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PTSD: It is a condition experienced by many nurses, physicians, mental health workers, and other health care workers. The recent explosion of assaultive behavior and traumatic events has reached epidemic proportions. Nurses are in the front lines and care for victims of such acts, often witness the destruction, and too often are the victims of violence.
I decided to write this blog as a result of creating a social media page for stress management for nurses. The nurses that responded to the page all had some trauma in one form or other to report.
Nursing is a profession that is present for the best and the worst in the human condition. Upon speaking with any one of my colleagues regarding this subject a story or stories emerged. They were stories that elicited surprise, sadness, and pain and remained with surprising detail. Almost always a small detail such an object present, an expression on a co-worker's face, a smell, a noise, or any small detail like a bookmark in a gripping story. These are the markers of a traumatic event. These events usually occur without warning and leave an imprint on the heart and soul.
In an early personal experience I was called to the nursery in a small hospital that tried its best in the beginning years of infant mechanical ventilation. The physician was working with all his ability to save this little boy, placing an umbilical arterial line, the ventilator was set up, but unknown to any of us there was a growing air embolism in the baby's pericardial sac. Despite our efforts his condition deteriorated and just before the arrival of the transport helicopter and the x-ray film confirming a sad presence, the infant lost the fight. The physician was visibly distressed and conferred with the arriving neonatologist who assured him that he had done everything to save the child. The physician sat in a nursery rocking chair holding his head in his hands. A medical student who was present asked me what should he do as the situation was beyond him. I suggested he go to the cafeteria for breakfast and that I would talk with the grieving physician. Again I recalled the details of the experience as if it happened last week.
That experience precipitated my leaving acute care to study for mental health nursing-no frying pan, no fire? I have talked with many nurses touched by the death of a child-both expected and unexpected. They were sad and traumatizing bookmarks. How many leave the profession after a traumatic event?
In mental health I found new trauma bookmarks, staff bullying other staff, violent patients whose explosions caused harm or death, disasters and criminal violence that took lives. I was present for a violent event but will not comment on it here in reverence for the lives lost and the suffering of victims and staff-also unwittingly victims.
One event in a mental health center involved a chronically psychotic man who in anger at the no smoking rules set fire to a hotel in which he was living, taking the life of one of the residents and disclosed his role in the fire at the mental health center to this nurse.
These events happen to nurses every day and it is now known that if these events are left without effective care that physical or emotional distress follows.
I refer you to Dr. Gabor Maté's book "When the Body Says No" and the new e-book "Horror in the Mind" by Mark Tyrrell.
Nurses deserve the same high quality level of care they provide on a daily basis. This care needs to be provided without stigmatizing or re-traumatizing the nurse. This includes labels applied to nurses seeking treatment as being damaged, and ineffectual in some way.
It has been reported that some states require reporting the use of prescribed antidepressants by nurses even for the management of chronic physical pain. This sort of labeling could result in avoiding treatment or leaving nursing. Unless a nurse demonstrates the inability to function in a safe and effective manner, this is wrong and harmful as many will refuse to seek treatment in fear of losing their job and possibly their career.
Somehow we need to make effective and confidential treatment available for anyone who finds a trauma has changed their life. Mark Tyrrell has suggested that trauma be dealt with using therapies that do not produce re-traumatization such as EMDR, EFT, and a new technique named the Rewind Technique. Mr. Tyrrell stated that “PTSD has often been treated by having sufferers confront their nightmarish memories head on. But for the one in four people who seem naturally prone to long-term PTSD, trying to talk about the trauma can actually reinforce the memory and the emotions that come along with it.” In effect my interpretation is that reciting and reliving the trauma could have the effect of re-traumatizing the client.
Bessel A. van der Kolk stated: “Psychologists usually try to help people use insight and understanding to manage their behavior. However neuroscience research shows that very few psychological problems are the result of defects in understanding; most originate in pressures from deeper regions in the brain that drive our perception and attention. When the alarm bell of the emotional brain keeps signaling that you are in danger, no amount of insight will silence it."
Faster EFT is rapid and effective, with the least amount of re-exposure to traumatic memories. In fact, there is a process named no content that focuses solely on the emotions and does not require a story. Faster EFT is a process that addresses the traumatic thoughts and emotions drawing upon other disciplines such as NLP, hypnosis and is evolving. Certainly nurses, who are the front line providers of healthcare deserve the best, most effective, and compassionate treatment modalities available.
I have written this in the hope of providing new answers to stress, trauma, and burnout in nursing.
When the Body Says No by Gabor Matè
PTSD Horror in the Mind by Mark Tyrrell
Bessel van der Kolk You Tube Videos
Written by Rose Hargrove, RN, FEFT
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