PTSD in Tx ICU Nurses

Abstract

Purpose Developments in surgical technique has led to increasing complexity in clinical caseload in transplant intensive care units (ICU) in the UK. The ICU nurse plays a pivotal role in the safe and effective delivery of this complex care. Studies suggested that that ICU nurses experience a greater prevalence of post traumatic stress disorder (PTSD) in comparison with general nurses. There is evidence to suggest that symptoms of PTSD correlate with greater staff burnout and absence rates, which in turn have a financial implication for healthcare providers. This study examined PTSD symptoms in ICU nurses in a cardiothoracic transplant setting in order to establish prevalence. Methods All ICU nurses (N = 180; 153 whole time equivalent) were invited to attend a psychology led support session with the aim of recognizing psychological difficulties in the workforce. All ICU nurses were screened using the Trauma Screening Questionnaire (TSQ, Brewin, 2002). The TSQ is a 10 item self report measure using DSM-IV criteria for PTSD. Demographic data on age, gender and nurse grade was collected. Data was collected on staff sickness and resignation over a 12 month period. Results Using the TSQ (N=136 nurses), indicators for PTSD ranged from 17-48% across the nursing groups. Common themes attributed to experiencing stress were treating adolescent patients and organizational dynamics. Staff sickness hours over the 12 month period ranged from 936.5 (6.24 wte)- 1592.25 hours (10.62 wte). The most common reason for sickness absence were reported as back or knee injury. During this period, 14.4% (N= 26) of the ICU nurses resigned. There was one suicide attempt in the last 18 month period. Conclusion These preliminary findings suggest high levels of PTSD in ICU nurses in a cardiothoracic transplantation centre, in comparison with general nursing. The impact of increasingly complex clinical care places unique demands on ICU nurses. Further studies are needed to explore what psychological support would benefit this cohort, in order to protect them from developing PTSD or other psychological comorbidities. In the short term, all ICU nurses were reminded of how to access occupational health support services. The clinical psychologist also undertook a rolling programme on nurse led team days to provide a reflective practice space for nurses to share their experiences and receive peer support, with a focus on self care and compassion.