PTSD in Nurses Causes Major Concern

• PTSD in nurses seems to be occurring more frequently all over the world. Due to its prevalence, the need to optimize the well-being of nurses should be a priority. 
• PTSD in nurses is especially a concern during the current nursing shortage meaning, nurses are likely not getting the help, support, or time off needed, to appropriately deal with the trauma they have experienced. 
• Healthcare organizations and leaders need to be proactive in preventing this from happening, as well as process in place to support those who are suffering. 

PTSD in Nurses

Work-related Post Traumatic Stress Disorder or PTSD in nurses seems to be occurring more frequently all over the world. Due to its prevalence, the need to optimize the well-being of nurses should be a priority.  

PTSD can lead to negative emotional, mental, and physical effects.  Nurses who are suffering from PTSD typically begin to show declining work performance and issues related to organizational, intrapersonal, and interpersonal factors in the workplace.   

It is important for nurses to develop healthy coping strategies in order to promote well-being and mental health among this demanding and challenging profession.   

The following are important areas to focus on when assessing the issues and impacts of PTSD in nurses: 

• What does PTSD look like in nurses? 
• Which areas of nursing have the highest occurrences of PTSD?  
• What can be done to help nurses with PTSD?  

A Picture of PTSD in Nurses

Nurses may experience an array of symptoms when undergoing PTSD such as nightmares, flashbacks, or intrusive thoughts.   

Typically, low self-esteem, dissatisfaction, lack of pleasure, or a feeling of numbness often occur.  Some nurses begin to withdraw from people and places in an attempt to avoid talking or even thinking about the events.   

Nurses see people of all ages die; they work on performing cardiopulmonary resuscitation on individuals; they try to control severe bleeding issues; they must assist with end-of-life discussions; and they sometimes even experience verbal or physical attacks by patients or the patients’ families.

Nursing Areas With Highest Occurrences of PTSD

One may ask if there are specific areas of nursing in which nurses suffer from PTSD the most.    The answer can be broad as nurses in the military, nurses caring for trafficked individuals, trauma nurses, psychiatric nurses, opioid addiction nurses, developmental disability nurses, and many other areas of nursing constitute the effects of PTSD.   

Research published by The Journal of Heart and Lung Transplantation also noted high levels of PTSD among intensive care unit nurses, due to the fragility of patients such as those who are intubated, ventilated, or are on life-sustaining medication drips.   

Typically, nurses who work in outpatient settings are less likely to have a diagnosis of PTSD based on the type of primary unit in which the nurse is employed.  

The occurrence of PTSD seems to be higher in the area of inpatient settings where there is more continual exposure to the events that may serve as contributing factors versus more intermittent exposure in outpatient settings.   

It is important to note that PTSD in nurses varies since one nurse may not be affected by working in a specific area, but another nurse may be affected greatly.   

Many times, it depends on the current environment and stress levels in a particular setting, and it can also depend on the personal experience of the nurse who may be dealing with previous exposure to traumatic events.  

Assisting Nurses with PTSD

As with any work environment or life experience that has become stressful and wearisome, there is always the potential for exhaustion and burnout to settle among nurses.  The danger of this phenomenon can lead to poor work performance, a decreased desire to meet objectives at work, and a decreased mental and physical ability to care for those patients in the stressful environments that contribute to the traumatic and stressful events.   

Nursing has long been considered one of the most stressful careers, and with the current state of staff shortages, increased workloads, and a lack of life-work balance, the issues revolving around mental health, post-traumatic stress disorder, and burnout are all being noted at an increasing rate.   

It is important for other nurses to be aware of the symptoms of PTSD and to assist with offering or leading the nurse in the right direction to obtain the needed mental health counseling and/or physical care that may be needed.   

Leadership

Nurse leaders and managers can play a pivotal role in PTSD by encouraging employees to take care of themselves through mindfulness, offering proper training related to traumatic events, and conducting debriefings after traumatic events have taken place.   

Leaders must be engaged with their nursing staff by listening, caring, encouraging, supporting, and developing trust among their nurses.  Often, the nurse experiencing PTSD does not fully understand what he/she may be suffering from, and it is imperative to speak out and seek therapy as needed.  

Treatment

The National Alliance on Mental Illness recommends a combination of medications known as psychotropic medications that may be needed for PTSD, along with complementary approaches such as yoga, service animals, and water therapy.   

The treatment modalities can differ vastly for everyone based on the traumatic events that are leading to PTSD; therefore, it is important to be mindful that it may take one or more treatment approaches to find what works the best for each individual.

Adaquate Staffing

As hospitals and organizations strive to provide high quality care in the changing healthcare environment, the nursing supply of nurses remains insufficient.  Although issues surrounding the nursing shortages are due to various factors, it is important for nursing leaders and administrators to understand that part of the underlying cause of nursing turnover is due to many nurses developing PTSD and leaving the workforce.   

The Bottom Line

While it is important for all organizations to have coping strategies in place and to implement these among staff, it is important to understand that sometimes it goes beyond what the coping strategies can offer.   

For instance, modifying individual coping mechanisms without any modification of the working environment may not be adequate to treat PTSD in nurses or to prevent its development.  Creating awareness that PTSD is a common modality among nurses and taking a proactive approach to the disorder has the potential to assist nurses dealing with PTSD and therefore to assist with decreasing the nursing shortages.   

It is of great importance to identify and implement effective strategies for PTSD in an effort to prevent more serious events from occurring such as substance use/misuse and/or possible suicide.   

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