Chapter 1: Vicarious trauma & moral distress in the ICU



’Ten years ago, the implicit policy in ICU was to keep things to yourself and say, ‘It is just part of the job’. Now it seems more acceptable to be vulnerable. Because of the burnout and staff distress, we are more attuned to the pressures of the work”. - ICU Physician


Vicarious trauma can take a physical, mental, spiritual, and emotional toll on people who experience it. A concurrent phenomenon which both similar and dissimilar features is work-related grief which occurs in response to patient death. The impact of patient death on health care providers is well established. The nature of your relationship to the family and patient, the way in which you personally identify with a loss, and the extent to which your grief goes unacknowledged can all result in work-related grief.  

With your ongoing exposure to grief as a professional working in ICU, the potential risk for you to experience vicarious trauma is greatly enhanced. In this chapter we will explore vicarious trauma in detail including what it is, it’s potential impact, why it is generally not discussed in the ICU and how you may also experience moral distress while working in ICU.