Extending the Post-Traumatic Stress Disorder (PTSD)

Extending the post-traumatic stress disorder (PTSD), legislation as an occupational illness to frontline nurses will extensively cover nurse’s psychiatric issues and expedite access to benefits, resources, and treatments following traumatic events. This is a major positive change to the healthcare system as the previous legislation implemented in 2016, did not include nurses and many other healthcare professionals. The change in this legislation creates controversy regarding why nurses are deserving of access to these benefits and why the previous legislation did not include them.

Post-traumatic stress disorder (PTSD) is a mental health illness triggered by external traumatic events experienced firsthand by an individual (North, Hong, & Downs, 2018). The new PTSD legislation creates conversation regarding the stressful and unpredictable work environment of nurses and their traumatic encounters (Wheeler, 2018). Throughout this paper, the prevalence and impact of PTSD on nurses in addition to other health care professionals will be discussed, as well as the ethical and economic considerations. Inclusion of all nurses, past and present should be implemented in the PTSD legislation, as lack of health care support and benefits can result in severe consequences for the individual, public and the healthcare system.

Inclusion of all nurses, past and present should be implemented in the PTSD legislation, as lack of health care support and benefits can result in severe consequences for the individual, public and the healthcare system. Because nurses represent Ontario’s health systems largest workforce and are present in every aspect of the healthcare setting, appropriate supportive resources are needed to increase employee health and wellbeing (Doris Grinspun, 2017). According to the DSM-5, a diagnostic mental health manual, nurses experience qualifiable exposures pertaining to a direct diagnosis of PTSD (North, Hong, & Downs, 2018). As nurses encounter some of the highest rates of workplace harassment and violence, their ability to properly function in home and work environments can be negatively impacted (Hassankhani, Parizad, Gacki-Smith, Rahmani, & Mohammadi, 2018). Due to these stressful environments, nurses have been known to experience PTSD within the first four years of practice, warranting a high burnout rate and contributing to staffing shortages and poor patient outcomes (Laschinger et al., 2018). With a PTSD legislation in place, the healthcare system would be providing a supportive environment that is desirable for nurses and creates conversation around the traumatic issues that nurses face.

Inclusion of all nurses, past and present should be implemented in the PTSD legislation, as lack of health care support and benefits can result in severe consequences for the individual, public and the healthcare system. Because the ethical implications of nursing directly relate to patient safety and healthcare outcomes, adequate healthcare support and benefits for nurses should be in place. The Canadian Nurses Association code of ethics (2008), calls for nurses to provide safe, competent and compassionate care to patients, however, the ability to do so is limited without the appropriate supportive measures (McIntyre & McDonald, 2019). Nursing environments warrant the implementation of ethical actions that benefit the victim, such as expedited benefits in times of crisis, and not needing to prove a causal link between the workplace trauma and PTSD symptoms, which the new legislation provides (Austin, Saylor, Finley, 2017). This legislation will allow nurses to openly discuss the moral distress and ethical implications the nursing career experiences in an appropriate setting with resources that can support the individual’s mental health and wellbeing.

Inclusion of all nurses, past and present should be implemented in the PTSD legislation, as lack of health care support and benefits can result in severe consequences for the individual, public and the healthcare system. Economically, this is an issue as McIntyre and McDonald (2019), discuss issues of supply and demand, as the government’s demand for nurses to work under these conditions differs in accordance with the supply of nurses mentally suitable to continuously work. With lack of proper treatment and care, issues related to PTSD can exacerbate, resulting in sick days, staffing shortages and nursing burnout and result in an health care system economic burden as these nurses cannot provide adequate care, resulting in longer hospital admissions and stays (Cullati, 2017). These conditions do not coincide with nursing beliefs in relation to patient care, as it will ultimately result in a negative impact on the patient, healthcare system and the economy (McIntyre & McDonald, 2019).

Inclusion of all nurses, past and present should be implemented in the PTSD legislation, as lack of health care support and benefits can result in severe consequences for the individual, public and the healthcare system. It has been demonstrated that in order for nurses to provide safe and ethical care, nurses must have access to supportive resources in order to competently care for others. Nursing environments with supports in place such as the PTSD legislation, have proven to promote favourable working conditions which in turn positively impacts the healthcare system’s economy. The realities of everyday practice for nurses warrants traumatic experiences, these individuals should be commended for their efforts and given the opportunity to care for themselves as they care for others. Future research and clinical implementations should look to identify other healthcare professionals at risk for PTSD. As well, actions must to be taken to ensure timely access to structured debriefs in order for individuals to process traumatic events with a mental health professional. Trauma does not discriminate and it is ultimately in the power of the nursing community to use their voices to ensure proper legislations and mandates are put in place for the future generation of nursing.

References

  1. Austin, C. L., Saylor, R., & Finley, P. J. (2017). Moral distress in physicians and nurses: Impact on professional quality of life and turnover. Psychological Trauma: Theory, Research, Practice, and Policy, 9(4), 399-406. http://dx.doi.org/10.1037/tra0000201
  2. Brophy, J. T., Keith, M. M., & Hurley, M. (2018). Assaulted and unheard: Violence against healthcare staff. New Solutions: A Journal of Environmental & Occupational Health Policy, 27(4), 581–606. https://doi-org.ezproxy.library.uvic.ca/10.1177/1048291117732301
  3. Caramanica, K., Brackbill, R. M., Liao, T., & Stellman, S. D. (2014). Comorbidity of 9/11-related PTSD and depression in the World Trade Center Health Registry 10-11 years post-disaster. Journal of Traumatic Stress, 27(6), 680–688. https://doi-org.ezproxy.library.uvic.ca/10.1002/jts.21972
  4. Cullati, S., Cheval, B., Schmidt, R. E., Agoritsas, T., Chopard, P., & Courvoisier, D. S. (2017). Self-Rated health and sick leave among nurses and physicians: The role of regret and coping strategies in difficult care-related situations. Frontiers in psychology, 8, 623. doi:10.3389/fpsyg.2017.00623
  5. Hassankhani, H., Parizad, N., Gacki-Smith, J., Rahmani, A., & Mohammadi, E. (2018). The consequences of violence against nurses working in the emergency department: A qualitative study. International Emergency Nursing, 39, 20–25. https://doi-org.ezproxy.library.uvic.ca/10.1016/j.ienj.2017.07.007
  6. Laschinger, S., Wong, C., Read, E., Cummings, G., Leiter, M., Macphee, L.,…Wood, K. (2018). Predictors of new graduate nurses’ health over the first four years of practice. Nursing Open, 6(2), 245-259. https://doi.org/10.1002/nop2.231
  7. North, C., Hong, A., & Downs, D. L. (2018). PTSD: A systematic approach to diagnosis and treatment. Current Psychiatry, 17(4), 35-43. Retrieved from https://mdedge-files-live.s3.us-east-2.amazonaws.com/files/s3fs-public/Document/March-2018/CP01704035.PDF
  8. Wheeler, K. (2018). A call for trauma competencies in nursing education. Journal of the American Psychiatric Nurses Association, 24(1), 20–22. https://doi.org/10.1177/1078390317745080