Introduction
Nursing is a profession shaped by compassion, empathy, concern for people, and the will to help them through their care journey. However, the nurses are at the frontline and, thus, may be distressed for a prolonged time when they deal with long-term patients. Professional workers such as doctors and nurses suffering from workers’ affliction called secondary traumatic stress (STS) have been exposed to traumatic events like witnessing victims suffer from severe traumas. This essay explores how STS affects nurses’ ability to continue working, focusing on three specific contexts: birth/maternal mortality, COVID-19 care, and emergency room. Sentences like the one above must be converted from passive to active.
Understanding Secondary Traumatic Stress
Secondary traumatic stress represents the aspect of vicarious experience of trauma encountered by nurses on behalf of their patients and the concurrent symptoms similar to those of post-traumatic stress disorder (PTSD). Although the participants were victims of primary trauma, secondary trauma was caused not by their direct experience but by hearing about or witnessing someone else’s trauma. When it comes to nurses, their capacities comprise taking care of maternal health issues, including childbirth complications that lead to maternal mortality, as well as those women suffering from COVID-19-related deaths.
Effects of STS on Nurses’ Ability to Continue Working
Traumatic Birth and Maternal Mortality
Nurses who work in maternal healthcare centers have, at some point, died in grave emotional situations like stillbirths, neonatal deaths, and difficulty during childbirth. Prospecting these incidents might cause the reappearance of powerful emotions, which ultimately leads to secondary traumatic stress (STS). Besides STS, the emotional exhaustion phenomenon frequently emerges among nurses, who empathize with their patients and their families, but in the end, they burn out and are no longer satisfied with their jobs (Uddin et al., 2022). Furthermore, nurses end up developing numbness towards the emotional needs of their patients after extended contact with very stressful events like a distressful birth or maternal death. It seems to be the lowered empathy phenomenon that not only affects the quality of care but also burdens relationships among the healthcare staff. Nurses may turn this way as they struggle with active distress and will be emotionally distant or disengaged from their jobs at times. They do this to protect themselves from more pain (Uddin et al., 2022). it implies a growing gap in attention, efficiency, or even a will to leave the profession, and more who have experienced this are no longer effective in maternal healthcare settings. The STS problem profoundly affects nurses’ ability to continue working effectively in this area.
Nurses working with COVID patients.
The global outbreak of the COVID-19 pandemic has pushed healthcare systems worldwide to their limit, allocating nursing staff as the most important line of response against the pandemic with stresses at unprecedented levels. Nurses, doctors, and other health professionals caring for COVID-19 patients face excessive risk of acquiring Stress traumatic secondary (STS) due to the pandemic’s high mortality rates and everlasting nature. In such a situation, nurses are faced with the greatest grief and the saddest loss (Bergman et al., 2021). They work with the patients who are affected by COVID-19 and see them through the pain and, in the end, their death. Healthcare providers suddenly confront the really high number of patients dying. They cannot provide emotional support to their families, and this will cause an intensification of feelings of helplessness and despair among nurses. The nurses deal with ethical dilemmas and moral distress resulting from resource shortages, triage decisions, and the cluster of interests between personal safety and patient care (Bergman et al., 2021). However, exacerbating such difficulties can lead to the deterioration of nurses’ professional accomplishments and an intersection of feelings of weakness and moral injury. Also, prolonged exposure to the feelings, noises, and smells associated with sickness and death in patients who are affected by COVID-19 can cause the occurrence of symptoms like intrusive memories and flashbacks. Such cases make people recall episodes from their battlefield experiences.
Emergency Department Settings:
Nurses working in Emergency Departments (EDs) deal with a constant flow of traumatic injuries, emergencies, and deaths that lead to a high level of Prolonged secondary stress and trauma (STS). ED features’ quick and unpredictable nature causes emotional weariness; it just adds stress to the emotional health of the nurses (Javanmardnejad et al., 2021). There are times when nurses suffer from vicarious traumatization due to being the only ones who bear witness to the extreme distress of the patients and their families. The chronic accumulation of the mental load of daily intensive trauma cases is a stress multiplier, and therefore, this is common for all critical care nurses. Furthermore, the principle of repeated trauma experiential challenges the compassion of nurses as fatigue creeps in and gradually eats at the empathy and caring attitude of health workers toward the patients (Javanmardnejad et al., 2021). This process removes nurses’ ability to align with their patients emotionally, including in caring delivery, and makes the working conditions under STS harder.
Coping Mechanisms and Support Strategies
Self-Care Practices:
Nurses understand the critical role of self-care and pursue the essential activities for their well-being. They incorporate simple movements such as walking, jogging, and cycling. Along with mindful meditations, they turn to their friends and colleagues or support groups when needed. As a result of hobbies or creative activities outside of work, a necessary escape is provided by which a person is free from the usual demanding character of his job. They can then allocate some time to these self-care practices whenever they find the time for it, as they help nurses to replace entirely the energy they put out during their duties, which fosters their ability to deal with the challenges their role presents to them.
Professional Boundaries:
Maintaining professional boundaries is essential in nursing to protect nurses’ mental and emotional well-being. Nurse-caretakers maintain a clear distinction between work life and the home, thereby maintaining an emotional shield from the hardship of various circumstances. A sophisticated approach to mental and emotional preservation is a hallmark of a nurse capable of meeting patient care demands without compromising their psychological robustness. Nurses may achieve emotional stability by practicing detachment during emotionally charged situations to withstand the emotional overload caused by this experience. Imbibing the habit of clearly distinguishing their professional responsibilities from their sphere, nurses can deploy the means to self-preserve against the effect of primary traumatic stress and continue to provide their patients with compassionate and competent care.
Peer Support and Debriefing:
Peer support and debriefing processes are two of the vital roles in developing nurses’ strength of mind and emotions. Noticeably, in terms of the workplace, creating a space where the nurses can openly talk about their feelings and experiences in a relaxed atmosphere of peer support and camaraderie stands out. An effective counselor is supposed to have regular debriefing sessions or clinical supervision with experienced mentors for reflection and the creation of the much-needed emotional space. Such discussions allow nurses to exchange their tales, receive advice, and boost their understanding of their unique situations. Through open communication and compatriots’ and experienced leaders’ support, nurses can build resilience inside the healthcare team that provides a safe environment for everyone in the team. Alongside individual resilience, an actively collaborative strategy thrifts and bolsters a culture of mutual aid and well-being among professionals.
Conclusion
Secondary traumatic stress, an issue that nurses encounter in healthcare settings to the extent that it weakens performance in tiring working areas, can be viewed as the biggest problem. Whether it is peri-traumatic birth/maternal mortality cases, COVID-19 care, or emergency care, health roles are always confronted with recurrent traumas. These unending traumas could finally lead to a complete emotional breakdown and unresiliency. Health professionals can help nurses ease the strain of STS by recognizing the warning signs and early symptoms and using proactive coping strategies and support interventions. In that way, the nurses can mitigate the impact of STS and sustain their efforts to deliver quality health care to clients who need it most.
Reference
Bergman, L., Falk, A. C., Wolf, A., & Larsson, I. M. (2021). Registered nurses’ experiences working in the intensive care unit during the COVID‐19 pandemic. Nursing in critical care, 26(6), 467-475.https://doi.org/10.1111/nicc.12649
Javanmardnejad, S., Bandari, R., Heravi-Karimooi, M., Rejeh, N., Sharif Nia, H., & Montazeri, A. (2021). Happiness, quality of working life, and job satisfaction among nurses working in emergency departments in Iran. Health and Quality of Life Outcomes, 19, 1-8. https://link.springer.com/article/10.1186/s12955-021-01755-3
Uddin, N., Ayers, S., Khine, R., & Webb, R. (2022). The perceived impact of birth trauma witnessed by maternity health professionals: a systematic review. Midwifery, p. 114, 103460.https://doi.org/10.1016/j.midw.2022.103460
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