Traumatic Stress Institute Blog

Understanding Vicarious Trauma in Perinatal Nurses: The ARTIC Scale in Clinical Care

Written by Tasha Reece, M.S. | September 26, 2024

Traumatic experiences during pregnancy and birth can have lasting effects on maternal and infant wellbeing, impacting everything from breastfeeding, bonding  and attachment to maternal mental health. While the body of research on the consequences of birth trauma is vast and still growing, literature regarding vicarious trauma in healthcare providers who witness birth trauma is limited.

Vicarious trauma, a term coined by Lisa McCann and Laurie Ann Pearlman, refers to trauma symptoms experienced by care providers who witness or hear about traumatic experiences. Similar terms that are commonly used in the literature include secondary traumatic stress (coined by Charles Figley) and compassion fatigue (coined by Carla Johnson). All refer to the extra burden providing care to traumatized individuals can have on professionals caring for them.

In a recent study performed by Runyon et al., secondary traumatic stress incidence was explored in nurses working in clinical perinatal (the period from pregnancy to one year postpartum) settings who witness birth trauma. The study sought to determine the impact of a trauma-informed care (TIC) education initiative on the nurses' experiences of secondary trauma. The TIC education sessions focused on patient advocacy, acknowledging power dynamics in healthcare settings, listening to birthing people and their families, and investigating instances of obstetric violence/mistreatment. To measure symptoms of secondary traumatic stress, the Secondary Traumatic Stress Scale (STSS) was used. 

To determine participants' attitudes related to trauma informed care and their tendency to seek help when experiencing secondary trauma, the ARTIC Scale was used. Along with measuring participant attitudes related to systemic implementation of the trauma-informed care framework, the ARTIC scale also has a subscale (the Reactions subscale) that measures attitudes related to the effects of secondary trauma and whether coping would include seeking help or ignoring the impact. The study found that, following the education sessions, nurses reported significantly fewer symptoms of secondary traumatic stress. The study, and many others, continue to support the need for trauma-informed education and practice to support not only clients/patients but the staff that service them. Everyone has the ability to serve as a trauma treater!

References

Jenkins, S. R., & Baird, S. (2002). Secondary traumatic stress and vicarious trauma: A validation study. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 15(5), 423-432.

Runyon, M. C., Irby, M. N., & Landivar, P. R. (2024). Trauma-Informed Care Education Initiative Explores Impact on Perinatal Nurse Secondary Traumatic Stress and Workforce Challenges. The Journal of Perinatal & Neonatal Nursing, 38(2), 167-177.

Sabo, B. (2011). Reflecting on the concept of compassion fatigue. Online journal of issues in nursing, 16(1).