For today’s topic, we are going to talk about nurse specific traumatization, and we’re going look at a case study from a new graduate nurse who highlights her first year in practice.

This early career nurse experienced avoidable nurse specific traumatization right out of the gate.  It is oh, so common. I’m going to remind us, for those of you who are just joining us, that the American Association of Colleges of Nursing, the AACN, has a position statement regarding trauma. And that position is that nurses should assume that every person that we care for has experienced trauma or is traumatized in their life in some fashion in varying degrees. Now, nurses are a subset of the general population.

So by inference we could say that we should also assume that each nurse has been touched by trauma and we need to nurture ourselves and do the healing work accordingly. Nurses are just like the general population, only the burden of our work is so much greater. So for those of you, again, who are just joining us, my work is grounded in the recently published Middle Range Theory of Nurses’ Psychological Trauma brought forth by Dr. Karen Foli at Purdue University. And to review . . . nurses as whole human beings who are inseparable from the contexts and environments in which they live and work.  We have been affected by any number of individual traumas, which could be acute, chronic, complex, developmental, or any or all forms of neglect.

So within each of us, if, if any of those have touched our lives in any way and didn’t get completely healed at the time, those unintegrated traumas, or what I refer to as those unhealed bits of wisdom that are stored in Our Repository.  These unintegrated traumas, the unhealed bits of wisdom that are awaiting favorable conditions for healing, are stored primarily in our fascia, our neuro plexuses throughout the body, muscles, bone and skin. And so we bring all of those with us to work consciously or subconsciously, they’ll come with us, they’re a part of who we are, and then we get to work and we are exposed to an inordinate amount of trauma, much of which is avoidable.

So now we’re getting into the nurse-specific trauma exposures.  We have unavoidable vicarious or secondary trauma that is inherent with nursing. There’s avoidable historical trauma that we’re going talk about today in this case study. There’s avoidable workplace violence that we’re going to talk about today.  There’s avoidable insufficient resource trauma, second victim trauma, which is often secondary to healthcare system inadequacies and trauma from disasters. So it is a trifecta of trauma that I have spoken about. The, the individual traumatization that we experience as by virtue of being a human, the unavoidable nurse specific trauma exposure that is inherent with our profession. And then there’s, and then there’s the big doozy, the doozy that’s driving nurses right out of the profession.

And, and that’s that avoidable specific trauma exposure that is secondary to the broken healthcare system and a, a host of other factors. So just to ground our talk in evidence today.  I also want to introduce you to my Halen Nurse Community, which is a public forum on Facebook where nurses can come together and really share their stories and be seen and be heard and be supported. And so we can really take a deeper dive into what is really, really happening in the nursing crisis.

And what is happening is not just burnout, it just isn’t. I did five years of research across four disciplines. Burnout is part of the story, but it’s the tip of a much, much bigger iceberg. So let’s segue into todays case story that I’m going to read to you from the Halen Nurse Community Facebook page, and it says:

Hi, my name’s Kelly. I’m an ER nurse and just finished my first year. As we all know, the ER is busy as usual. If there is no time to take a sip of your water or even go to the bathroom in a 12 hour workday, then there is a huge problem on top of NEVER, getting a lunch break.

One one day when I was stretched so thin, I asked my charge nurse for a short walk away, touch my breath of fresh air break, just a moment or two so I could go outside and breathe . . .Before I started to cry, I was told no. As the charge nurse passed by not even stopping to acknowledge me or my pain, I’m just at my wits end. They must not care about me as a human. I guess it’s not fair. And this is nursing. Now it’s wearing me down until I’m no more. I can see why people are leaving nursing, and I don’t even touch on the cliques or the older charge nurses who thinks it’s funny to continually “haze” me.

I brought it up to my director who didn’t care, or she would’ve made changes a couple months ago when I brought it up as a problem. It’s affecting my whole work life . . . time to find a new job.

Well, first of all, Kelly, I, want to thank you. I wanna thank you for so bravely sharing your story.  One that I hear over and over again and, and has inspired me to do the work that I’m doing.

And so what we know is that we’re losing about 25% of our new graduate nurses. By the end of this decade, the world will have just over one half of the nurses that it needs. And so many of you might be thinking, “Well, there we go. It’s just nurses eating their young. Again. It’s just the way it is.”

It’s time to challenge that paradigm. I want to challenge that assumption that nurses are eating their young, because in my work, what I discovered is that nurses are not intentionally eating their young. When you really start doing some deep research and looking at now this phenomenon through the lens of social science, through the lens of polyvagal theory,  through the lens of integrative nursing, and through the end lens of relational neuroscience . . .you find the legacies of unintegrated nurse trauma being transmitted, just like traditional ancestral suffering is.

What we see is that we have the legacies of unintegrated, their unhealed nurse-specific traumatization being transmitted, often unknowingly, from one generation of nurses to the next, to the next, to the next. And like implicit bias, this is like an implicit transmission of nurse trauma.

And it’s been so pervasive and such a part of the nursing culture for so long that many, many nurses to take it for granted, shrug their shoulders and say, “Well, I guess that’s just nursing. I guess I should just suck it up buttercup, right?”

So let us be very, very clear what is happening to my friend Kelly is avoidable nurse specific traumatization. She is on the receiving end of the unintegrated trauma that nurses embody and transmit unknowingly from one generation to the next.

What she is also experiencing is workplace violence in the form of bullying, in the form of incivility and in in the form of hazing, in her own words, hazing.

So when we look at Kelly’s story through the lens of Foli’s Middle Range Theory of Nurses’ Psychological Trauma and Porges’ Polyvagal Theory, it all starts to make sense. Actually, it surprises me not in the slightest that we have one in four early career nurses leaving the profession. And what happens, just like Kelly, is that absent the tools and the resources and the education to really understand what is happening in one’s nervous system, how one’s brain is responding to all of this, how that is driving behaviors that nurses tend to, to job skip from, from one job to the next to the next.  That is a survival adaptation.  It’s exhausting and expensive to change jobs every year or two.  But nurses, like Kelly, have little choice but to do so.

This is a systemic problem. This is so systemic and pervasive that the vast majority of nurses are unaware of it. And, and that’s sort of my job is to hold up these big floodlights on it and, and bring forth as much of the evidence that I have researched and bring it out so that we can really start transcending, healing, and put an end to the the systematic oppression of nurses by all sorts of forces who are profiting and benefiting from our caring hearts – our healers hearts – and benefiting from our skillset, training, and our education.

And so it’s very expensive. It’s very expensive for a nurse to, to job hop and understandable. Like you can’t, you can’t stay in a toxic work culture. I mean, it’s healthy to make a pivot. But what I would like to do through my work is help nurses, like Kelly, learn how to insulate themselves from the broken healthcare system, insulate their nervous system, get more coherence between the left and the right hemispheres, start leveraging the properties of neuroplasticity while moving out of survival mode in practice to thrive mode.

So what we have are traumatized nurses, traumatizing nurses, you know, that old expression, “hurt people, hurt people?”  That’s what’s happening.

I’m here to be the cycle breaker, one of many cycle breakers. I’m doing my part to be a cycle breaker and interrupting the transmission of avoidable nurse specific traumatization. And end this “nurses eat their young” pattern that we find millions of nurses engaged in.

As we reflect upon the actions of Kelly’s colleagues, those nurses who may have been engaged in the hazing or the bullying . . . or the charge nurse who dismissively walked by when, when one of our most vulnerable nurses needed to take a moment . . .and dismissed her need to go outside and take three deep breaths before she starts crying,

It would be easy to shift blame to that nurse who walked by and dismissed her.

But, there’s no blame in the nurse traumatization game.  Nurses embody and transmit their unintegrated traumas and those of the nurses who have gone before them.

The charge nurse? That’s likely a traumatized nurse. The the director who took action, that’s probably a traumatized nurse, right? And so what happens is nurses start to get desensitized.  They have a diminished capacity to perspective shift.  They are probably compassion fatigued.  And have been for a long time.

We start to believe that this is normal and that this is okay. And this early career nurse Kelly, she knows it’s wrong. She knows this is not okay. The new generation of nurses coming in are saying, “Oh, oh heck no. Oh heck no. I’m not gonna be treated like this!”. And they’re leaving; one in four are bouncing from the profession.  Like Buh Bye. 🙋🏼‍♀️🙋🏾‍♂️🙋🏻‍♀️

And so let us come together as a global nursing community and understand that we have been systematically marginalized and abused for centuries.

We embody the unintegrated trauma of those who have gone before us. And we are unknowingly, unintentionally transmitting that from generation to generation to generation of nurses. I hope that you will join me in being a cycle breaker and saying “no more” 🚫 while helping me shine these flood lights on the nursing crisis, which is not just burnout.

So what can you do today?

You can certainly go to my website, drlorrelaws.com. There I have for you a free sample chapter of my book. I also have therefore you a short self survey where you can assess if and how you have been affected by nurse  specific traumatization. And you can also learn more about my non-profit’s Breakup with Burnout Academy for Nurses.

Until next time, I want to thank you so, so much for the important work you’re doing. I am holding in my heart Kelly and all the nurses who are experiencing what Kelly has experienced. I’ve got my heart wrapped around yours 💞. I’ve got my heart wrapped around all of us as we break, start to break the cycle, liberate ourself from all the oppressive forces who are profiting on the backs of our suffering.  May we can come together and insist upon a global paradigm shift for nursing, what I call Nursing 2.0, The Nurse Safety and Professional Wellbeing edition.

That’s the big goal in the big picture. In the small picture, it’s helping and supporting nurses just like Kelly, just like the charge nurse, just like the director, all of whom are sort of in this, demonstrating these unconscious behaviors as they transmit historical nurse traumatization. So thank you, thank you, thank you for tuning in. Thank you, thank you. Thank you for the important work that you’re doing. And until next time, namaste.

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