NUR103 Practical Nursing: Traumatic Events


 Emergency Nurses are routinely confronted with work related traumatic events and hectic work conditions. Several studies report a high prevalence of post-traumatic stress disorder (PTSD) in these nurses. Coping and social support seem to play an important role in the development of PTSD.
Objectives: This study examines (1) the frequency of exposure to and the nature of traumatic events in Emergency Nurses, (2) the percentage of nurses that report symptoms of PTSD, anxiety, depression, somatic complaints and fatigue at a sub-clinical level, and (3) the contribution of traumatic events, coping and social support to PTSD symptoms, psychological distress, somatic complaints, fatigue and sleep disturbances.
Design: Cross-sectional data from 248 Emergency Nurses, from 15 Flemish (Belgian) general hospitals, were analyzed Emergency Nurses were found to be confronted frequently with work related traumatic events. Death or serious injury of a child/adolescent was perceived as the most traumatizing event.Almost one out of three nurses met sub-clinical levels of anxiety, depression and somatic complaints and 8.5% met clinical levels of PTSD. Levels of fatigue were high but not directly related to the frequency of exposure to traumatic events. Emotional coping was related to an increase in all outcomes; avoidant coping was related to more somatic complaints; problem focused coping was related to a decrease in psychological distress and perceived fatigue. Social support from colleagues and supervisor (head nurse) was found to have a protective effect on the occurrence of PTSD
Conclusion: Emergency Nurses are especially vulnerable to post-traumatic stress reactions due to repetitive exposure to work related traumatic incidents. This not only personally affects the nurses, but can also impact quality of care. Hospital management should act on the findings of this study and invest in supportive, communicative, empathic and anticipatory leadership, and provide time-out facilities, cognitive-behavioral interventions and psychological counseling for Emergency Nurses on
Emergency unit is a stressful, fast-paced, and demanding environment [16] . The ED nurses are routinely caring of traumatized patients and life threatening. Such daily scenarios place nurses at an increased risk for occurrence of STS symptoms [2] . Psychological responses to traumatic events often seen as normal, and usually diminishes within short period of time. However, repetitive exposure to traumatic events may hinder the normal recovery process and may result in the development of psychological disorders [20] . Consequently, the ED nurses are at risk and tend to develop STS more than others due to nature being repetitively exposed to traumatized individuals [21] . Another factor may contribute to STS among the ED nurses is being involved in a high level empathetic relationship with the traumatized individuals [22] . Sharing empathy is a central concept and key component.
in the process of developing STS among nurses [21] . Although empathy is a core therapeutic technique in nursing care, however, empathy may transfer trauma feelings from victims to nurses. Consequently, nurses either have positive feelings about their ability to help others which is known as compassion satisfaction, or have negative feelings that may precipitate for STS [3] . Furthermore, imminence, nature, and increased frequency of traumatic events confronted by nurses in ED departments have also contributed to development of STS among ED nurses. The repetitive exposure to such events is assumed to be associated with serious ychological and physical consequences on nurses in ED departments and can contribute to high risk of STS among them [15].

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