Many emergency nurses are used to dealing with badly injured patients and sudden death, but when it comes to caring for victims of mass shootings and their families, the healing process can be very different. Lesa Beth Titus, BSN, RN, a trauma coordinator for Mercy Medical Center that treated victims of the mass shooting in Rosburg, Oregon, told Nurse.com that nurses think they are immune to the everyday tragedies of the emergency department, but the aftereffects of a mass casualty incident were very different.
Studies show that repeated exposure to traumatic events can have a similar effect to experiencing trauma directly; this experience of trauma is referred to as secondary trauma. One study found that about one in three emergency nurses experienced anxiety, depression and sleep disorders, while one in 10 showed clinical levels of Post-Traumatic Stress Disorder (PTSD). David Tetrault, PhD, MDiv, who worked as a chaplain at Banner-University Medical Center that treated victims from the Tucson, Arizona shooting, said that a mass shooting adds another layer of complexity, as it calls into question your personal values, which makes coping more difficult.
The public nature of mass casualties can make it more difficult for nurses suffering from secondary trauma as well. The media attention can serve as a constant reminder of the event, delaying the return to normalcy that many seek after a traumatic experience.
What can help nurses suffering from secondary trauma? It’s important to recognize that everyone reacts differently, and it’s important to respect that. Joy A. Lauerer, DNP, RN, PMHCNS-BC, explains: “We know that trauma is long-lasting and that it affects the brain and neurological systems… and some people process trauma more readily than others.” Struggles with trauma can last for years, and the trauma can be retriggered as well.
Basic self-care can have a positive effect on those dealing with trauma; eating well, proper sleep and exercise can all help the healing process. Talking with friends, family and others with similar experience can also help. As a manager, there are variety of stress management tools to help workers, and some hospitals have used protocols developed for first responders for their staff. A staff debriefing can be helpful, but it’s also important to checking in with staff regularly and provide them with voluntary ways to express themselves.
While it might be difficult to consider, having some preparation or training in place for dealing with traumatic experiences can help staff heal. As Lauerer points out, “[Emergency Departments] do a lot of disaster preparation. But I don’t think it ever prepares you for what this is going to feel like.”
To read the “The healer’s journey” article series, click here.