July 26, 2020
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Nurses are suffering "insufficient resource trauma" in the workplace

Nurses might just have one of the hardest jobs in the world, and that is with or without COVID-19.  They are most definitely not “playing cards” (as that one senator suggested last year). In fact, for many of them, the job is all but recreational.

On the other hand, the hardest parts of the job can become unbearable when a pandemic makes it hard to have proper supplies and protective equipment. Front line nurses are already suffering from skin conditions, so what could possibly be worse?

The answer lies in a recent paper published by the American Psychiatric Association in April. Researchers have found that nurses are experiencing not just anxiety and fear, but real trauma in the workplace. They’re calling this unique mental health condition “Insufficient Resource Trauma.”

More on the April 2020 study

The five authors polled 372 nurses (out of 1,478) in Indiana for their stories around personal and professional problems. The survey identified both general and nurse-specific traumas, which they categorized into five themes.

These themes contained everything from traumas related to the profession (such as watching a patient die) to traumas related to their place of work and professional network (bullying and workplace violence). One of these traumas is the newly named Insufficient Resource Trauma, which might be more than prevalent in the age of COVID-19.

The researchers described the nurses’ responses as “eloquent” but also “vivid,” with many nurses writing about their experiences with understaffing, and noting the personal and professional risks that they had to take while working one shift after another.

The nurses revealed that what goes on behind the hospital doors can include things like falsifying patient documents and working for more than 18 hours with almost no food or water. Rushing through tasks to get them done and being constantly ignored by doctors also put many of them in traumatic situations that jeopardized them, their jobs, and their patients.

“Insufficient Resource Trauma” explained

The authors, Karen J. Foli and peers, described insufficient resource trauma as the problem that “…occurs when nurses do not have the knowledge/expertise, personnel, accessibility to other professionals, supplies, and tangible and intangible resources to fulfill their ethical, professional, and organizational responsibilities.”

Nurses have been complaining about these issues for a long time, they are not something new. What is novel is the fact that this study presents peer-reviewed proof on the fact that they can result in mental health issues comparable to Post-Traumatic Stress Disorder.

The authors also noted that insufficient resource trauma can be helped “…with an appropriate education-to-practice foundation, comprehensive onboarding of new nurses, and appropriate staffing, supply levels, and access to team members.”

Does this have anything to do with COVID-19?

The researchers do not mention the novel coronavirus or the ongoing pandemic in their study. The statements made by the nurses also don’t reflect them (at least the ones that were included as citations). However, it wouldn’t be wrong to argue that COVID-19 has participated in making insufficient resource trauma a lot worse.

On one hand, nurses have already been protesting the lack of proper equipment needed to do their jobs right, as well as the lack of good hospital conditions. Combine those with the professional and personal risks already mentioned, and you will probably get more nurses suffering from avoidable mental health issues.

Even if the researchers deliberately chose not to include responses related to the coronavirus, or even if the surveyed nurses didn’t think it was relevant to mention it, the reality is that this pandemic has had an obvious toll on a great number of nurses around the US.

We live in a country where nurses sometimes choose to quit the job rather than face poor working conditions and high health risks. We can’t blame them. It is up to the authorities and the management in our hospitals to ensure that they get what they need, but the pandemic has shown that they are not doing a very good job, at least for now.

The researchers cited a nurse that said: “If I had known then what I know now, I would have been an engineer.” They also wrote that these nurses “…are still recovering from the traumatic experiences and making sense of what happened to them,” and that many of these experiences meet the criteria, again, for PTSD.

We can only hope and work for healthcare organizations to step up to combat overstaffing and provide nurses with the resources they need, and the attention they require from physicians and the management team. Insufficient resource trauma might be a psychiatric discovery, but the problems that caused it have been around for quite a while.

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