Post-Traumatic

Stress Disorder
in Psychiatric
Nurses
Amanda Mathy

Question Time!

Objectives
Identify and Define Post-Traumatic Stress
Disorder (PTSD)
Recognize significance of PTSD to psychiatric
nurses/nursing
Identify ways that nurses with PTSD can affect
patients and workplace
Identify preventative measures to reduce risk of
PTSD occurrence with nurses

Introduction
Veterans Disease - 1980
14% of overall nursing population
Emergency, Critical Care, and
Psychiatric areas
High rates of assault and psychological
morbidity
9-10% of psych nurses

Post-Traumatic Stress
Disorder
A mental illness that
comes from witnessing a
traumatic event, death,
or perceived threat of
death
SECONDARY TRAUMATIC STRESS DISORDER?

Signs & Symptoms of

PTSD

Fatigue
Extreme Fear
Irritability
Insomnia
Impaired Concentration
Anxiety, panic attacks, and depression
Flashbacks/nightmares of event
Exaggerated startle response

Events Leading to
PTSD

https://
www.youtube.com/watch?v=6kzlERcxquQ

Issue
Nurse:

Patient:

Workplace:

-Emotional and physical

changes

-quality of care

-Dont want to be viewed

as weak

-less time
with patient

-Psychiatric Nursing
shortage

-Shoulder the blame; cope

themselves
-Medical errors

-75% employers leave

after 6 months/ turnover
rate
-nurse-to-patient ratios

Betty Neumans
Systems Model
Stress & Coping
Stability
Prevention

Maslows Hierarchy of
Needs
PTSD- stressor
Threat to safety
Self-Actualization=
resilience of stressors

In
PT
su ad
pp eq
w SD
or
or ua
se sy
t s te
n mp
ys
to
te
m
m
s

St
w res
en ork sfu
vi
l
ro
nm
en
t
Un
pr ce
pa ed rta
be tie ict int
y
ha nt
to
vi s
or
s
Jo
di b
ss
at
isf
ac
tio
n

Ex
pa po
vi tie su
ha ole nt re
rm nc s to
e/
se
lf-

Root Cause
Analysis
High
Psychiatric
Nurse
Turnover
Rate

ANA Standards
Standard #11: Communication
-assess own skills
-conflict resolution skills
-health care providers
Standard #14: Professional Practice Evaluation
-self-evaluation
-strengths/improvements
-seek help/guidance
Standard #16: Environmental Health
.
-emotional/psychological safety
-medical errors
-own advocate

QSEN
Patient-Centered
Care
Teamwork &
Collaboration
Evidence Based
Practice
Quality Improvement
Safety
Informatics

SAFETY
!

Consequences/Implicat
Nurse:
ionsjob dissatisfaction,
Relationship/family problems,
burnout, medical errors
Patient:
Dissatisfaction with care and time provided by nurse
Workplace:
Liability for medical errors, nursing shortage in
psychiatric field, increased nurse-to-patient ratios, poor
reviews

Recommendations
Routine structured debriefing meetings
Critical Incidence Stress Debriefing
Support from management
EMDR therapy?
Preventative Measures: self-assessment;
management of aggressive patients;
CEUs;

https://
www.youtube.com/watch?v=GTLLfdcJE0Q

Managements of
Aggressive Behaviors

https://www.youtube.com/watch?v=NEPLwy_p2nA

Conclusion
PTSD in Psych Nurses
not acknowledged
High Turnover Rates
Preventative Measures
Own Self-Assessment

References
-Americans Nurses Association. (2010). Scope and Standards of Practice: Nursing. Silver
Spring,
MD.
-Betty neumans system model. (2012). Retrieved from
http://www.nursingceu.com/courses/473/index_nceu.html
-Hood, D,. (2011). PTSD in nurses. Retrieve from
http://nursing/advanceweb.com/Features/Articles/PTSD-in-Nurses.aspx
-Jacobowitz, W,. (2013). PTSD in psychiatric nurses and other mental health providers: A
review
or the literature. Mental Health Nursing, 34(11).doi: 10.1016/j.apnu.2015.01.002
-Mitchel, J. (2015). Critical incidence stress debriefing (CISD). Retrieved from http://drustvopsihologa.rs.ba/wp-content/uploads/2014/05/CriticalIncidentStressDebriefing.pdf
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Psychiatric and Mental Health Nursing. doi:10.1111/jpm.12264
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