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Stephanie R Paulmeno
Greenwich Department of Health, USA
Keynote: J Nurs Res Pract
The nations of the world have faced staggering death tolls and many forms of human suffering over the COVID-19 pandemic. We have had repeated COVID surges as the virus mutated, as viruses do. We faced endless workdays and fear of loss of our own lives. Healthcare providers went from being designated as heroes to being vilified around mask-use, vaccines and social isolation. The burden has been unequally felt by different nations, different populations, different socio-economic groups, and different health professionals. All of this renders a toll either through the direct trauma of caregivers and family members caring for the infected and dying, or through the secondary trauma of those who witnessed it from afar. In huge numbers, nurses have been and continue to be on the front line of this prolonged tragedy. Healthcare studies and literature supports that nurses are heavily impacted by work-related and work-generated distress. Reactions that follow trauma, repetitive trauma, and prolonged trauma encountered in nursing workplaces includes PTSD, suicide risk, depression, anxiety, grief reactions, and substance use and misuse. In contemplating nurses’ roles and functions in high-trauma settings, places with high-frequency death rates, & in fields of practice where infant & child mortality is high, it is easy to appreciate the degree of emotional trauma experienced by these nurses. It is more difficult to innately recognize other dynamics that contribute to similar emotional jeopardy for nurses; things like bullying, workplace violence, toxic work environments, inadequate staffing and supplies, a lack of transparency, and poor leadership at any level. Post-traumatic stress disorders and other sequela of trauma are not confined to the aforementioned work domains; they can occur in any working environment. The high-stress circumstance in which people in many countries have been living over recent years has taken a toll. By their very nature, people entering nursing tend to be high on the compassion index; nurses exude a desire to help others, which means we often suffer with those for whom we render care. We want to help alleviate death and suffering, and many times we cannot. Nurses are very good at showing concern for others through kind words, thoughts and deeds, but less good at offering self-compassion. The prolonged COVD-19 pandemic brought its own risk-factors to bear on the mental and physical health of nurses, which are entwined. U.S.-based data revealed that one in four nurses experiences PTSD during their career under normal circumstances. Behavioral health practitioners know that self-medicating & behavioral maladaptations are PTSD responses, as well as responses to depression and anxiety. Research shows that nurses have suffered with these symptoms since long before COVID-19. Nursing during this prolonged pandemic has intensified this. Deaths by suicide and suicide attempts among nurses in America are high in general, and in fact higher than among physicians. Who, after all, is at the bedside offering compassionate care all day and all night long? During the pre-pandemic period one study showed that the suicide risk of all health professionals is not equal. The suicide risk of female nurses’ was already twice as high as that of women in general. If we compare nurses to physicians, the study showed that female nurses are 70% more likely to die by suicide than female doctors. Our LGBTQ+ colleagues have additional risk factors that are distinctly associated with how they, themselves, are treated by healthcare professionals when they are the patients. New and younger nurses face greater coping challenges than more experienced nurses. The gap to be addressed in this program is that nurses need learn to recognize and reduce their personal and work-related risk factors, and to become aware of and use personal and profession-based protective factors. Nurses at many levels of practice must develop proficiency in instituting changes around factors that contribute to toxic workplaces, poor staffing levels, and inadequate supplies and equipment. Nurses must develop proficiency in recognizing personal warning signs of stress, as well as in being able to recognize and identify overt or subtle signs in over-stressed colleagues. Once recognized, they need to learn how to build strength and resilience. This program addresses recognizing a range of behavioral health and suicide risk factors, strategies for effectively discussing and intervening when a problem is suspected, and for dealing with suicide prevention. This includes recognizing risk factors/warning signs, tapping into protective factors, conducting effective on-the-job screenings, and learning how to implement preventive actions and referrals when confronted with a possible suicide crisis of a colleague, or anyone else. Resources and references are provided.
Recent Publications:
1. Fostering An Empathic Approach: An in-service curriculum for non-medical professionals, paraprofessionals and families of aphasic clients. Gerontology & Geriatrics Education · Apr 1, 1982
2. Psychogeriatric Care: A specialty within a specialty Psychogeriatric Care: A specialty within a specialty. Nursing Management · Feb 1, 1987 Nursing
3. Intentional and Unintentional Substance Misuse in the ElderlyIntentional and Unintentional Substance Misuse in the Elderly. Presentation: Contemporary Forums, Psychiatric Nursing, Philadelphia, · Apr 25, 2007
Stephanie R Paulmeno, CEO & founder brings 50 years of registered nursing & board certified clinical practice in public health, case management & dementia care. She’s had clinical, managerial, administrative & leadership roles, in nursing, gerontology & public, population & community health. She is a Doctorate-prepared nurse, a Master’s prepared gerontologist and licensed nursing home administrator. She brings capacity & coalition-building expertise to Boards, CEOs and administrators of health, social services, & mental health & addiction programs. She serves as President of several Boards and on multiple task forces and work groups.
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