What you learn in nursing school may not prepare you for the real clinical setting; Operating Room (OR), Emergency Department (ED), or even the Intensive Care Unit (ICU). Of course, not every nursing student needs trauma preparation, as not everyone works in a bloodbath. Either way trauma training is important.
Why trauma training is essential for ALL nursing students
- YOU CAN NEVER KNOW YOUR LIMITS
In as much as you may encounter the least form of trauma display at work, your emotional intelligence may be quite below par. Past experiences are known triggers of psycho-traumatic attacks, and you may need proper assessment to reveal that.
- NURSES ARE GENERALISTS
Nursing in most countries like the US is offered as a general course. Students may anticipate some specialization upon job entry, but this does not limit them to changing course in the future. Today you may be in the Outpatient Department (OPD) and the next you are in ICU.
The Many Types of Traumas You’ll Encounter as a Nursing Student that Require Training
Nurses on duty will in most cases experience Secondary Traumatic Stress (STS), or Vicarious Trauma. This is psychological stress from witnessing or hearing about other people’s suffering in the form of death, physical pain, disaster, or abuse.
A normal human being, nurse or not, will be emotionally struck by death. The stress is even worse when the person dies in your arms. Student nurses in the ICU have a hard time recovering from a resuscitation, especially if it failed. As young nursing students, the death of a patient can be a psychological trauma with lasting effects. However, as you may notice, experienced practitioners have developed coping mechanisms. This article will help you develop those.
- Physical Pain
Watching a patient suffer out of physical injury, labor and childbirth pains, or burns can be very traumatic. Attending to the patient undergoing that pain exposes the nurse to a huge risk of post-work psychological stress.
- Occupational Trauma.
One may take it that occupational trauma in nursing is far-fetched, especially when I start talking about physical attacks on nurses. But I know attendants in the mental unit may somehow resonate with me. Patients with distress or under the influence may direct their grievances to the nurses, and somehow the nurse is expected to give the needed audience. The nurse’s understanding of the patient’s distress may lead them to unfortunately present themselves to “be used”.
Occupational trauma is a broad topic. Nurses are prone to verbal abuse from visitors, mistreatment by colleagues, or even abuse by senior attendants in the hospital environment. Even more, nursing is just like any other occupation. Bosses and colleagues may become toxic, giving fresh entries a very hard time in their jobs.
- Occupational Burnout
Studies have revealed that approximately 62% of nurses suffer from burnout and related workplace labor stress (Nursing World). The statistics are even worse for young nurses under the age of 25 – 69%. When you get into the job, you will want to give it your all, but may overdo it and suffer emotional distress from work fatigue.
- Compassion Fatigue
Indeed, you can get tired from compassion for people undergoing pain. It’s attached in one way or another to overall fatigue, as you may put so much effort on a suffering patient and end up getting exhausted.
These things will get you emotionally sick, and to some extent, mentally unfit to continue offering care in a clinical setup.
Mental impacts of trauma exposure
- Attention Deficit/Hyperactivity Disorder (ADHD) is often diagnosed among children as a result of genetic and maternal environment factors. Stressful work-places, however, may expose nurses to risk factors like sleep disorders, poor nutrition, lack of exercise, and substance use.
- Post-Traumatic Social Disorder (PTSD) is the ultimate result of multiple sighting, hearing, or experiencing of traumatic events, posed to nurses as first-hand attendants to the worst of disaster-struck patients. Flashes of the traumatic events and distressing memories will grow into something that can take so long to treat, as is with most mental illnesses.
- Major Depressive Disorder is no more a condition, but now a mental disease from chronic pile-up of subsidiary psychological stress. Depressed nurses will become withdrawn, develop excesses, and are always wanting to commit suicide.
Nurses’ Preparation and Training Mechanisms for Trauma in Clinical Settings
Now let’s talk about how you will deal with trauma when you enter that ever-busy hospital as a fresh nurse, as well as some preparations you can do beforehand.
Developed institutions have simulation sessions within the curriculum to at least put to reality the knowledge learnt in books. It also depends on how immersive the simulation exercise will be, the more it engages handy work and reality the better it is to create real scenarios that have similar figurative impact as live human patients. Cadavers (experimental bodies) provide enough “disgust” to enthrall student nurses. At some point the feeling becomes normal and you feel like you can now take the challenge, but I tell you what, you’re not yet there.
Cadavers are good for simulating Operation Rooms and live human body scenarios. While students are busy familiarizing themselves with death, it’s very important that their reactions are monitored. That way you will know the sensitive ones, and have separate programs for them.
Pre-briefing and debriefing
An experienced nurse may shrug off debriefs after death because they perceive it very casually. Debriefs are also in most clinical settings meant to address code deficiencies on the part of the staff. In the company of young nurses, however, the hospital should consider conducting debriefs that cover the attendants’ reception of the death, and if there is no time, the nurses can be handled by professional therapists.
Pre-briefing, on the other hand, can be a regular brief meeting before the rounds begin, or before any simulation exercises. By the way, simulations are not only meant to be done in school. The best simulation exercise would be in a perfect clinical environment, but with professional learner monitoring.
Teaching students about any of the psychological themes associated with occupational trauma and secondary traumatic stress will configure their self-awareness, and then it becomes easy to detect any weaknesses or personal risk-factors. Many of these mental issues are very new to the world, and it’s very expected for someone to suffer even without the knowledge that they are suffering. Students should know the types of mental illnesses – Bipolar, PTSD, Anxiety Disorder, and Depression; their causes, symptoms, and measures to stay mentally fit.
Workplaces should address the many forms of violence, bullying, and abuse directed to nurses by both patients and staff. It’s one of the aspects that can be managed, unlike tragic trauma which is the order of the day at hospitals. Provide engagement procedures and spell them out to patients and the staff alike. Also avail neat channels where attendants can regularly and in need report any mistreatment, or just a form of safe space for personal-level assessment.
You as a nurse
It is important to take charge of your mental well-being. You are the best to do that. Any form of abuse whether from patients or visitors is not warranted and should be reported. Your life and health come first, as you cannot attend to a patient when physically or mentally unfit. Observe yourself keenly and find help when you detect any mishap in your behavior.