Post-Traumatic Stress in the Emergency Room - News, Weather and Sports for Lincoln, NE; KLKNTV.com

Post-Traumatic Stress in the Emergency Room

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Posted by: Abigail Wood

awood@klkntv.com

When you hear "Post-Traumatic Stress Disorder," images of war tend to spring to mind, but studies show ER nurses are at risk as well. They see death and trauma up-close and personal, every day. Many will tell you, it's a child's death that's hardest to forget.

"And then people started to hear his mother cry and that flipped a switch in a lot of individuals. Hearing that," ER nurse Luke Johnston paused in his remembering, then continued, "I can still hear it today."

Johnston is one of four emergency room nurses from the Bryan West Emergency Department who sat down with me to shed some light on what's been termed "shell shock in the emergency room," a version of PTSD that comes from nurses' continual exposure to trauma and death.

"We've trained ourselves here as nurses to know we're going to see people on the absolute worst days of their life," said Chelsea Russell, an ER nurse who's been at Bryan for three years now.

Gruesome wounds, young deaths, families torn apart: any one of the traumatic events these nurses face daily would sideline the average person, but it's assumed they will take it all in stride. A national study shows that at least 18 percent of trauma nurses have openly admitted to struggling with PTSD, and that's the one's that talk about it.

"I think for somebody to individually come forward and tell me as a manager about their experience it's very hard because it's part of the job," said Katie Kranau, a nurse manager in the emergency room. "It's part of the stigma that comes with being a nurse in general."

Patty Bollinger, a counselor with the Bryan College of Health Sciences, says with ER nurses, this is especially problematic. She says nurses have to move quickly from patient to patient, solving problems under extreme stress, without a real chance to work through hard cases.

"You become robotic," Bollinger explained. "This is what I gotta do, this is what I gotta do, and sometimes you have to put your feelings at bay. It's an art, and you can only do it so long."

HIPAA restrictions are another obstacle. Nurses can't take their problems home.

"A lot of times someone has said to me, you seem very callous and very cold about things," said Jessica Peterson, a nurse in the Bryan Health ER for four years. "That's not really my intention, it's just kind of how we deal with things. It's a compartmentalization."

The stress shows in a variety of ways. Changes in behavior, nightmares, and irritability top the list. Bollinger says it's also common for nurses to seem distant. She says this is often because, right or wrong, the nurse feels some responsibility if a patient is lost on their watch.

"The people that you help, those aren't the ones that bother you the most," Johnston said. "It's the people that you aren't able to do something for."

De-briefing after a particularly stressful case can help shift the burden of responsibility off the shoulders of each individual nurse. Bryan Health also has chaplains on call 24/7. But the nurses I spoke with say it often comes down to their immediate colleagues who understand the difficulties of the job, along with the reasons they're all there in the first place.

"I still love what I do," Russell said, and the others nodded in agreement. "There's nothing else I want to do besides this job."

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