Conclusion

(Canva, 2024d)

Created By: Alex Craig, RN

Post-traumatic stress disorder (PTSD) is a serious issue in the nursing profession. According to research done by Duarte et al. (2020), 20% to 30% of nurses report symptoms consistent with PTSD. This website has highlighted the definition of PTSD, the distribution of PTSD in certain fields of nursing, and then explored various interventions at the individual, organizational, and political level to reduce PTSD rates and improve outcomes.

(UAB, 2019)

What Is PTSD?

PTSD is a mental health condition that affects the way nurses function in their daily life and profession. Generally, PTSD develops after a traumatic event, such as death. In an effort to cope, those with PTSD will re-experience the event, take effort to avoid or numb themselves, experience increased arousal, and altered cognition or mood (Schuster & Dwyer, 2020). In addition, PTSD can cause other conditions to co-exist and create co-morbidity for nurses. For example, nurses with PTSD may develop dissociative disorders, depression, anxiety, phobias or suicidal ideation in an effort to cope with the distressing and traumatic events. The psychological distress from PTSD will often affect a nurse’s physiological systems. For example, nurses may experience pain, gastrointestinal issues, and other unexplained medical conditions.

Certain nursing specialties, such as emergency, intensive care, and psychiatric nursing, report even higher rates of PTSD due to the intensity of their roles. Additionally, nurses may experience “secondary traumatic stress,” which arises from empathizing with and caring for patients in distress over extended periods (Carmassi et al., 2020).

High-Risk Nursing Areas: Nurses working in military settings, trauma care (Emergency Department), psychiatric care, opioid addiction, and intensive care units are particularly susceptible to high levels of PTSD due to the nature of their work and continuous exposure to traumatic situations.

PTSD, Burnout or Moral Distress?

Burnout is not a medical condition and is considered an occupational phenomena (WHO, 2019) whereby nurses may feel exhausted, cynical, less motivation, a decrease in efficacy, and feelings of negativism. A traumatic event is not required to experience burnout.

Moral distress can be described as an internal conflict with our integrity. Generally, it happens when a nurse is unable to do the ethical action because of external barriers (AACN, n.d.).

PTSD on the other hand occurs from a traumatic event. It is possible for all of these to co-occur together. For example, Angelina’s constant experience of death is a traumatic event that can lead to burnout and PTSD. If the death was the result of an ethical dilemma, Angelina may experience moral distress.

What We Can Do

Individual Interventions

First, nurses can use various interventions within the Roy Adaptation Model to improve symptoms and outcomes. Examples include the use of mindfulness and acceptance-based smartphone apps (Reyes et al., 2024).

Organizational Change

Second, organizations can prevent PTSD among staff by providing resilience training (Qian et al., 2022). In addition, during traumatic events, an organization can implement a care debriefing, which is a structured process with the goal of processing emotions (Kolbe et al., 2021).

Institutional Regulation

Lastly, state and federal institutions can get involved to prioritize nurse well-being. Examples may include staff-patient ratios or greater audits for compliance among hospital organizations. At the political level, institutions can push organizations through regulation to focus on nurse well-being. There are a ton of different commissions that focus on patient safety and quality care. Perhaps more commissions need to be made that focus on the nurse.

There Is Hope and Help

If you find yourself struggling with PTSD or think you might have PTSD, there is hope and there is help. No matter how deep in the trenches you are. Here is a personal story of Sandra, an emergency room nurse, and how she recovered from PTSD and substance abuse.

National Alliance on Mental Illness (NAMI) HelpLine

Call 1-800-950-NAMI (6264) or text NAMI to 741-741.

National 211

Call 2-1-1 to connect with community services like food pantries, housing, and support groups.

SAMHSA's National Helpline

Call 800-662-HELP (800-662-4357) for substance abuse and mental health services.

(Hard knox talks: Your addiction podcast, 2024)

References

American Association of Critical-Care Nurses [AACN]. (n.d.). Moral distress in nursing: What you need to know. https://www.aacn.org/clinical-resources/moral-distress/

Canva. (2024d). DreamLab. [Nurse leadership generated with AI prompt]. https://www.canva.com/dream-lab

Carmassi, C., Gesi, C., Simoncini, M., Favilla, L., Massimetti, E., Olivieri, M. C., ... & Dell’Osso, L. (2020). DSM-5-PTSD in the aftermath of a natural disaster: Correlates and impact on quality of life. Journal of Psychopathology, 26(2), 67-73.

Duarte, I., Teixeira, A., Castro, L., Marina, S., Ribeiro, C., Jácome, C., & Silva, P. (2020). Burnout among Portuguese healthcare workers during the COVID-19 pandemic. BMC Public Health, 20(1), 1-10.

Hard knox talks: Your addiction podcast. (2024). PTSD Recovery Story | Registered Nurse | Addiction | Sandra Lander [video]. YouTube. https://www.youtube.com/watch?v=Qnbk3XPUSTc.

Kolbe, M., Schmutz, S., Seelandt, J. C., Eppich, W. J., & Schmutz, J. B. (2021). Team Debriefings in Healthcare: Aligning intention and impact. BMJ. https://doi.org/10.1136/bmj.n2042

Qian, J., Wang, W., Sun, S., Liu, L., Sun, Y., & Yu, X. (2022). Interventions to reduce post-traumatic stress disorder symptoms in health care professionals from 2011 to 2021: A scoping review. BMJ Open, 12(1). https://doi.org/10.1136/bmjopen-2021-058214

Reyes, P. M. R. A. T., Fudolig, P. M., Sharma, M. P. M. M., & S. Evangelista, P. R. F. L. (2024). Testing the Effectiveness of a Mindfulness- and Acceptance-Based Smartphone App for Nurses Traumatized by the COVID-19 Pandemic: A Pilot Study. Issues in Mental Health Nursing, 45(10), 1034–1045. https://doi.org/10.1080/01612840.2024.2385571

Schuster, M., & Dwyer, P. A. (2020). Post-traumatic stress disorder in nurses: An integrative review. Journal of Clinical Nursing, 29(15-16), 2769–2787. https://doi.org/10.1111/jocn.15288

University of Alabama at Birmingham. (2019). [Girl with risk factors and causes of PTSD]. UAB. https://www.uab.edu/news/images/2018/images/media-relations/expertsguide/PTSD3.jpg

World Health Organization [WHO]. (2019). Burn-out an “occupational phenomenon”: International classification of diseases. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases/

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