Many nurses suffer from PTSD. What can be done to help?

“Most associate PTSD with severe physical trauma, but the reality is nurses across the country are suffering from PTSD due to the mental effects of working on the front line,” Kathleen Gaines wrote last month for nurse.org. “Studies conducted in China, Canada, and Italy have identified that nurses are suffering from anxiety, depression, and insomnia related to the fight against COVID.

“Anxiety is crippling for nurses especially when there is no end in sight,” she continued. “Yes, there is a vaccine and while the outlook is hopeful — there is still an uphill battle. The newest director of the CDC predicts another record-breaking number of deaths due to COVID. Nurses are in a constant state of fear. Fear that there will be a PPE shortage again, fear they will bring the virus home with them, fear there will be a vaccine shortage and fear that the general public will not embrace the vaccine like medical professionals.”

But anxiety and mental health issues for nurses didn’t begin with the coronavirus pandemic.

In 2014, the University of Pennsylvania School of Nursing, the American Nurses Foundation and Little Bird Games created a post-traumatic stress disorder toolkit for nurses working with patients experiencing the mental health condition.

But nurses, too, are at risk.

In fact, according to an article in the New York Times, as many as one in four nurses experience PTSD at some point in their careers.

“Nurses see people die. They work on resuscitating patients. They try to control bleeding. They have end-of-life discussions. And sometimes they are verbally or physically abused by patients or visiting family members,” Meredith Mealer, an associate professor at the Anschutz Medical Campus at the University of Colorado, Denver, told the Times.

American Nurses Association’s Cheryl Peterson echoed Mealer’s sentiments, noting the numerous aspects of the profession that could potentially lead to traumatic events.

“A nurse who is in the military, or a nurse caring for trafficked individuals. Nurses who are in trauma. Nurses who are in psychiatric care. Nurses caring for opioid addictions. Any one of these individuals has the potential to suffer from burnout or PTSD,” she told the paper.

Research published in April 2019 in the Journal of Heart and Lung Transplantation also found high levels of PTSD among intensive care unit nurses. Providers in the ICU work with the most fragile of patients, many of whom are either intubated, ventilated or on life-sustaining medication drips.

Another study, this one from 2016, found age was a significant factor in quality of life for ICU nurses. Specifically, younger nurses were more likely to experience burnout and traumatic stress compared to nurses 50 years or older.

What you should know

According to the Mayo Clinic, PTSD is a mental health condition usually triggered by witnessing or experiencing a traumatic event.

Common symptoms include flashbacks, nightmares, severe anxiety or uncontrollable thoughts about the event.

Symptoms can be more intense when you’re stressed out in general, according to Mayo. Additionally, people of all ages can have PTSD, but those in careers with high exposure to traumatic events, including military personnel and first responders, are at increased risk.

It’s particularly common for PTSD patients to experience intrusive memories, to avoid thinking about or being around anything that may remind them of the traumatic event. It’s common to experience changes in physical and emotional reactions as well, including sweating, headaches, dizziness, thirst and fatigue.

According to the Mayo Clinic, PTSD can increase one’s risk of depression, anxiety, substance misuse, eating disorders, and suicidal thoughts and actions.

While those with PTSD can have trouble coping or adjusting to daily life, effective treatment, time and appropriate self-care can improve day-to-day function.

Learn more about PTSD at mayoclinic.org.

What can be done to help nurses with PTSD?

Nursing has long been considered one of the most stressful professions, according to a 2012 analysis by the National Institute for Occupational Safety and Health at the Atlanta-based Centers for Disease Control and Prevention in 2012.

Staff shortages, increased workloads and lack of life-work balance all contribute to mental health issues, including burnout and, in some cases, PTSD.

First, it’s important for nurses to look out for the aforementioned symptoms of PTSD.

Nurse leaders and educators can also play a role.

Cynda Rushton, a professor of nursing and bioethics at the Johns Hopkins Berman Institute of Bioethics and School of Nursing, told NPR in 2016 about a program she started to help new nurses deal with moral distress. The Mindful Ethical Practice and Resilience Academy features "a series of in-person workshops, some of which involve nurses using simulations to practice how to make their ethical concerns heard at work."

The program, Rushton said, can help improve staff communication and encourage nurses to take care of themselves through mindfulness.

A nurse PTSD resource guide from professional healthcare site Elite Learning also suggests nurse managers should offer proper training before responding to traumatic events and conduct debriefings afterwards.

“Leaders need to be engaged with their staff by listening, encouraging, and supporting them,” the site reported. “Knowing employees and developing trust is paramount.”

For nurses struggling with the disorder, it’s imperative to speak out and seek therapy.

The National Alliance on Mental Illness recommends a combination of psychotherapy and medication, plus complementary approaches such as yoga, aqua therapy and even service dogs.

More about PTSD treatment at nami.org.

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