Postcode stress: Critical care nurses take deaths of patients hard, experience PTSD symptoms

A surgeon focused on her work
A study in American Journal of Critical Care explores the relationship between postcode stress, PTSD symptom severity and coping behaviors after CPR fails. Photo Credit: Getty/Jupiterimages

Critical care nurses often experience postcode stress and symptoms of post-traumatic stress disorder (PTSD) when they are asked to recall an unsuccessful attempt to resuscitate a patient

The findings may help hospital leaders better understand how nurses cope after a patient dies following CPR and which nurses are most at risk for postcode stress, according to new research published in the American Journal of Critical Care.

The study analyzed the results of an online survey of 490 critical care nurses that included the Post-Code Stress Scale, the Brief COPE and the Impact of Event-Scale-Revised. Nurses who worked at organizations that provided institutional debriefing support reported significantly lower postcode stress scores than their colleagues without such support.

“Finding ways to minimize distress and improve resiliency not only helps the individual nurse but may also help combat high turnover and vacancy rates for critical care nurses,” lead author Dawn E. McMeekin, R.N., advanced clinical education specialist at Baycare Health System, Dunedin, Florida, said in a study announcement. “These results underscore the importance of maintaining a healthy work environment and nursing workforce.”

Previous studies have also found nurses who work in the emergency room to be vulnerable to “death anxiety,” a state which makes them more conscious of their own mortality and creates a high level of stress and unease.

One way to help decrease stress in nurses is to encourage them to take a “pause” after a patient’s death to honor the life of the person who died. The pause allows nurses and the trauma team members remember that the patient had a life and family and to thank one another for their efforts to save the person’s life. The medical team at the University of Virginia Medical Center said the pause helps them accept the loss and experience less emotional trauma.

Another way to help nurses better deal with stress and exhaustion is to encourage them to practice mindful meditation. The practice allows nurses to slow down, breath and be attentive to their own thoughts and feelings.

Other hospitals offer wellness programs and animal therapy to help relieve stress and improve morale.