Slide 1
Posttraumatic Stress Disorderby Tom ColePurpose: To review the
condition of PTSD from a nursing perspective, to design a patient
care plan using the TRUEPIC model, and to explore the role of the
nurse as an advocate for patients with PTSD.
Rationale: Debilitating mental health condition Can have a
profound effect on a person's ability to function Nurses can play a
critical role in assisting in treatment and recoverySummary:
Overview of PTSD Brief critique of the study Design a patient care
plan using TRUEPIC Address the role of the nurse as patient
advocate
Evidence for Care:What is PTSD?
Experienced directly, witnessed, or learned about
(Videbeck, 2014) (Adriaenssens, de Gucht & Maes,
2012)Evidence for Care:Nursing TheoryInterpersonal Relations in
Nursing theory by Hildegard Peplau
Major Concepts of theory: Purpose of nursing is to help others
identify their difficulties Nursing is a therapeutic art for
healing Nursing is an interpersonal processSteps: Orientation
Identification Exploitation Resolution
(Videbeck, 2014)("Peplau's theory of," 2012)Evaluation of the
Evidence:Summary of study methods and results
248 nurses; 15 hospitals
87%
Social Support
(Adriaenssens, de Gucht & Maes, 2012)
Evaluation of the Evidence:Critique of the Research Study
Limitations: What is trauma? Potential for subjectivity
(Adriaenssens, de Gucht & Maes, 2012)
Patient Care Design:Collaboration of Care
Social/Family Support
Peer Support
Emotional Support
Medication Support
(Adriaenssens, de Gucht & Maes, 2012)
TRUEPIC
Situation: ER nurses have the potential of developing
posttraumatic stress disorder following seeing traumatic events in
the emergency room, such as gruesome injuries or combative patients
or their family members. Subjects may experience abnormally strong
emotional, cognitive, or behavioral reactions that negatively
affect emotional, social, or occupational well-being.
1.IDENTIFY the variables in this situationER NursesPTSDAn
Anxiety Disorder
Emotional Stress Negative Effects
Fatigue
Loss of Job Satisfaction
2. RELATEOr put the variables together to form
propositions.Primary Proposition: Pt. is experiencing PTSD because
of exposure to traumatic emergency room situations.Possible
Assumptions: Pt. is unaware that job as ER nurse leads to the
potential development of PTSD.Possible Confounding Variables: Lack
of understanding or recognition of effects on ER nurses by the
nurse or the healthcare system.
3. UNDERSTANDthe importance of the propositions, assumptions,
and confounding variables.Proposition: If situation is not
addressed and stress increases, PTSD can develop.Significance of
Assumptions: If pt. is not aware of the possibility or dangers of
PTSD, the condition could negatively impact job performance and
satisfaction, as well as lead to fatigue and burnout.Possible
Confounding Variables: If pt. has a conviction that they should not
be impacted by trauma due to their being a nurse, they may not
accept the possibility that they could develop PTSD.
TRUEPIC4. EXPLAINthe significance of the situation to those
involved based on their individual KSVMEProposition: In a way
meaningful to the pt, explain what PTSD is, how trauma can
contribute to it, and what undesirable conditions PTSD can
contribute to during work in the ERAssumptions: Explain how
recognition of potential complications can help benefit the patient
and their work.
Confounding Variables: Explain how dismissing the potential for
PTSD can negatively impact the job performance of the ER nurse.
5. PREDICTwhat will happen in this situation if one or more
variables are not changed.
Proposition: If PTSD is suspected and is not resolved, then the
ability of the ER nurse to perform their role at work might be
hindered or compromised.
Assumptions: If the patient will cooperate with regular stress
reduction techniques, then the risks of PTSD will be lessened.
Confounding Variables: If patient can accept that they may have
the potential to develop and uses appropriate coping techniques,
then the patient may be able to perform at their job more
effectively.
6. INFLUENCEsomeone to change one or more variables in order to
achieve a desired outcome or prevent an undesirable one.
Proposition: Make sure the patient understands the importance of
maintaining a low stress level for optimal results.
Assumptions: Make sure the patient understands benefits of
effective stress management and its relationship to PTSD. Encourage
regular stress reduction techniques.
Confounding Variables: Encourage the patient to practice stress
reduction techniques regularly in order to experience positive
outcomes.
7. CONTROL- Patient (ER nurse) is required to complete
in-service training on the signs, symptoms, causes, and coping
mechanisms of PTSD.
Advocate RoleAdvocacy: Act on behalf of client Promote health
and wellbeing
EmpathyEquity: Just, fair, impartial(Videbeck, 2014, p. 80)
9Advocate RoleEmpathy = key
(Adriaenssens, de Gucht & Maes, 2012)Advocate Role
(Adriaenssens, de Gucht & Maes, 2012)ReferencesAdriaenssens,
J., de Gucht, V., & Maes, S. (2012). The impact of traumatic
events on emergency room nurses: Findings from a questionnaire
survey. International Journal of Nursing Studies, 49(11),
1411-1422. doi:10.1016/j.ijnurstu.2012.07.003
Peplau's theory of interpersonal relations: Hildegard, e.
peplau. (2012, January 31). Retrievedfrom
http://currentnursing.com/nursing_theory/interpersonal_theory.html
Videbeck, S. (2014). Psychiatric-mental health nursing. (6th
ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams
& Wilkins.