Wednesday, December 11, 2019

PTSD and nursing

The first image that many have when they hear the word PTSD, an acronym referring to post traumatic stress disorder, is of one associated with the military. While those who have served, do make up a large portion of those who have PTSD, PTSD is not exclusive to just members of the military and can be a result of any kind of severe trauma and can affect anyone. By increasing awareness of PTSD as a disorder that can affect anyone and it’s prevalence in other fields besides the military, not only can more people find access to diagnosis and treatment, but better and more directed research can occur in order to find more effective treatment options. 

One of the professions  in which PTSD is especially prevalent is nursing. Since PTSD can arise after exposure to a traumatic event, which is most commonly involves death, injury, and sexual violence. This exposure can be both first hand as well as seeing  or hearing about it happen to someone else. Nurses repeatedly hear upsetting and stressful details regarding their patients as well as repeatedly being exposed to death and violence. Up to one in four nurses experience PTSD at some point.  Nurses are also involved in a variety of different stressful environments providing care to vulnerable and high risk patients, and as environments and patients become more challenging and distressing, incidence of PTSD also increases. A recent study found that nearly 48 percent of nurses who work in critical care met the criteria for PTSD symptoms. This not only presents problems for the nurses and medical staff, but high rates of PTSD result in high rates of turnover creating fewer more experienced professionals as well as nursing shortages. Since nurses will often have the most patient contact, this can affect medical care across the board.

While there is increasing awareness of PTSD affecting medical providers and as a result there has been a push for better working environments, this is often not enough due to the inherent nature of the job. One of the ways that many have hoped to reduce and alleviate PTSD in this field is through directed research focusing on mechanisms causing PTSD and more effective treatment options. 

On October 22nd, one of the leading researchers in the field, Dr. Michael Fanselow of UCLA, hosted a seminar at Loyola University Chicago presenting his research on PTSD. While current research and treatment options are primarily focusing on behavioral responses and exposure therapy, Dr. Fanselow’ s research looks at non-associative model called stress enhanced fear learning or SEFL. This model theorizes that a large number of symptoms of PTSD are a form of sensitization rate her than the context or environmental cues surrounding the trauma. As a result of this Dr. Fanselow’s research looks at how the mechanisms of this sensitization behavioral response can be used to treat PTSD. One of the ways he believes is by blocking receptors in the amygdala. This type of revolutionary research may be used to help treat many of those who suffer from PTSD and help better the quality of healthcare provided as a result. 

Perusini, J.N., Meyer, E.M., Long, V.A., Rau, V., Nocera N., Avershal, J., Maksymetz, J., Spigelman, I., & Fanselow, M.S. (2016) Induction and Expression of Fear Sensitization Caused by Acure Traumatic Stress. Neuropsychopharmacology, 41, 45-57.



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