in foster parents should be examined yet there has been minimal research in this area to date. This study analyzes the STS experiences of foster parents from one state’s child welfare system (N = 1213). Descriptive analysis of their experiences as well as an examination of factors associated with the development of STS was conducted and confirmed the significance of STS this sample of foster parents. Hierarchical regression analyses of risk and beneficial factor models accounted for 23.2 and 46.5 percent of the variance in STS symptoms respectively. Implications and strategies for foster care systems regarding points of prevention and intervention based on this research are provided.