Vicarious Trauma Affects Oncology Nurses in Every Care Setting

Hematology/oncology nurses experience emotional dissonance and vicarious trauma in outpatient as well as inpatient settings, according to Kathryn (Kate) Shady, PhD, RN, OCN, presented her findings at the 2026 ANCC Magnet & Pathway Conference Research Symposium in Chicago, Illinois, on October 28, 2026.¹ Shady, in an interview prior to the meeting, told Oncology Nursing News the work is meant to inform nurse-designed interventions.

What did the study examine?

The poster, "Carrying the Weight: Emotional Dissonance and Vicarious Trauma in Hematology/Oncology Nurses," addresses sources and impacts of emotional dissonance, barriers to emotional processing, and nurse-recommended, trauma-responsive supports.¹

"My goal was to figure out what the characteristics of those traumatic experiences and emotionally dissonant experiences were so that then I could hopefully work with nurses in a larger study to develop interventions," said Shady, manager of Evidence-Based Clinical Outcomes and a nurse scientist.

Where do oncology nurses encounter vicarious trauma?

Interviews with nurses showed that the burden was not limited to inpatient units.

"For me, the most shocking thing was it did not matter where people were," Shady said. "They could be in the outpatient space, which I always thought in my mind, well, that's where the healthy people are. That can't be as bad as the inpatient space."

She described one participant's experience: "One person in an interview talked about coming in every Monday morning and having to sign a stack of sympathy cards from the patients who had died over the weekend and just how much she dreaded doing that. And I realized that it really was in all areas."

Why does emotional strain matter for patient safety?

"I wanted to figure out how do we sustain our oncology nurses?" she said. "We know that they stay in the profession for a long time, but are they really at their best throughout that entire professional career?"

She explained that accumulated emotional scarring and vicarious trauma can make errors more likely, and that errors involving chemotherapy can be deadly.

What supports do nurses say they need?

"I think a lot of burnout and compassion fatigue interventions are made without nurses. And I strongly believe the 'nothing about us without us' theory," she said. "Nurses need to be involved in every step, but it also needs to be something that's feasible."

Nurses are often given coping tools without time to use them during a shift, she noted, and her work asks whether recovery time after a difficult event should be required. "Does it need to be forced? Like, ... you need to go take a 10 minute break because of what happened. I will see you in 10 minutes," she said.

Prior Oncology Nursing News coverage has highlighted peer connection, debriefing, and vicarious resilience as counterweights to vicarious trauma.^2,3

What are the key takeaways for oncology nurses?

• Vicarious trauma and emotional dissonance can occur in outpatient as well as inpatient hematology/oncology settings.
• Emotional strain may affect safety in high-risk tasks such as chemotherapy administration.
• Well-being interventions are more likely to be feasible when nurses help design them.
• Coping tools have limited value if nurses lack time during a shift to use them.

References

1. Shady K. Carrying the weight: emotional dissonance and vicarious trauma in hematology/oncology nurses. Presented at: 2026 ANCC Magnet & Pathway Conference Research Symposium; October 28, 2026; Chicago, IL. Poster PS1-05. Accessed October 23, 2026. https://pagv3.virtual-meeting.org/us/anajoint2026/en-US/pag/presentation/698183
2. Paul S. Embracing vicarious resilience in oncology nursing: a light in the dark. Oncology Nursing News. April 10, 2024. Accessed October 23, 2026. https://www.oncnursingnews.com/view/embracing-vicarious-resilience-in-oncology-nursing-a-light-in-the-dark
3. Caba A. Vicarious trauma among oncology clinicians of color. Oncology Nursing News. January 7, 2026. Accessed October 23, 2026. https://www.oncnursingnews.com/view/a-community-in-distress-vicarious-trauma-among-oncology-clinicians-of-color