Is Post-Traumatic Stress More Prevalent in Hospital Emergency Nursing?

• A retired emergency nurse shares her thoughts on the prevalence of post-traumatic stress among ER nurses. 
• Studies indicate that those in the ER specialty are more likely to be diagnosed with post-traumatic stress. 
• However, several interventions exist to help nurses navigate what they’ve experienced. 

Having been an emergency department registered nurse for the better part of my 49 years in nursing practice, I’m of the opinion that post-traumatic stress disorder, or PTSD as it is more commonly known as, has a higher incidence among ED nurses.  

As we all know, PTSD is a mental health condition brought on by an extremely stressful or frightening experience. It can be a disturbing occurrence that happens to you or that you witness. There may be intense emotional and physical manifestations even when just reminded of the event. 

Watching Post-Traumatic Stress Manifest

Physical symptomology can be seen in palpitations, anxiety, or panic disorders. Emotional flashbacks can trigger nightmares, avoidance, diminished interest in previous activities, or recollections of similar traumatic incidents. 

On a personal note, I collaborated with a wonderful nurse who, unfortunately, was attacked by a patient in the emergency department. She was grabbed by the hair and thrown to the floor. Her PTSD was so intense that even with counseling, she decided to give up her position in the emergency department and went to work in the laboratory. It was sad to see her leave as she was an excellent nurse but could not get over the trauma that this patient had caused her. 

According to research studies, emergency nurses are considered to have a significantly higher prevalence of post-traumatic stress disorders compared to other nursing specialties. This may be due, in part, to the more frequent exposure to traumatic events that occur in that environment.  

There’s high exposure to trauma, such as motor vehicle accidents, critical injuries, and sudden deaths, and violent situations with patients who might be experiencing mental emergencies.  

A significant portion of emergency nurses have reported symptoms of PTSD, with certain studies predicting the rates to be as high as 20-30%. There is such a thing as secondary traumatic stress, of which emergency nurses are most vulnerable. This occurs due to emotional distress from exposure to the trauma of their patients, not from something that was done to them personally. This could be witnessing a younger patient going into cardiac arrest, or seeing a family at the bedside of a patient who couldn’t be saved, such as an accident victim.  

Post-Traumatic Stress Interventions 

Several interventions are available to help nurses who have been diagnosed with PTSD. Cognitive therapy allows you to speak to a counselor about the traumatic event. Social workers, psychologists, and psychiatric mental health professionals can all help.

A minority of nurses may need the assistance of psychopharmacology on a short-term basis under the watchful eye of a trained mental health professional. 

The Bottom Line

Again, on a personal note, I was assaulted in the emergency department by a female patient I was about to medicate. Unfortunately, I had my stethoscope around my neck and the patient grabbed the scope and pulled it tight around my neck. Luckily for me, my emergency department tech was at the bedside with me, and he was able to grab her hands and get her down on the stretcher. Another nurse jumped to help and medicate her while the ER physician pulled me away from the stretcher. It happened so fast that I could not believe it was happening. I did have to speak with a counselor after the incident, but I said I was alright and I had learned a valuable lesson, which was never wear your stethoscope around your neck, especially when dealing with a psychiatric patient. 

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