Has Nursing Given Me PTSD?

[TeresaBuRN]

Perhaps, like me, you experience nighttime dreams of being in a hospital or healthcare setting accompanied by feelings of anxiety.

Despite being away from the bedside for many years, I still have dreams and occasional flashbacks related to distant events from my nursing career.

These recollections can be a mix of reality and imagination. For instance, I once had a nightmare where I found myself in a patient's closet entangled in IV tubing. No, that never really happened.

I have specific video-like memories of traumatic events that I experienced in my healthcare career. Memories of drowned toddler twins, vegetative patients, unsuccessful resuscitation scenarios, that lady who asked if she was going to die and then proceeded to do so, a chocked-full emergency room, a fetal demise, a therapeutic abortion, erratic, violent patients, miscarriages, and rape exams, to name a few.

Is this evidence of PTSD? Let's look at the definition of Post Traumatic Stress Disorder (PTSD) and see.

Definition of PTSD

Post traumatic stress disorder (PTSD) is considered a mental health condition. PTSD can develop after going through or seeing a life-threatening event. It's normal to have stress reactions to these types of occurrences. The majority of people begin to feel better after a few weeks or months. However, if it's been longer than a month (years in my case) and thoughts and feelings from the trauma are upsetting you or causing problems in your life, you may have PTSD.

Symptoms of PTSD

• Reliving the event (Yup, had that)
• Avoiding things that remind you of the event. (I changed jobs when I felt "burnt out”)
• More negative thoughts and feelings than before the event/s (yes)
• Feeling on edge or keyed up (also called hyperarousal). (Yes, I've had that).
• Feelings of guilt or shame (Could I have better?)
• Difficulty sleeping (Check)
• Bad dreams (Check)
• Avoiding places or activities (Maybe)
• Easily frightened (Not sure I have that one)
• Always on guard
• Flashbacks (Definitely)
• Substance abuse (Thankfully no)
• Lack of concentration (Huh, what?)
• Unexplained outbursts (My husband would say yes)
• Avoidance of thinking about or talking about the traumatic event/s (There is a reason I'm not at the bedside anymore)

Risk Factors for PTSD

• Number of years in nursing. The longer you've been a nurse, the more likely you are to have PTSD. I've reached the 45-year mark and am going strong.
• Area of nursing. Emergency, trauma, critical care, obstetrics, and psychiatric nursing are the highest for PTSD. I've worked in all of them except Psyche.
• Inadequate staffing. Been there, done that.
• Nonsupportive manager. I left many nursing jobs due to a lack of support or respect from a manager.

Potential Consequences of PTSD

• Compassion fatigue
• Reduced productivity
• Burnout
• Increased risk of patient falls
• Medication errors
• Depression - which can precede or be a result of PTSD.

Finding Support

• Debrief
• Mental health counselor
• Employee Assistance Programs (EAP)
• Peer support groups 
• Why not start your own group?

Emotional Healing

• Psychotherapy
• Medication

Spiritual Healing

Organizations have focused primarily on nurses' physical and mental health through employee wellness programs and mindfulness interventions but have neglected the spiritual aspect.

Supporting the spiritual health of nurses is a way a healthcare organization can care for nurses in ways beyond the conventional support methods.

Promoting meaning and purpose is a crucial aspect of ensuring the well-being and self-care of nurses.

In Promoting Spiritual Well-Being Among Nurses, it is asserted that religion/spirituality has been associated with higher mental well-being, self-compassion, sense of personal accomplishment, less depression, anxiety, and burnout.

According to the authors of Spirituality and Spiritual Self-Care: Expanding Self-Care Deficit Nursing Theory, having a "higher purpose in life" is associated with greater personal resilience.

Luckily, I have a strong faith community and belief system, which makes a massive difference in how I deal with trauma from my past.

Conclusion

I may not have been officially diagnosed with PTSD, but I show most of the signs of it.

Hopefully, the information I've shared will make other nurses more aware of the risks and consequences of PTSD. My wish is that more nurses and their managers will explore ways to avoid PTSD and seek interventions before their ability to provide quality care is affected.

References

U.S. Department of Veterans Affairs, PTSD: National Center for PTSD

Post-traumatic stress disorder symptoms in healthcare workers: a ten-year systematic review

[Been there,done that, ASN, RN]

They are only dreams. We all have crazy dreams. If you are concerned  about PTSD.. consult a psychiatrist.  They will give you xanax  and  antidepressants. 

 

[hppygr8ful, ASN, RN, EMT-I]

Per TOS we can't diagnose any condition still if your symptoms are causing difficultty in everydayy life I suggest you consult a psychiatrist. Medications and therapy have done wonders for me. 

Hppy

[TeresaBuRN]

I don't believe I need a psychiatrist or medication but thanks for your concern. My activities of daily life are not affected, although I occasionally still have nightmares. I no longer feel anxious, however, maybe that is because I'm no longer at the bedside and haven't in years.

To Hppy- I also was postulating not diagnosing.

How much of what we call "Burn-Out" is actually PTSD?

Teresa 

[hppygr8ful, ASN, RN, EMT-I]

TeresaBuRN said:

I don't believe I need a psychiatrist or medication but thanks for your concern. My activities of daily life are not affected, although I occasionally still have nightmares. I no longer feel anxious, however, maybe that is because I'm no longer at the bedside and haven't in years.

To Hppy- I also was postulating not diagnosing.

How much of what we call "Burn-Out" is actually PTSD?

Teresa 

Glad to hear your daily functioning has not been affected. I truely belive that PTSD is a very real thing. About 4 years ago I was diagnosed with Complex Post Traumatic Stress Syndrome. It was not work related but it does at times affect my work performance. I don't take medications for it preferring a more holistic approach. Gled you are well at this time.

Hppy