Use of Psychological First Aid for Nurses

Christine M. Corcoran, PhD, RN, FNP-BC


Nurs Econ. 2020;38(1):26-32. 

In This Article

Abstract and Introduction


Individuals exposed to trauma or repeated traumatic experiences are at risk for vicarious traumatization, compassion fatigue, and post-traumatic stress disorder. Psychological first aid (PFA), a technique used to assist trauma-exposed individuals in the psychosocial aspects of recovery, is used worldwide in community settings where disasters occurred. Scant literature exists on the use of PFA for nurses.


The occurrence of disasters seems more frequent and common due to media exposure. Disasters, whether natural or human-made, happen regularly. Disasters could be wide-scale with global effects, or to a lesser extent affecting counties and communities. Healthcare providers, specifically nurses, are first-line caretakers when disasters occur. With repeated exposure to traumatic events, nurses are at risk for vicarious traumatization (VT) subsequent to decreased resiliency and compassion fatigue (CF) as well as post-traumatic stress disorder (PTSD) (Laposa et al., 2003; Lavoie et al., 2016; Park, 2011). The terms vicarious trauma, decreased resiliency, and compassion fatigue are frequently interchangeable in reference to the aftereffects of trauma exposure. VT may occur in healthcare providers from continuous exposure to traumatic experiences and stories. The emotional residue of these experiences leads to countertransference of trauma in the healthcare provider (American Counseling Association, 2016).

In the literature, VT and CF are typically used synonymously. Resiliency is the ability to adjust or recover from change. Coping skills are often employed when exposed to traumatic events; resiliency is the result of coping. When coping skills are exhausted, CF may occur. CF leads to a feeling of disconnect not only from patient care but also outside of work relationships (Honig et al., 1999; Salmond et al., 2017). Healthcare providers will focus on technical rather than interpersonal care. PTSD may occur in individuals who have been exposed to trauma or repeated exposure to trauma (American Psychiatric Association, 2017). Clinical criteria for diagnosis include intrusive thoughts, self-negative feelings and thoughts, hyperirritability, and avoidance of reminders of the trauma (American Psychological Association, 2013, 2019). The APA estimates 1 out of 11 people will experience PTSD in their lifetime with women twice as likely as men to have an occurrence (American Psychological Association, 2019). To avert the possibility of VT, decreased resiliency, CF, and PTSD from occurring in those exposed to traumatic events, a technique, psychological first aid (PFA), was developed.