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  • Writer's pictureMegan Filoramo

Trauma of nursing

You’re not broken.

Something isn’t wrong with you. 

You haven’t lost your empathy or your compassion or your drive. 


It’s time we talk about the trauma of nursing. If you’re like me, your undergraduate nursing program probably involved a few sentences about trauma in reference to veterans or victims of sexual assault. That was the extent of our nursing education in trauma.


This really explains why we are where we are now.


We don’t understand that there’s a name for what we’re experiencing, the emotional exhaustion, the personalization, the lack of interest in activities that usually fulfill us.


This needs to change. We all know that healthcare is in crisis, but the lack of acknowledgement of the trauma of nursing is just pouring gasoline on the flame. If we don’t do something about it, we, and the world we are part of, are in deep trouble. 


So let’s talk about trauma. It was the topic of my presentation at the AANP Conference yesterday. As it turns out, trauma is not reserved for people exposed to the atrocities of war or sexual abuse. 


Let me explain what I mean by starting with a definition. Trauma is an ‘unclaimed experience’, the result of an event that is too much, too fast, too overwhelming to be claimed and understood by your conscious mind.


The incidence of trauma in the general population is between 55 and 90% (including all or us BEFORE we were nurses). This means many of the patients we care for on a daily basis may have characteristics of traumatic stress. Their underlying trauma, combined with their reasons for seeking medical care, puts us at risk for secondary stress. In addition to this, and the nurse's potential personal history of trauma, there are other factors that contribute to secondary trauma. These include feeling that your care is futile, watching a patient die, fear of medication errors, staffing ratios, and anger of patients or family members to name a few.


In some studies, as high as 22% of nurses have exhibited signs and symptoms of PTSD, with 18% reaching diagnostic criteria. This is particularly sobering as these studies were conducted prior to the COVID-19 pandemic, before the trauma grew 100-fold


I’m not telling you all this bad news to make you feel worse. I am telling you this to explain to you why you may feel broken, overwhelmed, and at the end of your rope.


You are experiencing the signs and symptoms of secondary trauma:

Sleep disturbance

Ruminating thoughts

Lack of a sense of personal accomplishment

Fatigue

Relationship problems

Lack of interest in activities once enjoyed.

Change an appetite, overeating, or under eating

Feelings of helplessness related to work.


These are just a few. I didn’t make them up, this is what the evidence shows.


This is activation of the sympathetic nervous system, the flight, fight, or freeze response. 


You aren’t broken.


That is what I want you to know. That is what I want you to experience, the compassion for the person who has been repeatedly exposed to difficult events and patients who are suffering.  I want you to feel some understanding for your coworkers who are in the exact same boat and experiencing the exact same thing. 


We are part of the crisis AND part of the solution. 


Trauma is treatable. 

When you wake up at 3am with palpitations and racing thoughts. Put your hand on your heart and tell yourself slowly and repetitively that you are safe. 


Once we know our sympathetic nervous system is activated, we can use our prefrontal cortex, the smart part of our brains, to start to create safety and bring ourselves to the present moment. We can use our thoughts to help us heal.


There are lots of other approaches, approaches that I want to share with you but are beyond the scope of one article, but after giving this talk yesterday and seeing that people were blown away by just knowledge that they weren’t broken, that what they were experiencing was normal and treatable, I thought we better start there.


You can feel better, you can get back to a fulfilling work life. Start with some compassion for and understanding of where you are now.

 

If this is blowing your mind and you want to explore what you're experiencing with me 1:1, reach out and schedule a consult call. We can get you through this together. 


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