Nicki Annunziata talks to the SSA about her research into how addiction nurses experience trauma in their jobs, and what resilience looks like in a role that exposes you to ‘vicarious trauma’.

Nicki Annunziata is a registered nurse and a PhD student at Trinity College Dublin. She presented a poster at the 2022 Lisbon Addictions conference on the topic of her PhD – vicarious trauma among nurses working in addiction services. The SSA interviewed Nicki at the conference and asked her to talk about what vicarious trauma is and why it’s particularly pertinent to the experience of addiction nurses.

In the interview, Nicki explains that ‘vicarious trauma’ is an indirect form of trauma, which addiction nurses are particularly vulnerable to because so many of their patients have experienced trauma and because “the relationship [they] share with [their] patients is different from the other specialisations”.

“Vicarious means ‘indirect’. So, it’s the indirect trauma that the nurse could potentially develop by working with traumatised people. And people with addiction are traumatised.”

Vicarious trauma can present with the same symptoms as PTSD, which can have devastating consequences for nurses in their own lives, and can also affect their ability to care for their patients.

Nicki’s research has involved surveys with 175 addiction nurses in Europe, and follow-up interviews with 15. So far, she has found that most addiction nurses – roughly 9 in 10 – could be at a moderate to high risk of vicarious trauma.

“Vicarious trauma is real. It’s a high risk among nurses who work in addiction because they are exposed to trauma.”

Existing research has primarily considered other addiction healthcare professionals, such as psychiatrists and counsellors. Nicki says that there is a gap in the evidence base about the effect of trauma on addiction nurses, and, specifically, a gap in understanding the risk factors for vicarious trauma, and what coping mechanisms could help to mitigate these risks.

Nicki’s own experiences as a nurse have informed her lines of enquiry. She witnessed how many of her colleagues felt unable to continue in the profession, which sparked her curiosity about the factors that can make the job feel untenable, but also the factors that can boost someone’s resilience in a job that continually exposes them to trauma.

“After just twelve months that I was working in the addiction centre, I became the senior nurse because everyone dropped before me. So, I also realised that there were probably some coping mechanisms that I was using that helped me through this hard work.”

Nicki says that she hopes that one of the outcomes of her PhD is to “develop some guidelines to help to minimise or prevent the risk of vicarious trauma among nurses”.

by Natalie Davies

Editor’s note: Quotes have been condensed and edited for clarity.

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