Authors: Natalie Humphrey PhD CEAP American University of the Caribbean Medical School, Cupecoy, St. Martin; Caroline van Oost MSc White Yellow Cross Care Foundation

There is a difference between feeling tired because you put in a hard day’s work and feeling fatigued in every cell of your being… The kind of tired that results from having a trauma exposure response is a bone-tired, soul-tired, heart-tired, kind of exhaustion…” –Lipsky and Burk

The healthcare providers and emergency response teams of St. Maarten were undoubtedly available to the people affected by Hurricane Irma. Most recently, these teams have continued to prepare for future disasters, with a commitment to serving others with compassion, dignity and excellence.

However, there is a chance that the people who heal our wounds during a disaster are themselves wounded. This is a reality too often ignored. People who take care of victims during a disaster or frightening event can experience the same emotional and physical changes as the families they are taking care of.

This phenomenon is known as secondary trauma. Imagine working in a busy emergency room or rescuing victims during a disaster, without knowing the whereabouts of your own family, the condition of your own home or being able to attend to your own injuries. Imagine how difficult it can be to hear so many stories about loss, fear, terror and pain experienced by the families that receive their care.

If you are an emergency response provider that is not aware of how you are personally affected by a disaster, you may experience changes that are a threat to your own health and your capacity to assist others. That state of distress is called vicarious traumatization, which can become permanent burnout.

What are the needs of our emergency response providers in a disaster? Who cares for the caretaker and what are the consequences of forgetting about their needs? These are important questions to ask as St. Maarten prepares to provide disaster response that will last on a long-term basis.

Check in with yourself!

If you or a loved one is experiencing vicarious traumatization, here are some things that may sound familiar. For those of us who have loved ones that serve in disasters, awareness of these experiences can help you to provide the support and care they need when they return home after service.

Changes in how you see yourself:

“I do not see myself as capable as I once did.”

“I don’t know why I am doing this anymore.”

Changes in how you see the world:

“I never really feel safe anymore.”

Changes in spirituality:

“Honestly, I have not prayed in a long time.”

Compassion fatigue:

“I don’t look at suffering in the same way.”

“I don’t feel like I can afford to care.”

Physical changes:

“I don’t have the same appetite.”

“I can’t seem to sleep the way I did before.”

Personality changes:

“I am always angry and on edge.”

“I am taking everything on.”

“I don’t trust my co-workers and family anymore.”

“I don’t feel connected to my spouse and children.”

“I can’t seem to connect with my patients.”

Mood changes:

“Nothing feels good anymore.”

“I don’t enjoy helping people the way I did before.”

“I don’t seem to have control over how I feel.”

“I am easily frustrated by challenges on the job, where I was once more flexible before.”

“When I get home, I cannot relax.”

“It seems like the workday never ends.”

“I feel tired all the time.”

The good news is that there is a solution to vicarious traumatization, which is being proactive to ensure that you are emotionally well. If you are an emergency response provider, below are some things to consider to help make sure that you are at your best in the weeks and months after a disaster.

The following tips have been proven to help those who respond to emergencies to recover to emotional wellness.

* Give yourself the credit you deserve.

Have confidence that you made the best decisions you could during an emergency situation. It is important to let go of any shame or guilt, which can be more damaging than memories.

* Check-out when you need to.

Set aside time to say “no” and give yourself some self-care. Self-care can be time given to anything that you enjoy or that feels relaxing. This can sometimes be challenging to loved ones who expect you to always be there. They need to know that you can be a better nurse, friend, mother or spouse if you take some time for yourself.

* Find meaning in disasters.

Tapping into your wisdom or spiritual foundation to understand why bad things happen can be very healing. What is the blessing behind the challenges that you faced?

* Say yes.

People who take care of others often find it hard to recognize when others are offering help. Saying yes to an offer of assistance with daily tasks or a significant challenge does not mean you are incapable. Sharing your thoughts and feelings with someone you trust can also be helpful. Accepting support yourself is the secret to longevity as a caretaker.

* Healthy avoidance allows time to recover.

Watching the news stories or reading about emergencies that you responded to will make it hard for you to relax when you return home. There is a chance that you will relive those experiences. Turn off the news and indulge in something relaxing.

* Look to your organization and team for support.

Workplaces have provided informal and formal support networks after a disaster, which can help you refocus on your goals. Most administrators and human resource professionals in your organizations can make arrangements for these psychological services with professionals in your workplace. If informal, peers can educate their teams about mental wellbeing before and after a disaster.

Reference: Lipsky LV and Burk C. Trauma stewardship: An everyday guide to caring for self while caring for others. San Francisco, CA: Berrett-Koehler Publishers, 2009, p. 50.