It was an episode of the TV show ER that first got Chris interested in emergency-room nursing.
At that point, Chris had job experience in construction, graphic design and restaurants. Yet the next goal became clear: go back to school to become a nurse.
After graduating, Chris spent almost 10 years in the ER at Nanaimo Regional General Hospital in B.C. It was a busy, high-stakes job, and Chris enjoyed the adrenaline. Or so it seemed. On one shift, a horrific case came in: multiple deaths from a terrible motor vehicle crash. Chris had reached a breaking point.
In retrospect, the pressure had been building. “I had a really bad day, but I had been sitting on the edge of a cliff for about a year and didn’t know it,” Chris recalls. “There was really no procedure in place to deal with what I was going through.”
Diagnosed with post-traumatic stress disorder (PTSD), Chris is on leave from a once-loved job. Instead of an ER shift, for Chris the daily routine is now constant anxiety.
“Being an ER nurse, you’re cool in a crisis. But now my anxiety runs as a baseline at a 4 out of 10 and I never know what’s going to make it a 10 out of 10,” explains Chris. “It’s exhausting.”
PTSD is a mental health condition brought on by experiencing or witnessing traumatic events. Symptoms vary, and can include reliving the event, nightmares and difficulty sleeping, negative changes in thinking and mood, avoiding places that remind you of the event, trouble concentrating, feelings of guilt, and other emotional distress.
In the pressure-filled environment of health care, job demands often lead to stress, anxiety, burnout or worse. According to WorkSafeBC, more than six nurses registered claims for PTSD every month in 2016.
In fact, nurses accounted for over 10 per cent of all claims registered specific to PTSD. During that year, nurses also made up 12 per cent of all mental health disorder claims filed with WorkSafeBC.
“That shouldn’t be surprising,” says Christine Sorensen, president of the B.C. Nurses’ Union (BCNU). Like other frontline health care workers, nurses are exposed to routine suffering and trauma. That has always been true, but factors such as hospital closures, nursing shortages and higher patient needs are adding to the physical and psychological load of the province’s nurses.
“The reality is that we’re human and we’re caring individuals, which is what draws us to the nursing profession in the first place,” says Sorensen.
Adding to the burden, many nurses suffer in silence.
“It starts at the beginning, when we’re in our nursing education,” explains Sorensen. “There, we are taught to put on this stoic ‘nurse face’, where you’re not showing your emotion and how things are affecting you.”
There are other reasons why nurses can find it hard to get help, says Sorensen. “If someone asks you about your day, you may say, ‘It was busy’ or ‘It was difficult’ but you can’t talk about the details – the stressors, the traumas you observed – for privacy reasons. So, we don’t disclose what we’ve experienced to our support systems.”
Sorensen says nurses need to feel supported in their workplace if B.C. is to maintain the health of its current nursing staff and attract future nurses into the profession.
“As a result of increased pressure on the system and lack of relief, we know that many nurses find it difficult to take good care of themselves both physically and mentally,” she says. “Nurses often don’t have great coping mechanisms to manage the workload and the stress.”
That is one reason why BCNU offers personal resilience workshops for nurses across the province. The sessions help nurses to identify and recognize signs of compassion fatigue and PTSD in themselves and their colleagues, and mitigate some of the risks.
When people are looking to choose or change careers, and see the demands on nurses, Sorensen says many ask, “Why would I choose nursing?”
She says caring for the well-being of nurses starts with increased awareness about the conditions in which nurses are asked to work – long shifts, understaffing and the stress of trying to deliver the best care amid over-capacity operations.
As an ER nurse, Chris knows these conditions firsthand, and suggests the system has to change to prevent more cases of PTSD. On a more personal level, Chris feels nurses need to be more open about their mental health and the workplace pressures they face.“
We don’t talk about PTSD that has to do with us,” Chris says. “I really want nurses to be up front and have a conversation about this.”
Pushing for Faster Treatment
When the B.C. government introduced legislation to provide faster treatment for PTSD and other mental health diagnoses for first responders, nurses were excluded from the list. The decision “discriminates against nurses who are psychologically impacted from providing care in traumatic situations taking place in acute, residential and community-based settings,” says BCNU President Christine Sorensen.
Under the legislation, firefighters, police officers, paramedics, sheriffs and correctional officers will no longer need to prove that their disorder is work-related. This will mean faster access to the resources and compensation they deserve. The BCNU is urging the provincial government to amend this legislation so that nurses can also receive timely support and treatment when needed.
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