Written by Elizabeth Cairns, Mobilize Recovery Special Projects, and reviewed by Code Recover Peer Advisors, August 2026

Peer recovery support specialist Christy Reser talks about witnessing trauma in the ER and how she takes care of herself to avoid burnout.

The Emergency Department is an intense environment for peers. You will witness life-and-death moments, severe physical suffering, and the systemic gaps that keep people stuck in cycles of use. While your empathy is what makes you good at your job, it also exposes you to three specific risks: burnout, vicarious trauma, and compassion fatigue. Understanding the difference between these pillars of workplace stress is the first step in staying resilient.

• Burnout: Burnout happens because of conditions in the workplace environment. (source) It's caused by long hours, heavy caseloads, high-pressure deadlines, or feeling like you don't have the resources to do your job. You may feel depleted, like you're "running on empty."
• Vicarious Trauma (VT): Witnessing the trauma of others (overdoses, deaths, or domestic violence) can cause a shift in your worldview. (source) You may start to see the world as an inherently dangerous or hopeless place.
• Compassion Fatigue: Compassion fatigue is the physical and emotional exhaustion that comes from the constant output of empathy. (source) It shows up as a decline in your ability to care. You might find yourself feeling numb or checked out when talking to a patient in crisis.

Recognizing the Symptoms

Stress shows up differently for everyone. Watch for these "check engine" lights:

• Physical: Chronic fatigue, headaches, or difficulty sleeping.
• Emotional: Irritability (especially with clinical staff), feeling trapped in the job, or a lack of joy in your own recovery.
• Behavioral: Isolation from your recovery community, working through lunch or other breaks regularly, or neglecting personal hygiene and hobbies.

Resilience Strategies: Professional Self-Care

Self-care in the ED isn't about bubble baths; it's about tactical resilience.

• Debrief Culture: Never leave a hard shift without talking it out. Talk to your supervisor or a fellow peer for 10 minutes before you leave for the day. Don't take the trauma home.
• Compartmentalization: Create a ritual that signals the end of your shift. You could change your clothes, listen to a specific podcast on the drive home, or physically wash your hands to wash off the day's intensity. Take time to breathe and ground yourself at the beginning and end of each shift.
• Self-Awareness: If you find yourself feeling cynical about a patient's "revolving door" visits, that is a sign of compassion fatigue. Use your professional supervision. It's okay to admit it; it's a normal response to an abnormal environment.

To stay in this field, you must treat your mental health with the same seriousness as your recovery. By recognizing the signs of workplace stress early, you can adjust your boundaries and your workload and ask for support before you reach the point of no return. Peers are valuable assets to the Emergency Department team, but they are only effective if they can maintain their own health and resilience.