title: Secondary Traumatization in Psychiatric Mental Health Nurses: Validation of Five Key Concepts.
abstract: OBJECTIVE
  The purpose of this study was to validate five concepts central to secondary traumatization (ST) using narratives of psychiatric mental health advanced practice nurses.
  
  
  METHODS
  The study was designed as a directed content analysis of narrative notes (N-30).
  
  
  RESULTS
  Consistency was found between narrative notes and the concepts. This study revealed that exposure and vulnerability precede empathic engagement, reaction, and alteration/transformation. The bidirectional outcome of alteration/transformation suggested that conditions leading to ST could have a positive outcome.
  
  
  CONCLUSIONS
  Failure to recognize symptoms of ST and provide reflective supervision may compromise the nurse's ability to maintain a work-life balance and provide quality patient care.
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Grace B
authors.initials: GB
authors.lastname: Hubbard
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Beeber
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Eves
mesh_terms: D000328:Adult; D057179:Advanced Practice Nursing; D005260:Female; D006801:Humans; D008297:Male; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000523:psychology*; D011568:Psychiatric Nursing; D000067073:Psychological Trauma / Q000523:psychology*
keywords: Cultural influence; psychiatric nurse; secondary traumatization