• Unfortunately, PTSD is on the rise for nurses. But thankfully, awareness and supportive programming options are increasing, too
  • We talked to SHIFT Talker Michelle Schuster about developing a peer-led coaching program at Boston Children’s Hospital that provides in-the-moment support to nurses
  • While not every hospital has this level of support available, our hope is that in the coming years, nurse-led programs like this can be replicated across the country

Nursing can be equal parts soul-filling and soul-draining. Patient care is absolutely our passion, but it’s often exhausting and emotionally taxing. And as many nurses and nursing leaders now realize, our experiences sometimes actually translate into trauma.

Research shows nearly 30 percent of nurses suffer from post-traumatic stress disorder (PTSD) during their careers. While certain settings, such as emergency medicine or oncology, are more likely to expose us to trauma, all nurses are at risk, and this has never been truer than during the COVID-19 pandemic.

We aren’t just talking about burnout, which is emotional exhaustion due to chronic overwork. As we’ve discussed in the past, PTSD is a diagnosable mental health disorder and requires a specific set of resources and treatment. According to the Mayo Clinic, PTSD symptoms include intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions.

The good news, SHIFT Talkers, is that as awareness grows, so does the prevalence of interventions and resources for nurses experiencing PTSD.

After experiencing trauma, one nurse takes action

You might remember Boston Children’s Hospital nurse Michelle Schuster from episode four of SHIFT Talk. Michelle and her mentor, Tricia Dwyer, opened up about how they and other nurses are affected by trauma experienced on the unit floor. The best way to address trauma is in the moment, Michelle said. Nurses should receive support immediately, and from someone who is not involved in patient care with them.

At Boston Children’s Hospital, that someone is a coach from the Hematology/Oncology/Stem Cell Transplant Advancing Resiliency Team (HART) team. In 2019, Michelle’s passion for helping nurses deal with PTSD led her to develop a program for this much-needed support and the coaches to provide it. A generous donor backs the program financially, and funding will continue for the next two years.

A year into the pandemic, it’s more important than ever.

“I do feel like you can troubleshoot with someone in the moment,” Michelle says, describing the value of having a HART staff member available on the hospital floor. “They don’t have to answer all my problems, but just to be able to sit next to me and say, ‘I am supporting you, and I am here to back you up and help you advocate for what you need.’”

Peer support on the floor

At SHIFT, we’re all about nurse-led, peer-to-peer programming like this. Coaching provides an accessible way for nurses to acknowledge and process what they may have experienced when their patient codes or they have a particularly traumatic shift.

The HART program is offered on-site at Boston Children’s and is open to all staff members—not just nurses—who care for hematology, oncology, and stem cell transplant patients. In the past year, HART coaches have often consulted with staff on issues related to COVID-19, such as patient care and personal concerns, at a time when caring for critically ill, isolated patients has been highly distressing. 

Staff support, 24/7

HART coaches work eight hours at a time, covering both day and night shifts, and are present three days a week on the unit. More than just medical staff, the team offers a variety of services. The program is actually modeled after one that was developed in the cardiovascular and critical care unit at Boston Children’s Hospital.

Sometimes, all we need is a listening ear and a place to decompress. But other times, we may need more support. HART coaches are not trained therapists, but if an issue arises that needs escalation, they are able to connect nurses in need with the appropriate resources.

The program seeks to enhance staff resiliency, create a healthier work environment, and improve team morale. It’s geared toward all unit-based staff—nurses, other clinicians, and non-clinicians alike—which is important, because our job depends on working together with other health care professionals. We need the whole team to have access to support.

As of December 2020, there have been nearly 1,600 HART coach consults across 127 HART shifts—which is more than 12 per shift—so the team is tapped regularly, and numbers have been steadily rising. Overall results indicate that the HART program is well received and widely used by staff.

Building new programs, and a few other resources to tide you over

Clearly, we’re big fans of Michelle and the program. We also recognize that not every hospital necessarily has such a framework in place—yet. But our hope is that in the coming years, programs like this can be replicated across the country.

“It’s OK to talk about [trauma]; it’s not taboo,” Michelle says. “Recognizing that trauma is happening is important, and then we need to ask, ‘OK, well, how do I build myself up to be ready for whatever might come next?’”

It’s definitely worth asking your supervisor or HR team what resources your hospital has. You might be surprised—after all, the HART program was inspired by a program in an entirely different specialty at the hospital. And in the meantime, if you don’t yet have a program in place or the resources to start one, consider looking to outside sources of support.  Organizations like the Sigma Theta Tau International Honor Society of Nursing offer programs and tools for nurses working during the pandemic that may be useful for managing trauma. The American Nurses Association Enterprise also offers a 24/7 call line that connects nurses with a compassionate listener.