Management of Post-Traumatic and Secondary Traumatic Stress in Healthcare Professionals _ ____________
Janice’s parents entered the room, and she reaches out to her mother and begins to cry. She thanks you for “being there.” You leave the room, numbed by the experience. On your way home, you keep thinking about Janice—her face, her tears, and the coldness of her hand. You turn on the car radio for diversion, but you can’t block out the intrusive thoughts. Nor can you ignore a wave of nausea. Once at home, you greet your children but quickly become annoyed by their conversation and the ringing of the telephone. You eat dinner mechanically, watch television late into the evening, and go to bed exhausted yet unable to sleep. You toss and turn and can’t get warm. The nausea recurs, as do thoughts of Janice, and when sleep finally comes, it’s plagued by nightmares about physical assault. You wake with a start and wonder, “What’s happening to me? I’m a seasoned trauma healthcare professional and have seen just about everything. Why is this situation so distressing?” Questions 1. What factors are contributing to your intense physical reaction? 2. Why are you questioning yourself and your experience? 3. Who should you confer with about Janice? Discussion Emotional responses like these aren’t unusual—in fact, they arise frequently among healthcare professionals who care for trauma victims. Experts define a traumatic event as a situa- tion that is so extreme or severe, so powerful or threatening, that it demands extraordinary coping measures. Secondary traumatization is an occupational risk for all professionals who provide direct or indirect patient care (Badger, 2001). When employees interact with victims of trauma being aware of self, senses and emotions is important to protect self from STS. Some common experiences are listed below: 1. Your senses are engaged when interacting with Janice. You see her distress, you feel her skin, and you hear her story. You sit with her and comfort her when she is scared. Your entire self is present with Janice during her trauma. 2. Many healthcare professionals, especially those that have been caring for clients/patients for years, have the belief that they should no longer be physically or mentally affected by their work. However, extreme situations are not seen every day. There is an expected level of trauma that healthcare professionals see in the workplace, but not all will affect you the same way. There are many factors at play when caring for a trauma survivor. 3. Leaders, coworkers, and staff should be available to process secondary trauma responses. The people you work with can understand and be able to process the feelings surrounding the treatment of a trauma survivor. Your coworkers share your experiences and professional language, and they can help you process STS.
Some symptoms of STS include denial and shock, fixation on a single detail of the traumatic event, immobilization or the inability to act or think, and serenity as an adaptive response. Those affected may feel emotionally numb, withdraw, be emotionally unstable, be irritable, have difficulty focusing, and experience sleep disturbances. When symptoms persist for more than 72 hours and affect daily functioning, evaluation by a mental health professional should be sought (Badger, 2001).
Self-Assessment Question
3. How should organizations support employees who are struggling with STS symptoms? A) Ignore the issue and focus on work performance. B) Provide mandatory counseling sessions to address the symptoms. C) Implement training on STS awareness and self-care. D) Assign additional workload to keep employees busy. Healthcare Consideration: Psychological trauma: Damage to the psyche that occurs as a result of experiencing either a single traumatic event or multiple reoccurrences of traumatic events. PTSD : May develop following trauma and hinders the indi- vidual’s ability to cope with that experience; these symptoms cause significant distress and problems functioning, and they persist for longer than a month to many years. STS : Considered a stressor for PTSD; an ongoing or cumula- tive exposure to triggering events defined as biological and emotional exhaustion and dysfunction that may lead to an inability to empathize with and support others. (Raudenski et al, 2020) CASE STUDY 1 It’s just after midnight in the emergency department when city rescue workers arrive with a 28-year-old assault victim, Janice. You report to a trauma room to find her shivering, disheveled, and hesitant to speak. J anice begins to describe what brought her there: She was grabbed from behind while walking from a bank’s automated teller machine, at which she had stopped on her way home from work. She tried to scream for help, but the assailant silenced her by placing his hand over her mouth. During an attempted rape, she was choked until she was rendered unconscious. She regained consciousness en route to the hospital. Rescue workers said that the assailant had run away when an automobile entered the bank parking lot. She asks that you stay with her, claiming to still be terrified of being injured. You assure her that she is now safe and promise to stay with her until a family member arrives. She asks you to hold her hand, and you do. You note how cold it is.
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