My fiance is starting his nursing degree topup and would like to use this topic. He is particularly interested in the phenomenon/concept of PTSD in staff as a result of ongoing exposure to trauma/death/resuscitation as opposed to one single traumatic event.
Any research or suggestions regarding incidence, contributing factors, management and avoidance of burnout/stress would be lovely.
Thank you!
Along with the mass of literature on vicarious trauma/vicarious traumatic stress, you may be interested in the concept posed by Eagle and Kaminer (2013) of Continuous Traumatic Stress (CTS):
Eagle, G. and Kaminer, D. (2013). Continuous traumatic stress: Expanding the lexicon of traumatic stress. Peace and Conflict: Journal of Peace Psychology, 19(2), 85-99.
Interesting topic! My work on The Revolving Door Effect may also prove helpful. You should be able to access it through my profile publications - I have also attached it here for you.
Conference Paper The Revolving Door: The Missing Link to Assessing Burnout
I have observed how the ED staffs work for about 4 years now.
Perhaps the initial reaction of the PTSD is inevitable. Some new nurses even MDs succumbed to vasovagal syncope. But subsequent images of similar incidences would erase all signs of PTSD and burnout if they happen.
When they have worked for my same observation period, some as early as 3 months, they tend to be seen to be abusive - verbally and in action. Some even enjoy torturing LOC patients using painful, abusive stimuli instead of applying subtle and noxious stimuli. The latter works perfectly well but out of boredom of seeing the same incidences, accidents, chores and patients make them so non-professional.
Surprisingly, there are still genuinely dedicated, caring and passionate nurses though rare especially in the ED environment. Even the MDs, Consultants and all other ED medical staffs are facing the same experiences but the ethical divide remains. The choice is the nurses themselves to make as to whether they wish to acquire the PTSD, impose it on their poor LOC or other defenceless patients or be great persons just like Florence Nightingale.
If you are relating the PTSD with burnout - the contributing factors would most likely be the speed and state of the emergencies themselves. The patients status - alert or LOC, regular or first-timer. Is it for resuscitation, observation or facing the death patients - all would normalise in no time at all. Soon, your fiancé would notice that the staffs would either enjoy being good nurses or happily succumb to be man-made abusive persons.
Your fiancé could see whether the nurses could take the pressure of the speed, gravity and workload of the ED. Because I have yet to see one till date acquiring the PTSD, rather I see the reverse - their relishes in remaining to be abusive in whatever ways they could find. This is rampant in 2 hospitals out of 3 that I have observed. Only 1 hospital has great staffs who genuinely perform their Nightingale's duties without being asked.
The staffs' burnout could easily be compensated with short or prolonged work leave but PTSD is very rare given the staffs' enter the profession with full knowledge and expectations of becoming good nurses - PSTD can be overcome because if the staffs' cannot conquer their own PSTD, who would assist and appease the patients having the same syndrome albeit of different profession?
This is also especially true - a high salary would eliminate any signs of burnout so the issues of both PTSD and burnout are not applicable especially in ED environment through my personal 4 years of observation at 3 public hospitals locally.
You might want to look at the following papers, and others by the same authors:
M Howlett, et al. Burnout in emergency department healthcare professionals is associated with coping style: a cross-sectional survey. Emerg Med J Online First doi:10.1136/emermed-2014-203750
Tajek B Hassan. Averting compassion fatigue and burnout. Who should help us conquer our demons? Emerg Med J Online First doi:10.1136/emermed-2015-204752
Tajek B Hassan. Sustainable working practices and minimizing burnout in emergency medicine. Br J Hosp Med 2014; 75(11).
DOI: http://dx.doi.org/10.12968/hmed.2014.75.11.617
Best wishes,
Jason
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