Post-Traumatic Stress Disorder in Intensive Care Unit Nurses: A Concept Analysis

Abstract

Background: Intensive care unit (ICU) nurses are at an increased risk of post-traumatic stress disorder (PTSD) due to their stressful work environment. Using the Walker and Avant conceptual analysis method, we sought to review the literature to better understand PTSD as it pertained to ICU nurses and its impact on their lives, patient care, and health care organizations. Methods: For the review, we searched the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, and PsycINFO. The keyword searches included the terms “post-traumatic stress disorder” AND “psychological stress” AND “intensive care unit nurses.” Abstract and full text reviews were conducted. Ten articles met our inclusion criteria of being published in the past 10 years (2010–2020), peer reviewed, written in English, and referred specifically to PTSD and psychological stress in ICU nurses. Findings: Antecedents for PTSD in ICU nurses are their stressful work environment, where exposure to traumatic events is experienced, and a lack of support from their manager, coworkers, and organization. Defining attributes for ICU nurses with PTSD included reexperiencing, avoidance, negative alterations in cognition and mood, and hyperarousal. Consequences identified included burnout, job dissatisfaction, and the intention to leave their job. The conceptual definition of PTSD in ICU nurses was illustrated by the attributes, antecedents, consequences, model case, empirical referents, and by the negative impact on the nurse, patients, and the health care organization. Conclusion/Application to Practice: Hospital administrators, nurse managers, and occupational health nurses should ensure that policies and interventions are in place to recognize and reduce the risk of PTSD among ICU nurses.

Prevalence, Risk Factors and Burnout Levels in Intensive Care Unit Nurses: A Systematic Review and Meta-Analysis

“…As corroborated by other studies, the excessive number of daily working hours and a high workload, in addition to a lack of time for patient care, produced emotional disorders and low job satisfaction [ 40 , 41 ]. In critical care service, the emotional and physical domains are overloaded due to the complex labour interventions carried out by nursing staff [ 42 , 43 ]. Other authors highlight that high levels of EE were related to personal factors such as being single and caring for children, as well as work factors such as long working days, poor quality work life, and a lack of time to dedicate to self-care [ 44 ].…”

Risk and protective factors for the possible development of post-traumatic stress disorder among intensive care professionals in France during the first peak of the COVID-19 epidemic

“…It nonetheless enabled us to use an appropriate tool developed specifically for the ICU context, taking account of the unique features of the ICU environment (Laurent et al, 2020 ). It is also important to note that although the assessment of the traumatic impact was specifically focused on the crisis, the ICU population has long been reported to present a high prevalence of PTSD (Levi, Patrician, Vance, Montgomery, & Moss, 2021 ; Mealer et al, 2009 ; Mealer, Jones, & Moss, 2012 ). Thus, we must remain cautious in interpreting our results regarding the prevalence of PTSD following the health crisis.…”

Interventions to reduce post-traumatic stress disorder symptoms in health care professionals from 2011 to 2021: a scoping review

“…21 22 This may lead to adverse consequences among healthcare professionals, such as burnout, job dissatisfaction and the intention to leave their job. 15 It is also likely to cause other mental disorders, including depression 23 and secondary stress disorder. 24 The poor mental states of healthcare professionals may increase the risk of medication errors and lower the quality of care provided for patients.…”

“…Due to occupational specialty, healthcare professionals have more opportunities for indirect or direct exposure to trauma by providing care to patients, and it has the potential to induce the symptomatic responses of PTSD 10 11. PTSD symptoms have been reported by a variety of healthcare professional groups, including physicians,12 13 nurses14 15 and midwives 16 17. The respective prevalence of PTSD in ambulance personnel, emergency physicians and midwives were 11%, 22% and 36%, respectively 18–20…”

“…Healthcare professionals are facing the dilemma of PTSD symptom distress and insufficient organisational support. It has been reported that a stressful work environment and lack of sufficient organisational support could be antecedents of PTSD 11 15. Healthcare professionals described their experiences of trauma and PTSD as feeling alone and unsupported and lacking emotional support 21 22.…”