man dealing with stress
Blog June 30, 2022

By Cat Colvin

Secondary Traumatic Stress within the Registry Community

We’ve all had that case. The one that you can’t get out of your head; the photos, the visuals play back in your head over and over again. Mine is a 12-year-old boy that sustained 50-percent burns after an arson fire that killed his mother over a Christmas weekend. This happened 15 years ago, and I still see the agony and suffering on his face and his body. We live with it every day and we don’t forget. 

Secondary traumatic stress (STS), vicarious trauma, compassion fatigue, and second-hand trauma can affect registry professionals and medical personnel with a variety of symptoms that present themselves physically or mentally. The most common manifestations are sleeplessness, nightmares, avoidance, stress, appetite changes, physical responses, and lack of concentration. STS can affect work and personal relationships—at times, leading to decreased productivity and performance  

Vicarious trauma can exhibit in hypervigilance with family and friends. In a recent poll, family members indicated a negative impression of our roles within the registry profession as we become over-protective with life scenarios, such as cooking (grilling), falls, and outdoor activities. Nod your head if you have removed all of the rugs from an elderly relative’s or friend’s home. My nephews dread the “driving talk” when they are set to get their driving permits. It’s not uncommon for us to bring “our work” home. 

The Ramifications of Secondary Traumatic Stress in the Registry Community

A poster presentation by Jane McCormick, Amanda Truelove, and Dr. Anna Newcomb, entitled “Compassion Fatigue in Trauma Registry Professionals” delved into the ramifications of Secondary Traumatic Stress within the registry community. Of the 751 respondents, 26-percent reported abstracting a case for a colleague to protect them from an emotional trigger. Sometimes, it’s not one case that triggers STS, but the accumulation of exposure to tragedy. 

There have been instances where I have reassigned a registry professional because they could no longer emotionally handle pediatric abuse cases, domestic violence cases, or burn patients. We sometimes see the worst in humanity and it’s hard to turn off—not to mention, being bombarded with violence and tragic images that affect our community, country, and the world. Understanding STS and recognizing the symptoms are steps you can take to begin the healing process or to manage your compassion fatigue.

Best Self-Care Practices

Take a vacation or a long weekend to recharge

  • Eat a healthy diet, take a nap, establish a regular sleep pattern
  • Physical activity – take a walk, go to the gym, enjoy an outdoor activity (safely)
  • Connect with friends and family
  • Get creative - journaling, creative writing, delve into art projects, learn to play a musical instrument, take up dancing!
  • Meditate – practice meditation or self-guided imaging
  • Reach out to your Employee Assistance Program (EAP) – AMN Healthcare and other employers offer EAP programs for healthcare, mental health, and financial support.
  • Recognize Success! Focus on the positives whether they be personal or professional.

If you should take any one thing away from this article, it is this: Your stress is real, your compassion fatigue is real. I encourage you to practice self-care. Reach out to your support system to restore well-being, because you are not alone.


Information on secondary traumatic stress from the U.S. Department of Health and Human Services

Employee Assistance Program (EAP):  844-888-9780


Poster, “Compassion Fatigue in Trauma Registry Professionals”-, Jane E. McCormack, RN, BSN, CSTR, Amanda Truelove, RHIA, CSTR, Anna B. Newcomb, PhD., MSW, LCSW

Figley, C (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatize. New York, NY: Bruner-Routledge