Burnout in healthcare social work does not always look like collapse. It can look like a social worker who is technically performing every required function but is no longer actually present with the people they serve. It can look like a practitioner who processes grief efficiently — the family is referred, the paperwork is filed, the next family arrives — without registering any of it emotionally. Kayla Bonkowski, a social work graduate student in Sterling Heights, Michigan, is entering a specialty where this risk is well-documented and frequently underestimated.
Healthcare social workers, particularly those in end-of-life care settings, face sustained exposure to death, grief, family crisis, and institutional pressure. The cumulative effect of that exposure has a clinical name: secondary traumatic stress. It is distinct from ordinary occupational stress in that it arises not from the social worker’s own direct experiences but from sustained empathic engagement with people who are suffering. The worker absorbs something from each interaction. Over time, that absorption accumulates.
Secondary traumatic stress presents differently than primary trauma. The social worker has not experienced the death directly. They were not the patient or the patient’s child. But they have sat with dozens of families in the same situation, have heard the same grief in different voices, have held the same weight in different hands. At some point, the weight does not lift the way it did at the beginning of the career.
Vicarious trauma is a related concept. It refers to the cumulative transformation of the clinician’s inner world that results from empathic engagement with traumatized clients. It is not a failure of clinical skill. It is a predictable consequence of doing the work. Social workers who enter end-of-life care without structures in place to manage it will encounter it.
Kayla Bonkowski is completing her Master of Social Work at Louisiana State University with this awareness. Her clinical training covers self-care not as a personal wellness practice but as a professional requirement — the practitioner who is not attending to their own sustainability will eventually not be able to attend to their clients either.
The institutional dimension of burnout in healthcare social work is significant and frequently underacknowledged. Social workers in hospital and hospice settings often carry caseloads that exceed what the research would consider sustainable. They are asked to provide clinical depth with the time resources that allow only administrative breadth. The gap between what the role is supposed to provide and what the system resources it to provide generates a chronic, low-grade stress that compounds the effects of secondary traumatic stress.
Bonkowski holds a Bachelor of Science in Psychology from Rochester College, where she graduated Cum Laude in 2017. Her psychology background gives her a clinical framework for understanding burnout at the physiological and psychological level: chronic stress dysregulates the same systems that regulate empathy and emotional processing. A social worker in burnout is not choosing to disengage from clients. Their nervous system has made the adjustment without their consent.
Prevention involves multiple layers. Supervision that addresses not just clinical decision-making but the emotional experience of the work. Peer support from colleagues who understand the specific demands of the setting. Personal practices that restore the capacity for presence — for Kayla Bonkowski, consistent physical training at CrossFit Teneo in Macomb, Michigan, is one such practice. Research on the relationship between regular exercise and stress recovery is well-established; the physiological benefits translate directly into the capacity for sustained clinical work.
The institutional dimension also requires advocacy. A social worker who recognizes burnout in their own practice has a professional obligation to address it — through supervision, through reduced caseload if that is possible, through the kind of direct communication with supervisors that the institutional culture sometimes makes difficult. Bonkowski is preparing to be a practitioner who can advocate for sustainable conditions, for herself and for the colleagues she will work alongside.
In Sterling Heights, Michigan, Kayla Bonkowski is preparing to enter a specialty that asks practitioners to sustain a particular quality of presence over the long arc of a career. Burnout prevention is not a peripheral concern. It is a clinical commitment — to the clients, to the role, and to the practitioner’s own sustainability across the years the work requires.