• vicarious trauma;
  • compassion fatigue;
  • post-traumatic stress disorder;
  • traumatic countertransference

Purpose: To begin examining the nature of vicarious or indirect trauma and to discuss risk factors and prevention strategies. Despite the fact that many nurses are traumatized indirectly, few recognize the insidious development of such trauma. The dynamics of indirect trauma are relevant to nursing as are risk factors and prevention strategies.

Scope: Brief review of the literature (1974–1997) on vicarious trauma, compassion fatigue, secondary traumatic stress disorder, and traumatic countertransference using short vignettes for illustration.

Conclusion: Nurses who are informed about vicarious trauma and who actively maintain a balanced personal and professional life are in the best position to bring themselves and their clients through the many hazards of trauma work. The implications of vicarious or indirect trauma for nurses and clients are serious and complex requiring thoughtful analysis and research to clarify its effects.