First Responders to the System: Real-Time Trauma Mitigation for Healthcare Burnout
Health care providers experience severe emotional exhaustion. Because of the heavy demands, the 2025 average turnover rate for hospital-based nurses was 17.6%, with the average cost of hiring a new nurse around $60,000 based on a recent survey by NSI Nursing Solutions. The hospital vacancy rate nationally is 8.6%, with nearly one-third of hospitals having at least a 10% nurse vacancy rate. The savings that could be accrued to a hospital by reducing turnover by 1 percent is nearly $300,000. While the figures for nursing are staggering, the turnover of other health professions, while lower, still has a major impact. Some of the reasons that create chronic stress and untenable working conditions are based on system-wide inefficiencies, inadequate support, and poor leadership competencies.
Efforts have been made by health care organizations to “help” staff be more resilient. This has largely had the effect of blaming the staff for the overwhelming conditions and expectations, while the organization takes little responsibility for poor leadership, broken systems, and lack of adequate support. The efforts to date have had little impact, noting that the increase in turnover of nurses from 2024 (16.4%) to 2025 (17.6%) shows an increase.
What can we do to help staff given the current situation? What if we had an emergency response coaching team available to health care providers? This could help those who have experienced both chronic stress response and trauma. The loss of health care providers is an emergency situation.
Healthcare Workers as First Responders to Human Pain
We generally think of EMTs, paramedics, firefighters, and police as first responders. They are remarkable people who do incredible work that can be at great cost to themselves. And every day, health care workers of all types experience and absorb the pain that our patients experience. Caring for people in all types of pain is our calling.
While we experience many happy events and outcomes, we have committed ourselves to care for people who are in need—people who are in pain, fearful, dying, and experiencing significant loss, whether physical or emotional. The experience of caring for people in pain often creates primary trauma for the caregiver. For instance, when we attend a birth when the baby dies, the pain experienced is direct and primary. We also experience secondary trauma, also known as vicarious trauma, when we listen to the stories of trauma experienced by our patients. We know that secondary trauma can have the same psychological and physiological impact as primary trauma. Many clinicians also face moral injury when system constraints force them to act in ways that conflict with their professional values. It is no wonder that physicians, nurses, and others experience healthcare burnout.
The culture of caring in our health care systems expects us to manage the impact of daily stress and trauma. However, our mind and body are not built to withstand interminable high-level stress without having a strong support system and tools that will help mitigate the impact of traumatic stress.
A Personal Lesson in Trauma Mitigation
An innovative model of help to mitigate chronic stress and trauma came when I worked in the burn unit at Cook County Hospital years ago. Caring for burn patients was high stress and traumatic for staff as well as patients. As a result of multiple high-emotional-impact patient situations, the medical director recognized that the staff was calling in sick, having blunted emotional responses to patients and colleagues, and experiencing extreme fatigue. Most of us had emotionally checked out to protect ourselves from the pain we were experiencing.
In recognizing our struggles, the medical director brought in a social worker and psychologist who met with us in small groups once a week for six weeks. Participating in the meetings was not optional. This intervention helped nearly all of us manage the exposure to daily trauma of patients and ourselves. We could name and share our feelings and understand that we were not alone or an “outlier.” Through the meetings, we built a system of support for each other, and we were offered tools to manage our stress. This was a life-changing experience where I could recommit to my nursing path. It was an early form of trauma-responsive support that reduced the long-term effects of traumatic stress and prevented deeper healthcare burnout.
Building Trauma-Informed Emergency Response Coaching
How does that experience inform a way of helping staff in today’s world? We have many emergency response teams in our hospitals: rapid response teams (RRT), code blue teams (CBT), behavior emergency response teams (BERT), and stroke/trauma teams, appropriately and necessarily aimed at helping patients. The addition of response teams could be focused on helping the staff who also need an emergency response when experiencing severe stress and trauma situations.
Having emergency response coaching is a response that can be very useful to clinicians. Not everyone may need this help. Some clinicians have strong support systems, and those systems help mitigate the stress. However, trauma exposure among health care providers is nearly universal. Every one of us experiences it at some time, and it can affect us in ways that are unhealthy and counterproductive. Emergency Response Coaching for staff, either individually as needed or in small groups, could be a very effective way of supporting staff to continue their work of caring. This approach aligns with trauma-informed and trauma-responsive leadership coaching practices that address both individual needs and system-level conditions.
What Emergency Response Coaching Can Look Like
Several key opportunities exist. Savings from reducing nursing turnover by 1% could save up to $300,000 that could be invested in the emergency response coaching team.
The health care organization could contract with a team of coaches to provide quick response to clinicians identified in need of assistance. While this may be the preferred way to begin, over time, 8-10 clinicians from the organization would be identified to become coaches and complete a coaching program and a trauma mitigation program. Thus bringing the emergency response coaching team capability within the organization.
Staff in need of a response team intervention would be identified in different ways. One way is that a leader would identify individuals and/or teams that have been exposed to severe chronic stress and/or traumatic situations. Another way is for individuals to self-identify and refer themselves to the emergency response coaching team for help.
This model of healthcare coaching supports trauma mitigation in real time. It moves organizations beyond awareness of healthcare burnout toward practical, trauma-informed action that reduces vicarious trauma, traumatic stress, and moral injury while strengthening retention and care quality.
While the details of establishing an emergency response coaching team would need to be worked out, it is time to try a new approach to helping health care providers continue to do the work that they committed themselves to and give the best care possible to the patients who need them.
