In brief: not much. From various studies, such as those found over at Medscape here and here, we know it is real and can be highly detrimental to a nurse’s ability to practice, but it seems to be more easily ignored than actually monitored and treated.

I actually found more articles like this one (military) and this one by Geoff at AusmedEducation related to nurses recognizing and treating PTSD in patients than articles and information related to nurses experiencing PTSD from one or more clinical events.

In addition to the resources listed week before last, I thought I could broaden the scope of my discussion, and mention some of the input of our nursing peers on the subject of PTSD, death, and clinically traumatic events. Not surprisingly, nurses are the ones recognizing the reality of PTSD and wanting to take action to prevent it or lessen its effects.

I agree with Adam over at NursingTimes.net that the best defense is a good offense. Being prepared for patient deaths should begin in nursing school. I know I, for one, hardly received any preparation for patient deaths or potential mental repercussions during my 4 years in school.

I also agree with Megen, writing for OnlineLPNtoRN.org, who suggests that perhaps PTSD could be more seriously addressed if some nurses weren’t claiming to have traumatic stress from management or other non-clinical events. (Although I will throw in that management seems to be highly inclined to ignore staff signs/symptoms of true PTSD, thus perhaps compounding the effects of the original trauma.) Secondary trauma is recognized to occur even in those who do not witness “trauma in technicolor,” but are just repeatedly exposed to the tragedies of patients who are terminally ill or who cannot afford adequate care. This trauma “is a significant issue for nurses, causing burnout, depression, and absenteeism and even causing nurses to leave the profession altogether.”

The scary thing is, as with myself, a nurse may not even personally recognize the core cause of the burnout and depression.

“Does it get any easier?” a new nurse asked on a popular forum. Responders brought up many suggestions for coping, such as education about death, religious practices or beliefs, or family time.  The comment that spoke to me the most was this:

“The moment you walk away from a code with no more thought than hanging an IV bag, I think it’s time to move on.”

An important reminder to not allow yourself to simply push away the natural emotional responses, and stop feeling anything…it’s a sure sign of overload.

I think PTSD in nurses needs to be talked about more often. Staff and management should be preemptively educated on recognizing and addressing the needs of those of us who need help. Good nurses need not fall out of the ranks because we refuse to admit that the suffering and death that surrounds us affects us.

Today’s Nursing Leader is Carol Gino, nurse, author, and advocate for true nursing leadership. Her articles have appeared in various publications, including New York magazine, Nursing, American Journal of Nursing, and The Chicago Tribune.

Carol, MA, RN, has more than 20 years of nursing under her belt, with experience in diverse areas such as ICU, pediatrics, and hospice. She currently presides over Starwater Press, and has published several books. The most notable book to date is the novel Nurse’s Story, which has been published in 9 foreign countries. Other published titles include Rusty’s Story (also a NY Times bestseller), Then An Angel Came, and There’s An Angel In My Computer.

Although Carol is somewhat famous for being the long-time companion of Mario Puzo, the author of The Godfather, her legacy is even more notable in current times for the support that she lends to the voice of up-and-coming nurse leaders, educators, and entrepreneurs. She has a vision for nursing leadership that extends beyond, and even outside, the scope of traditional corporate nursing professionalism. Carol does not stop at lip service to the respect and autonomy that nurses all over the globe strive to have in full measure, but actively promotes and participates in discussions regarding the importance of nurses, nurse autonomy, nurse well-being, and the state of healthcare today.

Carol was recently interviewed on our own Nurse Keith‘s nursing radio station RN.FM Radio. You can listen to the online broadcast with Carol here.

Find Carol at any of the following sites:

Facebook

LinkedIn

Twitter

YouTube

Hopeful Healer website

Starwater Press

Thank you, Carol, for your contribution to nursing leadership and education, past, present, and future!

Today’s Healthcare Leader is Denise M. Brown, Owner and Operator of Caregiving.com

Denise M. Brown operates Tad Publishing Co., based in Park Ridge, Ill. Through her organization, Denise helps persons who care for an aging relative. Denise gives presentations and seminars about the caregiving experience; created and maintains the Caregiving.com web site; and coaches family caregivers and professionals interested in working with family caregivers.

Denise is a certified caregiving coach, working with family members, professionals and organizations. As a coach, Denise helps individuals and organizations achieve goals, gain insights and plan for the future.

In addition, she is Executive Director and Founder, The Center for Family Caregivers. The Center is a non-profit organization dedicated to helping persons who care for chronically ill or disabled family members.

About Caregiving.com Caregiving.com features the blogs of family caregivers, weekly words of comforts, free webinars and online support groups. Visitors also can join the site’s Caregiving Happiness Project, which looks to determine if small, daily changes can add happiness during a difficult time in life. A campaign featuring the stories of former family caregivers called You’ll Be Okay debuted on the site in November 2010.

Caregiving.com also holds online events that entertain, encourage and provide an opportunity for a virtual escape. We regularly take breaks–for fall, winter, spring and summer. During our breaks, we take time to reflect on what’s going well in your caregiving role and what needs tweaking. In September, family caregivers of all ages show off their creative side in our Caregiving Art Show. In December, we sponsor a Holiday Progressive Blog Party.

In March 2011, Denise launched CareGifters, an initiative which funds caregiving solutions, one family caregiver at a time. Recipients of CareGifters donations detail their three challenges and then receive money to resolve or minimize at least one of those challenges.

Check out Denise at: http://caregiving.com, on Twitter, on LinkedIn, or on her blogtalkradio show.

Thanks Denise for your contributions to our healthcare community!

My first conscious memory of wanting to be a nurse dates back to when I was 9 years old. My dad was sick fairly often when I was growing up, and that particular time I remember being in the waiting room of Lenox Hill Hospital in New York City with my mom. My dad had been diagnosed with what I’m assuming was a third degree heart block, and had a pacemaker implanted. Back then, patients were in the hospital much longer than they are now, and I remember him being in there for several days that time. When I finally got to see him, his normally clean-shaven face was riddled with a several-day growth of beard. This wasn’t my dad!

When his nurses realized the significance of this, they helped him to shave and he began looking like my dad again. I thought, wow, these nurses take such good care of my dad, I want to do that when I grow up. Naturally it wasn’t for many years that I understood the true scope of the nursing profession; but that event was enough for the seed to be planted in the mind of a little girl who just wanted Daddy to look and feel like himself again.

Fast forward to my high school years. My mom’s older brother was married to a nurse. My Aunt Virginia Bondi had worked in Worcester, MA in a retirement home for elderly nuns. She was so pleased when I announced my decision to go to college for nursing. She was a diploma nurse, but heartily applauded my plan to work towards a bachelor’s degree. She was my nursing pen pal during my college years, sending me cards and letters and encouraging me all along the way right up through my graduation. Our career was a bond we shared long after she retired, right up until her death in 2010.

I’ve been an RN now for nearly 24 years, and as you know if you read my column, I finally completed working on my MSN a few months ago. I have had an incredible journey in my career, working in such varied areas as medical/surgical, neurological stepdown, intensive care, emergency department, staff development, and management/supervision. My love and respect for my profession has grown exponentially over the years, as has my respect for my colleagues and co-workers. I marvel at the nurses who have been at the bedside for 25, 30, 35 years or more despite backaches, long hours, and more stressful conditions than ever.  I love seeing the eagerness of the newly graduated nurse who has just discovered that she has passed her boards and can now proudly wear the initials “RN” after her name. I applaud the nurses who, despite various obstacles, have embraced the opportunity to further their careers with bachelor’s, master’s, or doctoral degrees or various certifications. I thank God for the foresight, brilliance, and dedication of people like Florence who understood the need for good care, infection control, sanitation, and other things we take for granted now in healthcare.

I was always a good student, a typical type-A overachiever (thanks to the aforementioned dad). There were times in my studies when I heard that most annoying of questions, “You’re so smart; why don’t you want to be a doctor instead of a nurse?” And aren’t there just a million different answers to that question? I think the better thing to ask would be, “You’re so smart; why wouldn’t you want to be a nurse?” I love learning and love the art and science of nursing. As a bedside nurse I loved bringing comfort to my patients while managing some of the most complex health issues.  As a staff development specialist, I take such joy in seeing moment when a nurse finally “gets” how to interpret a cardiac strip or run a code blue. As a supervisor, I take such pride in our team when I see them pull together and work almost as a single unit for the benefit of the patients and each other. There’s not anything I’d rather do for a profession.

Today’s Nursing Leader is Kenneth W. Dion RN, MSN/MBA, PhD, Founder and CEO of Decision Critical.

Ken has over 30 years of service to the healthcare industry and has always maintained a focus on influencing the quality of patient care. Kenneth’s wide-ranging experiences as a firefighter/paramedic, emergency room nurse, healthcare IT consultant, healthcare management educator and entrepreneur have all served to deepen his understanding of the regulatory, educational, employment and budgetary challenges facing today’s healthcare organizations.

Kenneth’s passion and dedication to his profession have led to numerous awards, including The National Student Nurses’ Association’s Honorary Member Award, The University of Central Florida’s Professional Achievement Award for the College of Health and Public Affairs, the Florida Nurses’ Association’s “Nurses Who Made a Difference” award, the Austin Business Journal’s Healthcare Hero award, induction into the Blue Ridge Institute for services to the non-profit sector and Sigma Theta Tau the International Nursing Honor Society. He is currently the sits on the Board of Trustees of the Foundation of the National Student Nurses’ Association serving as President.

Since 1998, Decision Critical, Inc. has led the way in the field of competency management tools for healthcare institutions. Their entire suite of software includes learning management, skills checklists, evaluation tools and portfolios; giving executives and managers the most complete set of competency management tools in a single system.

Find Ken at http://www.decisioncritical.com/ or on Twitter, on LinkedIn or on YouTube.

Thanks Ken for your contributions to our profession!

Advancing your career and collecting CEUs has never been faster or easier than with CoursePark’s learning networks.

Pick a course from any of the following streams:

• Cardiology (Basic and Advanced)
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• Neurology
• Perioperative
• Community and Public Health
• Infection Control
• Patient and Occupational Safety
• Leadership and Communications
• Legal Issues

Today’s Nursing Leader is Elizabeth Scala, currently a personal coach on her site Living Sublime Wellness, and a clinical nurse researcher at Johns Hopkins in Baltimore, MD.

Elizabeth “Coach” Scala, MSN/MBA, RN was born in Carmel, NY. She attended the University of Delaware for a Bachelor of Arts in Psychology and a Bachelor of Science in Nursing. After college, Elizabeth went to work at the Johns Hopkins Hospital as a psychiatric nurse on one of the most acute inpatient units in the state. During that time she received her Masters degrees in Business and Nursing.

Due to burnout and compassion fatigue, Elizabeth left the hospital and took a job at a Wellness Center, running an exercise program for physician-referred exercisers. What she enjoyed most about this role was guiding people back into healthy habits and helping her clients identify their true motivators. During her time at the gym, she completed her training as a health and wellness coach.

Elizabeth was asked to come back to Hopkins, where she now works part-time as a Clinical Nurse Research Fellow. Returning to the hospital has awakened her true calling: to guide nurses to be healthy, happy, and whole so they can provide the best care to their patients on a daily basis.

In that interest, she has authored a book Back to Basics, specifically for nurses seeking to find balance and wellness in their own lives, in order to better serve their patients. She also authors posts for Scrubs magazine and NurseTogether.com

Check out Elizabeth “Coach” Scala at Living Sublime Wellness, on Twitter as Coach Scala, on LinkedIn, on Facebook, and on her blog.

Thank you Elizabeth for leading the way into better care for ourselves as nurses, and as a result, better care for our patients!

Today’s Nursing Leader is Matthew Browning, CEO of YourNurseIsOn

Matthew Browning MSN, RN is Founder and CEO of YourNurseIsOn.com™.  After graduating with a BSN from Sacred Heart University, Browning earned a Master of Nursing from Yale University.  While at Yale, he developed the patent-pending Intelliblast™ communications system to address the challenges inherent in trying to efficiently allocate a scarce, distributed healthcare workforce via modern, real-time, multi-channel and two-way communications.

The Your Nurse Is On™ platform is an awarding-winning healthcare communications platform founded by an entrepreneurial healthcare practitioner in response to the need for more efficient staff communications. The YNIO platform is the first software communications solution designed for healthcare that offers two-way messages via voice, SMS and email for real-time response capture. The platform automates vacant shift fulfillment notifications and important organizational messages so that your Company can focus on patient care.

Check out Matthew Browning at: http://yournurseison.com, on Twitter, on LinkedIn, or on his blog

Thanks Matthew for your contributions to our profession!

(Currently, I celebrate by buying more scrapbooking stuff. Which means technically I celebrate Nurses’ Week every week. Ha!)

Every year, Nurses’ Week lasts from the official Nurses’ Day, May 6^th, through May 12^th, Florence Nightingale’s birthday. I have traditionally been on the receiving end of the gifts, food, and random swag passed out to staff nurses during this week. This year, I find myself on the GIVING end of things, and I think I like it!

I’ve been with our blog NursesNetwork.com and our learning network Nursing.Coursepark.com since October 2011, and just wanted to thank all of the nurses, bloggers, and others who have participated on our Facebook (FB) page, blog, and learning network to make these sites fun and interactive! Every day this week we are giving out prizes to our top commenters on both our blog and FB page as a thank you for participating…we want to hear from you!

And when the week is over, we hope to continue hearing from you. Our byline states: “Together, we learn more,” and that is so true! We cannot possibly know all the practice variabilities or the solutions to every question, but more heads are better than a few, so we want to put our heads together and help each other learn and grow as competent and confident nurses!

For my fellow nurses, especially here in sunny Georgia, find the history of Nurses’ Week and a list of events going on here.

And while we’re celebrating the living, let’s not forget about all those fabulous and dedicated nurses who have blazed trails before us. We owe a great debt of gratitude to those who have made our profession as valued and trusted as it is today. We still have a long ways to go in many areas, but when nurses in the future look back, I want them to be able to be thankful at whatever progress we can make in the next 30 years!

Happy Nurses’ Week!

Contact Hours: 1.1

“I enjoyed this course and it made you think. It was interesting to learn about the signs and symptoms of MI’s and how these may differ depending on the location of the infarct, plus how these are treated. MONA is mnemonic to remember in relation to treatment of an MI.”

Course Description: This module provides an overview of the proper management of the symptoms associated with myocardial infarction, including the acronym “MONA” and basics of thrombolysis.

Course Objectives:

• Describe typical and atypical symptoms of cardiac chest pain
• Compare and contrast inferior, right ventricular, anterior and silent MI symptoms
• Explain MONA and the indications for medications used in MI symptom management
• Discuss various treatments for cardiac chest pain and the indications for thrombolytic therapy