Recognizing the Signs of PTSD in ED Nurses

Recognizing the Signs of PTSD in ED Nurses

Recognizing and Supporting Nurses who have PTSD

Shane Parker, RN
Co-founder and Chief Nursing Officer

Many people don’t realize the role of post-traumatic stress disorder (PTSD) in the medical field. It’s estimated that one in ten emergency workers have some form of PTSD, which is much higher than the PTSD rate in the general population. One reason nurses might be so stricken with PTSD is because of the difficult things they see and go through on a day-to-day basis. Many must deal with violent patients, which leaves an imperceptible mark on their psyche that can sometimes leave them unable to work.

Numerous studies have been conducted on the role of stress of patient care, and nearly all of them conclude that when nurses are stressed or anxious, patient care drastically suffers. PTSD often prevents nurses from doing their jobs to the best of their ability, as the normal stresses of the job can produce frequent anxiety, or even worse, panic attacks.

To prevent PTSD in the workplace, it’s important for nursing leaders to recognize the signs of PTSD. They can then take appropriate interventions to get the nurse the help they need to get better.

Causes of PTSD in Nurses

These days, PTSD is no longer classified as an anxiety disorder by the DSM-V. Instead, it’s in a new category of illnesses known as trauma- and stress-related disorders. PTSD can come about because of numerous factors, including:

  • Witnessing a traumatic event.
  • Experiencing a traumatic event.
  • Hearing about a traumatic event that happened to a loved one.
  • Being repeatedly exposed to specific details of a traumatic event.

For nurses, the top cause of PTSD is dealing with the sudden death or resuscitation of a young patient. 57.2 percent of emergency room nurses rated this factor as one of the most distressing from a list of events. 15.1 percent said that dealing with train and car crash victims was the worst, while 8.7 percent felt physical trauma and burn patients were most disturbing.

Nursing leaders need to be aware of what their nurses are dealing with. If a nurse has experienced any of these situations, it’s important for them to be extra vigilant when monitoring that nurse for symptoms of PTSD.

Symptoms of PTSD in Nurses

Because of the tough nature of nurses, many try to hide their PTSD symptoms in an effort to appear as normal. Not only is this dangerous for them, but it’s also bad for their patients. Nursing leaders should always keep a look out for these symptoms in order to get nurses the help they need to perform their duties.

Physical symptoms of PTSD can range from chest pain to difficulty breathing. Some people even suffer symptoms of shock, such as a rapid or weak pulse, shivering, nausea, pale skin, and dilated pupils. Other physical symptoms that are less specific might include:

  • Sweating.
  • Headaches.
  • Being tired.
  • Dizziness.
  • Trouble with sight.
  • Jaw clenching.
  • Thirst.

There’s also a large amount of cognitive and emotional symptoms a nurse might suffer. They’ll often feel confused and disoriented and have trouble concentrating on the task at hand. They might not be able to remember things like they used to, and they might have problems identifying people and objects that are familiar to them.

Emotionally, nurses might be showing signs of guilt, anxiety, denial, grief, and fear. They might display these emotions in an array of behavioral symptoms, including:

  • Withdrawal from society.
  • Bursts of anger.
  • Changes in eating habits.
  • Acting restless.
  • Drinking on the job.
  • Other emotional outbursts.

These symptoms might be triggered whenever a nurse encounters a patient that reminds them of the traumatic incident.

How Nursing Leaders Can Provide Support for PTSD

Given the fact that nurses in general often avoid seeking help for their PTSD, it’s often up to leaders to be proactive in helping their staff deal with traumatic events. In one study that looked at emergency department nurses in Canada, 67 percent believed they did not receive adequate support for their traumatic experience. What’s worse, only 18 percent sought critical incident stress debriefing, and none of the nurses ever looked into getting outside help.

Nursing leaders should institute a Critical Incident Debriefing policy for traumatic incidents, and consider allowing the department to form a group that can meet to discuss traumatic events that an employee has encountered.  Additionally, nursing leaders must provide nurses with the community support they need to heal. Leaders can offer nurses time off to do something enjoyable and get therapeutic support from a counselor. They can also refer patients to the National Center for PTSD or the PTSD Foundation of America for more appropriate care.

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