Being a nurse in any healthcare setting today is full of daily challenges, stress and sometimes occupational burnout. What is much worse, is when nurses experience a traumatic event and then develop post-traumatic stress disorder or PTSD. Some nurses may present behaviors including irritability, tearfulness at work, detachment, and some type of personality change. While it may not have been a focus of prevention in the past, post-traumatic stress disorder among nurses is gaining more attention and is now considered a serious mental health problem that demands more research and awareness.
Post-Traumatic Stress Disorder
According to the American Psychiatric Association, PTSD is a condition that may develop after experiencing or witnessing a traumatic event like a serious accident, a natural disaster or terrorism. People with PTSD have very intense and disturbing thoughts and feelings associated with their experience. They might relive their experience through flashbacks or nightmares. They can experience sadness, anxiety, anger or detachment from people around them. Avoidance of places where the trauma occurred is common.
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Symptoms of PTSD fall into four categories including intrusive thoughts, avoiding reminders, negative thoughts and feelings, and arousal and reactive symptoms. It is reported that over 3 million cases of PTSD are diagnosed each year in the United States. It is estimated that 1 in 11 people will experience PTSD sometime in their life and women are twice as likely to develop symptoms of PTSD.
Why Nurses?
Health care is stressful and complicated. It is full of demands and unpredictable changes. Organizations, patients and families may have unrealistic expectations of nurses. Each year it seems that nurses have to do more with less all while trying to deliver high levels of clinically superior and ethical care. It is estimated that up to 14% of nurses experience symptoms that meet the criteria to be diagnosed with PTSD, which is 4 times greater than the general population.
Nurses working in critical care and the emergency department in hospitals have higher incidence of PTSD than nurses working in other areas of health care. Factors including being repeatedly exposed to serious and life-threatening illnesses, dying and death, may be at an increased risk for developing PTSD. Not only witnessing the actual death of a patient, but experiencing the suffering of the family and others also takes a toll on nurses.
Military nurses, those on labor and delivery units, and on first responder teams are also more likely to develop symptoms of PTSD than nurses working elsewhere. Being witness to disasters, violence from patients or family members, the threat of needle sticks, and events involving disturbing behavior from people on drugs or alcohol can leave nurses with intense emotions that they will need to address.
PTSD can be short-lived or chronic and debilitating, depending on several factors including the nurse’s personality, training, pre-existing emotional problems and social support. Some nurses will suffer a lifetime of symptoms and others will adjust to their experience and be symptom-free within weeks or months. Early intervention is key to helping nurses with the trauma experienced and effectively working through their emotions and thoughts about what took place. Therapy can help improve outcomes and has been associated with fewer symptoms and decreased severity of symptoms.
Final Thoughts on Nurses and PTSD
What kinds of images come to mind when you think about post-traumatic stress disorder or PTSD? Police or firefighters? The military or first responders? Terrorism or natural disasters? While all of these may be associated with PTSD, let’s not forget about the thousands of nurses in the United States that go to work each and every day, not knowing what will happen on their shift. How many patients will be brought into the ER after a mass shooting? How many babies or children will they see die in front of them? How much can a nurse take emotionally until he or she succumbs to PTSD?
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