01 30 van epps workplace trauma header
Jen Rosio, University of Utah Health
Coping with Trauma in Healthcare: A Guide for Caregivers
Caregivers in healthcare are often exposed to intense injury, horrific or gruesome experiences, or death. These traumatic experiences can leave us with a stress injury. Associate Director of the Resiliency Center Jake Van Epps shares what to expect and strategies for recovery.

aregivers in healthcare are often exposed to intense injury, horrific or gruesome experiences, or death. Examples of potentially traumatic events include:  

  • Very difficult cases 

  • Exposure to violence 

  • Being sexually assaulted or witnessing sexual assaults 

  • Working with families with ill or injured children 

  • Dealing with hostile patients 

  • Deaths or injuries that involve a lot of blood or suffering 

  • Exposure to life threatening infectious agents.  

These traumatic experiences can leave caregivers with what the National Center for PTSD calls a stress injury. Stress injuries can result in no longer feeling like one’s normal self, stronger emotions than what is typical, excessive feelings of guilt, shame and blame, difficulty experiencing pleasure, or uncontrollable physiological reactions.

Like other stress injuries, these experiences are associated with more severe and persistent distress and can leave an emotional scar. If not attended to, this emotional experience could even lead to clinical mental disorders like PTSD, anxiety, depression, or even OCD.

According to the DSM 51, people may experience some of the following symptoms for 3-30 days following a trauma: 

Intrusive Symptoms 

  • Intrusive, distressing memories 

  • Distressing dreams related to the trauma 

  • Flashbacks, or daydream-like remembering 

  • Psychological distress of physiological reactions to the memory 

Negative Mood 

  • Inability to experience pleasure 

Dissociative Symptoms 

  • Altered sense of reality (time slowing, feeling dazed, sense of surrealism) 

  • Difficulty remembering aspects of the incident 

Avoidance Symptoms 

  • Efforts to avoid internal reminders of the incident including memories, thoughts, and feelings 

  • Efforts to avoid external reminders of the incident like work, patient rooms, patient diagnoses, or coworkers 

Arousal Symptoms 

  • Sleep concerns 

  • Irritable behavior 

  • Hypervigilance (always looking out for something to avoid or threats) 

  • Difficulty concentrating 

  • Exaggerated startle response 

In order to obtain confirmation of a psychological diagnosis, please consult with your primary care provider or therapist.  

Impact: why is it important? 

These kinds of emotional reactions (or stress injuries) can make working difficult. It can be hard to go to work, let alone concentrate and be present at work and maintain safety standards. For some, these symptoms can even lead to questioning their own competence and capacity to sustain their current career path. It can also lead to fear about experiencing another trauma on the job.  

Implementation: how do we do it? 

It is important to remember that many of these reactions are normal adaptive responses to an abnormal situation. The emotional impacts that one might experience are typically temporary. Caregivers tend to experience the most intrusive memories and sleeplessness within the first week or two. Things like feeling anxious returning to work or working with patients that are reminders of the incident may still be hard for a few more weeks. For most, functioning returns within a month. If functioning is still impacted after a month, it is possible that recovery is hindered to some degree and reaching out for professional mental health support could be helpful.  

The Three R’s, (recognize, recover, rebuild) may be helpful to consider when coping with a work-related trauma. 

1. Recognize:

It is important to slow down and acknowledge what you went through, how much you accomplished, and notice the emotional impact the incident is having on you. If we fail to take time to listen to ourselves, knowing what we need becomes more difficult. Emotions help us figure out what is going on and what we need to take care of ourselves.   

2. Recover:

 If we are kind to ourselves, we can prioritize our recovery. Caregivers will benefit from carving out time to recover. Stress injuries, like many other injuries, need healing time. Without healing time, reinjury or extended injury is possible. Reach out to managers and let them know how you are doing.  

  • Talk to colleagues whom you feel safe with so the people around you know what is going on.  

  • Reach out to friends or family that help you feel better when they are around.  

  • Be patient with yourself.  

    • Many caregivers become impatient and self-critical about feeling strong emotions and having reactions. That impatience and self-criticism only delays healing.  

  • Engage in evidenced-based strategies that address your stress.  

    • These can include breathwork and mindfulness to calm physiology and check in on our emotional needs. According to Nagoski (2019), other evidenced-based methods to address our stress include laughing, crying, doing something physically active or creative, showing and receiving affection, and having positive social interactions.  

    • The practice of self-compassion helps us cope and grow through difficult times and is associated with better learning. 

If you would like some more ideas, download this coping handout.

3. Rebuild:

Rebuilding often involves approaching the things that remind you of the incident and cause distress. This could be going into the room where a patient died, facing the same kind of illness at the bedside, or making decisions related to patient care.  

  • Notice the experiences and feelings you have and seek support.  

  • If you are unsure about decisions, ask a colleague if it is OK to run certain types of decisions by them until your confidence returns.  

  • Practice coping strategies as you face the stress of returning to some of your duties.  

  • Speak to your manager and let them know how you are feeling.  

  • Consider requesting a limited number of patients so they can wade back into the work at a manageable pace that prioritizes (re)building confidence and expertise.  


1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)

2. Nagoski E. (2019). Burnout: the secret to unlocking the stress cycle. Random House Publishing Group. 

3. Watson, P., & Westphal, R. J. (2020). Stress First Aid: Manuals and Resources for Health Care Workers.


Jake Van Epps

Associate Director, Resiliency Center, University of Utah Health

Subscribe to our newsletter

Receive the latest insights in health care impact, improvement, leadership, resilience, and more.