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  • 17 July 2023
  • 7 min read

Psychological Management Of Trauma In Nursing

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    • Clare Fisher
    • Mat Martin
    • Richard Gill
    • Rachel Fines
    • Clare Fisher
    • Matt Farrah
  • 1
  • 2423
Reflect, heal, and develop from traumas your workplace“With pressures on healthcare services growing at an unprecedented rate, nurses continue to experience significant trauma as part of their daily duties.”

As a nurse, there will be countless time when you have to deal with potentially traumatising situations. This article covers the impact these can have, and how to reflect, heal, and develop from traumas you could encounter in your workplace.

Despite international recognition of nursing amongst professions most intrinsically associated with subjection to traumatic imagery and profound human suffering, the ways in which nurses can overcome this is a frequently neglected discussion.

Coping mechanisms nurses may implement to manage its impact on wellbeing are explored below, with particular reference to services available to those who may benefit from psychological and therapeutic intervention.

Physical And Emotional Health Impacts

Whilst the scenarios outlined above may lend themselves more inherently to emergency department, first response and intensive care environments, their prevalence and subsequent implications may also be applied to the wider network of nursing practice.

Unrelenting exposure to major trauma, acutely unwell adults and children, violence and death are amongst the assumed but overly dismissed by-products of the profession. Contemporary research clearly indicates the plethora of mental and physical suffering that all too often arises as a result of these experiences, ranging from emotional burnout to depression, anxiety, and PTSD diagnoses. Perhaps most worryingly, prolonged exposure to this trauma has been increasingly linked to self-harm amongst nurses, and in severe instances, suicide cases.

In light of the ever-advancing pressure and responsibilities placed upon nurses within the National Health Service, it is imperative that clear action is taken to challenge these outcomes, to protect the health of the current and future nursing workforce, ultimately maintaining the safety of patients under their care.

Reflection

The Nursing and Midwifery Council (2023) consistently promote the validity of reflective practice as an evidence-based approach to compartmentalisation of trauma in nursing, and the way in which this exercise contributes to resilience and improved wellbeing for staff.

Echoing this sentiment, The Royal College of Nursing (2023) regards reflection as a lifelong ritual, providing a comprehensive template for nurses to explore how a particular incident affected them both emotionally and physically, the learning this generated, and how this may be translated into improved future practice.

By allowing nurses to diffuse the intensity of challenging experiences and consider what may have been addressed differently, this technique is highlighted to uphold safety and quality of patient care as well as improved holistic wellbeing for staff.

Whilst an array of reflective paradigms exists for nurses, including journaling, mental exercises and debriefing amongst colleagues following a traumatic incident, resources on these respective approaches are readily accessible to nurses, posing significant health and career benefits.

With pressures on healthcare services growing at an unprecedented rate, nurses continue to experience significant trauma as part of their daily duties.

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The Elusive ‘Work-Life Balance’

Undeniably, demands of the current nursing climate have resulted in profoundly longer working hours, the frequent omission of breaks to which nurses are legally entitled, and a significantly wider scope of professional responsibilities.

Interestingly, Farber et al (2023) recently examined the way in which workplace trauma has impacted nurses throughout the COVID-19 pandemic, offering discussion around counteraction of these stressors. Positive correlation was found between daily self-care practices, such as quality time with family and friends, physical exercise, animal and music therapy, and improved wellbeing in nurses.

More broadly, these interventions were concluded to support staff retention within specific units as well as the wider profession, threatened by considerable volumes of nurses pursuing alternative careers due to these issues. Reductions in health-related absence, medication errors, and stress levels amongst nurses were determined to boost overall job satisfaction, improving patient outcomes as a direct consequence of greater staff wellbeing and trauma resilience.

In turn, this may remedy the current suboptimal recruitment of Student Nurses, as the profession may therefore be perceived as a more attractive and rewarding vocation.

Cognitive Behavioural Therapy and Counselling

Lastly, in cases where the discussed foundational approaches pale into insignificance against the extent of suffering from trauma exposure, it is vital to consider the professional services accessible to nurses.

Where these experiences have led to mental health diagnoses, and have begun to impinge upon normal daily functioning, clinical trusts are placing strong emphasis upon counselling and cognitive behavioural therapy resources available to nurses both privately and within the workplace.

Offering rapid access to assessment and treatment of various trauma-induced psychological complaints, ‘wellbeing hubs’ are widely promoted across NHS trusts for referrals to talking therapy and pharmacological interventions via general practice or within the community.

Whilst the entirely unjustified stigma around nurses accessing these services must continue to be challenged, large volumes of staff report reduced levels of stress, burnout, and psychological distress as a result of engaging with these resources.

Consequently, as traumatic events continue to occur in the workplace, nurses may be more appropriately equipped to withstand the challenges these present for physical and mental health.

Conclusion

With pressures on healthcare services growing at an unprecedented rate, nurses continue to experience significant trauma as part of their daily duties. However, through consideration of the above techniques, it is equally possible to minimise the ramifications these may present for wellbeing. In doing so, the sustainability of the nursing profession may be facilitated and protected.

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About this contributor

Since qualifying in 2021 as a Registered Nurse, I have worked exclusively in the emergency department, both at a district general hospital and now a major trauma centre. I believe there is no better setting for nurses to rapidly develop their skills in clinical decision making and managing the acutely unwell patient.

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    • Clare Fisher
    • Mat Martin
    • Richard Gill
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    • Matt Farrah
  • 1
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    • Matt Farrah one year ago
      Matt Farrah
    • Matt Farrah
      one year ago

      Excellent piece, thanks Rachel.

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