PTSD: Nurse, Heal Thyself

Post-traumatic stress is real and insidious. See my previous blog post. But in reality, not much is said about PTSD when nurses are brought up. Are we just experts at being in denial? Do we view it as a weakness. Or are we immune to the effects of the work that we do and the horrors that we see?

Indeed, we are not. The few studies exploring PTSD in nurses have exposed that nurses, espsecially those in the critical care and emergency areas, experience PTSD at rates four times higher than the general population, up to 33%.  Statistics also give the indication that critical care nurses develop PTSD more frequently than overall military personnel in war zones, whose rate of PTSD averages between 6% and 20%.

Because we are at war. At war with death. At war with disease. At war with abuse. I don’t know about you, but some days “war zone” became the perfect description of the units in which I’ve worked.

So, what do we do about it?

First, we understand what it is, and what it looks like. Most sources define PTSD in summary as a mental disorder stemming from one or more traumatic experiences, whether those were personal experiences, close family experiences, or other experiences that induce horror, helplessness, grief, or fear.

It can manifest with symptoms such as depression, anger, mood swings, unexplained behaviors, bad dreams or flashbacks, insomnia, and/or memory issues, among others. Women are usually at twice the risk for PTSD than men.

Second, we recognize our risk for developing PTSD as legitimate and potentially career-altering. This applies to the nursing profession as a whole. Managers should be on the lookout for any of their staff exhibiting characteristics or behaviors indicative of PTSD. Support should be readily available. Unfortunately, many nurses can tell about times during their career when the support and patience was just not there for them. Perhaps programs could be instituted that offer “burned-out” nurses the opportunity to float to less stressful units for a set time to aid recovery, then given the chance to opt back into their original position if feasible. As it stands even now, I believe many nurses view PTSD as a weakness, and managers don’t want to have to deal with the fallout, preferring to dismiss the “troublemaker” and hire someone else that doesn’t have “issues” to be dealt with.

Third, we form both personal and public game plans, similar to what I have already mentioned above. Personal strategies may require some soul-searching to determine what our best coping mechanisms are, and if involvement in therapy of some sort will help. Having a good social network of family and friends contributes greatly to recovery.

Realizing that traumatic events or stress in our personal lives makes us even more vulnerable to PTSD in our workplaces may help us to avoid carrying over the negative feelings from home to workplace and vice versa.

The good news? PTSD is highly treatable—up to 90% of cases can be resolved. Combination therapy that includes medication and psychotherapy offers the greatest likelihood of PTSD resolution. The workplaces that offer Employee Assistance (EAP) attempt to address the issue through an external source of help. Unfortunately, staff may be reluctant to utilize those resources for various reasons.

For CE credit, we currently have a couple courses related to stress, workplace violence, and shift work available on our learning network, Nursing.Coursepark.com. This site is an excellent place to get all your yearly CE credit for one price. The courses are Support for the Shift Worker, and Preventing Workplace Violence.

Other sources of help and information:

Heal My PTSD

National Institute of Mental Health

Advance for Nurses

Nurse Kathy’s Story

Video: PTSD and Emotions

MedicineNet

Dept of Veteran Affairs

The Use of Gallows Humor

Twelve Steps to PTSD

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