Secondary traumatic stress (STS) is a syndrome similar to posttraumatic stress disorder (PTSD) that affects healthcare professionals who care for individuals who have experienced trauma. Maternal-newborn nurses, including labor and delivery nurses, certified nurse-midwives (CNMs), and neonatal intensive care unit (NICU) nurses, are particularly susceptible to STS due to their exposure to traumatic births and critically ill infants. Cheryl Tatano Beck provides an overview of a secondary qualitative data analysis conducted on three primary data sets to explore the presence of STS symptoms in these nursing populations. The analysis combines quantitative and qualitative data to provide a comprehensive understanding of STS and its implications for nursing practice.
Prevalence of STS in Maternal-Newborn Nurses: The secondary qualitative analysis revealed that high levels of STS were reported in all three nursing populations. Among labor and delivery nurses, 24% experienced high to severe levels of STS. Similarly, 29% of CNMs and 29% of NICU nurses reported high to severe levels of STS. These findings highlight the significant challenges posed by STS for maternal-newborn nurses and underscore the need for targeted interventions and support systems.
Traumatic Experiences: The qualitative analysis identified key themes and examples of traumatic experiences faced by maternal-newborn nurses. Labor and delivery nurses described distressing memories of failed intubations, the cries of mothers, and the sight of critically ill infants. CNMs encountered traumatic events such as fetal demise and severe congenital abnormalities, leading to intrusive thoughts, distressing dreams, and feelings of guilt. NICU nurses witnessed the fragile lives of newborns slipping away, causing distressing memories and emotional burden.
Symptom Categories of STS: The analysis categorized the nurses’ experiences into four symptom categories of PTSD: intrusions, negative cognitions and mood, arousal symptoms, and avoidance symptoms. Across all three nursing populations, intrusions were consistently ranked as the most prominent symptom, followed by negative alterations in cognitions and mood. However, variations were observed in the rankings of arousal and avoidance symptoms. Labor and delivery nurses and NICU nurses ranked arousal symptoms higher than avoidance symptoms, while CNMs reported the reverse rankings. Notably, NICU nurses did not report any avoidance symptoms.
Impact on Personal and Professional Life: The emotional toll of traumatic experiences extends beyond the workplace and significantly affects the personal and professional lives of maternal-newborn nurses. Many nurses reported strained relationships, reduced job satisfaction, and increased likelihood of burnout and compassion fatigue. The cumulative effect of traumatic experiences erodes resilience and sense of purpose, impacting the ability to provide compassionate care and leading to emotional exhaustion and detachment.
Preventive Strategies and Interventions: Interventions targeting secondary traumatic stress and compassion fatigue have primarily been explored among oncology and emergency department nurses. Compassion fatigue encompasses two components: secondary traumatic stress and burnout (Stamm, 2010). Research has demonstrated the effectiveness of interventions such as mindfulness-based stress reduction (MBSR), cognitive-behavioral therapy (CBT), and self-care strategies in alleviating symptoms of secondary traumatic stress and fostering resilience in healthcare professionals (Beck, 2011; Figley, 2002).
Self-care strategies play a crucial role in maintaining the well-being and resilience of healthcare professionals. These strategies encompass regular exercise, healthy eating, sufficient sleep, engaging in enjoyable activities, and seeking social support. Nurses must prioritize self-care and establish boundaries between work and personal life to prevent burnout and compassion fatigue (Figley, 2002).
Apart from individual-level interventions, healthcare institutions should implement organizational-level strategies to address secondary traumatic stress among maternal-newborn nurses. These strategies involve facilitating debriefing sessions, providing emotional support, fostering a culture of open communication and psychological safety, and offering access to counseling or mental health services (Catherall, 2015).
Prevention and early intervention play a pivotal role in mitigating the impact of secondary traumatic stress on maternal-newborn nurses. Hospitals and healthcare organizations can develop comprehensive programs encompassing psychoeducation, preparedness training, offering emotional support and fostering a culture of support to minimize the negative effects of indirect exposure to trauma. By offering education and support, healthcare institutions can create a nurturing environment that enhances both patient care and nurse satisfaction (Catherall, 2015).
Creating a supportive environment entail facilitating group discussions or debriefing sessions where nurses can openly share their experiences and process their trauma-related feelings. This fosters a sense of solidarity and validation among the nursing staff. Furthermore, an ecological approach that takes into account both individual and environmental factors should guide the development of interventions and support systems. This approach recognizes that addressing STS requires a multifaceted approach that considers the unique needs and circumstances of each nurse, as well as the broader organizational context.
Furthermore, ongoing education and training are essential to raise awareness about secondary traumatic stress and equip nurses with the knowledge and skills to recognize and manage its effects. Training programs can focus on identifying signs of distress in oneself and colleagues, developing self-care strategies, and seeking appropriate support when needed. By integrating this education into the professional development of maternal-newborn nurses, healthcare organizations can empower their staff and create a resilient workforce.
Conclusion: Secondary traumatic stress poses significant challenges for maternal-newborn nurses, with similarities to PTSD symptoms experienced by individuals directly exposed to trauma. The secondary qualitative analysis confirmed the presence of STS symptoms in labor and delivery nurses, CNMs, and NICU nurses. It emphasized the need for targeted interventions and support systems to address the psychological impact of traumatic experiences on these healthcare professionals. Ultimately, by prioritizing the mental health and resilience of these healthcare professionals, we can ensure high-quality care for both mothers and newborns.
Reference:
Title of the article: Secondary Traumatic Stress in Maternal-Newborn Nurses: Secondary Qualitative Analysis
Author(s): Cheryl Tatano Beck
Year of publication: 11/212/2019
Title of the publication: Journal of the American Psychiatric Nurses Association
Retrieved from https://journals.sagepub.com/doi/10.1177/1078390319886358?icid=int.sj-full-text.similar-articles.1