Haelan Nurse Podcast Episode #9 Employer Extortion: AVOIDABLE Nurse Specific Traumatization

So let us just talk very, very briefly about how we as individual human beings, every by virtue of living on this planet, we are exposed to individual traumas.

They could be acute, they could be chronic complex developmental neglect. And the list goes on. And then as nurses, we get additional trauma exposure, much of which is avoidable and secondary to healthcare system inadequacies. There’s of course inherent with nursing is the vicarious and secondary trauma. We also have trauma from disasters, but we also have historical trauma that needs to be transcended.

Nurses are an oppressed occupational class and have been for centuries. We also are exposed to an inordinate amount of workplace violence. Either, either physical or mental or emotional, visited upon us by our patients, their families and friends, and indeed our colleagues in the form of any number of gaslighting, bullying or other work place incivility. And we have insufficient resource trauma. This is one of the huge factors that’s driving nurses from the profession altogether.

And then we have second victim trauma. So if you’ve had a near miss an adverse or a sentinel event that is secondary to a healthcare system inadequacy, you are likely carrying the burden of guilt and shame that doesn’t belong to you.

And it’s so important that we heal and recover from all that we’ve endured; all the traumatization that we’ve experienced. That’s what my work is grounded in, is as I have proposed an evidence-based framework, five steps to guide nurses through their healing and recovery so we can transcend all that is being visited upon us as a global nursing profession and is resulting in a global nursing crisis. All of this and more can be found in my book, which is available wherever books are sold.

Shameless plug coming right now. The title of the book is Nursing Our Healer’s Heart.  It’s a recovery guide for nurse trauma and burnout.  Today I want to  talk with you a little bit, share a case study from Julie who is a nurse or recently retired in the U.K. And she writes, 

“I’m retired from nursing four years and I have dreamed about being at work.  And in them, I’m always in a situation that is stressing me out.”

What Julie is describing is a recurring dream. This is a recurring dream that is post-traumatic stress disorder symptom. Now for those of you who are just getting introduced to my work, 91% of nurses report one or more symptom of PTSD, almost one in four nurses meet the diagnostic criteria for PTSD.

When we look at Julie’s story four years post-retirement, she is having recurrent dreams. She goes on to say, 

“I’m floated to trauma ICU and I’m told that they’re only giving me their lightest patients, but I’m only overwhelmed and can only do the hands-on for one of my patients and have neglected my charting while trying to get my other patient.

And time is going by extremely fast. I feel incredibly inadequate and unsafe. I never worked trauma ICU during my entire career, right?”

 So, here we have a nurse, experiencing insufficient resource nurse-specific traumatization. She’s been floated to a unit that she has no expertise, no training.  That is an unsafe working condition. And what do you think that does through the lens of polyvagal theory in terms of how our physiology is going to respond, that is clearly unsafe for that nurse to be there without, without any training, without any orientation just being thrown into the lion’s den.  This practice is unsafe for the patients as well.

Julie’s doing her very best to practice safely and within the scope of her license.  But the game is rigged.  What we have here is insufficient resource trauma. We also have system-induced trauma. Both of which are avoidable.  The most care system itself by the decisions that are being made are putting the nurse in a trauma traumatizing situation for her and the putting the nurses, the patients in her care in an, in an unsafe and potentially traumatizing situation.

Let’s move to our next case study.  This one is from the patient perspective.

A patient came into my container, for which I’m so glad,  also from the U.K. Sandra, who says that nurse-specific traumatization negatively impacts the patients as well.

“I’m a mother of a child that has a medical accident which causes us to use the NHS, which is the National Health Service, which is the universal healthcare in, in England, off and on for 29 years and spent 30 hours in an A and E unit.

And what happened in the holding bay, I swear, will be the death of me and I’ll never get over it.”

Patients are chiming in that they, too, are being traumatized by the system, by the broken healthcare system, by insufficient resources. Any number of nurse specific traumatization is also being visited upon the patients.

Let’s return to Julie’s story where she offers another study from her practice.

She said, ” I was my hospital’s chief nursing steward, which maybe here in the US translates to a chief Chief nursing officer, A CNO.

And I protected a nurse and she was suspended for her refusal to float to trauma ICU. And she was suspended for patient abandonment. Now mind you, she had never worked in trauma. ICU, not a day, not one day. Showed up to work is like, well, you gotta go. She’s like, it’s not safe for me to go, I’ve had no training. It’s not safe for my patients for me to go. I can’t go. You know, if you wanna gimme training, I’m happy to go.

But like I, you can’t just throw me off the cliff and, and, and hope everything goes okay when I’m in a level of care and a unit that is not at all connected to my practice specialty, right?”

So here, Julie is being a patient advocate. Truly she’s being a patient advocate because she knows that is not safe care. And, and instead of being backed by her organization, she was suspended and and charged with patient abandonment.

This is extortion – a form of workplace violence and avoidable nurse specific traumatization.

Her manager told her she either went or she could go home immediately. So this nurse chose to go home. These are, these are the decisions that nurses are having to make in practice every day. And let us be clear, it is wrong that no nurse, never, ever should a nurse be put in a situation where they are forced to practice in an unsafe manner. And it is the nurse’s responsibility to be in compliance with their governing their licensing agency, right?

The state board of nursing here in the US wherever, whatever state in which you’re practicing similarly over in the U.K. And so here she, here’s this nurse doing exactly what she’s supposed to do and she gets sent home and then suspended and charged with patient abandonment. Now, Julie, who was the CNO says, 

“I was able to get her job back with pay after many, many weeks thanks to the contract wording regarding orientation prior to floating that wasn’t offered to her.”

So it’s written in the contract where, where these nurses work written in the contract that they need to be trained before they float to an unfamiliar unit that is outside of their, their practice specialty. And the healthcare organization chose not to honor their own contract and then threatened the nurse. And then when the nurse refused to practice in unsafe working conditions that put her patients at risk, she was charged with patient abandonment and suspended.

Now, not every CNO is gonna fight as hard as Julie did for her nurse, but this, this story, well I wouldn’t say it ended well, but it ended better than most so ended. The story ending well is that we’re never in this situation to begin with because, because this is what is happening to nurses across the globe. And this is extreme trauma exposure for which there are no resources or supports being offered to the nurses.

Over 86% of nurses report that they have zero or very little resources to manage the inordinate amount of trauma exposure that they are exposed to every single day as a high risk professional, right? Right up there with first responders, law enforcement, etc. So it breaks my heart and also fuels what I’m doing in my work. And I hope that you will join me in that I’ve brought forth a five step process to help nurses heal and thrive.

It’s called the Your Innate Care Plan framework. And what it does is it, it grounds nurses and connects them because each of us have within us our unique innate capacity for healing. And so the formula goes like this:

YICP = 3As + B –> 3Rs

So what is that? Well, it’s more than we can unpack in a single, in a single podcast.  But the 3A’s have to do with insulating yourself from the broken system and harsh practice conditions by starting with the vagus nerve and autonomic nervous system.

We can individually and collectively do the healing that is before us and be the cycle breakers of nurse specific traumatization and oppressive forces that would threaten us and keep us feeling weak and small and disempowered. Because at the end of the day, we’re over roughly 30-50%, depending upon the country, of the healthcare work workforce.

They don’t want us to get better. They don’t want to support us. It’s not in their interest for that to happen.

But it’s in my interest to help us make that happen. So the Your Innate Care Plan framework, the three A’s are awareness. First of all, let’s be aware of what’s happening, which is part of what this podcast and my work is doing. And then also let us be aware of how that impacts our autonomic nervous system, which drives physiological processes throughout the entire body.

The second A is attending. And that really speaks to learning the language of once in the system through the lens of polyvagal theory that was brought forth by Dr. Steven Porges. Learning not only learning the language of the vagus nerve, not only learning the language of the autonomic nervous system, but then how to navigate it effectively.

And importantly, how to start insulating ourselves from these toxic and dangerous unsafe working conditions where it’s trauma upon trauma, trauma upon trauma exposure, right?

And then the third A is alignment. So we have awareness attending and then alignment. Alignment speaks to the correspondence between our inner deepest truths and realities and how those are expressed or not manifested or not in our external world.

And so this is what I call the foundation. This is the foundation that underpins anything else you do in self-care without a regulated nervous system, without being connected within and with others, without knowing how to navigate your nervous system and how to use it to insulate yourself against all that you’re experiencing – you’ll continue to have the same symptoms. Then everything that self-care that puts on top of it kind of just keeps collapsing. It’s an endless cycle of hope and despair.

As an integrative nurse coach, there are major recurring themes that emerged out of my practice.  And it’s almost always the same thing. It’s “I’ve tried everything, nothing works.”

Well that’s because we don’t have that foundation of a regulated and effectively insulated autonomic nervous system and vagus nerve relationship. And that ventral vagal tone that is, is so required for nursing and indeed for life, right? And so, so we have the three A’s that are the first part of the, your innate care plan framework.

And the next one is the B, which is balance. And that’s everything you think of externally in your life, all your wellness domains. And I’m not gonna list all of those now ’cause we’ll unpack all of that later. So when we, so when we start with the foundation, which is awareness, attending and alignment, then we put good self-care and wellness on top of that in all, all dimensions of our wellness, then that leads us to where we really need to be, which is the three Rs, which is being regulated in our nervous system, which is hugely important in terms of, of chronic illness especially, right?

So we, we can talk about all that. I’ve talked about it in previous episodes and, and we’ll continue to talk about it. So being regulated in our nervous system has, has innumerable health benefits and, and wellbeing and wellness benefits.

That’s the first R The second R is being reconnected, reconnected within. Because what happens when we get traumatized is there’s an intern fracturing, there is a left shifting in between the hemispheres of our brain, right? And so getting that sense of internal coherence and reconnected ness within and with the people in our lives. Because oftentimes we have to socially isolate because all of this, quite frankly, is too much. I mean, Julie’s having recurrent PTSD dreams four years post-retirement for Pete’s sakes!

It’s not okay.  To summarize, we have:

3As = Awareness, Attending, Alignment (nurturing and insulating your nervous system)

B = Balance =traditional self-care in all wellness domains

When we engaged with the 3R’s and the B, that leads us to . . .

3Rs = Regulation, Reconnection (within and with others), and Restoration of our healer’s heart.

So, if you’d like to learn more, here’s how I and my team can help.

We have a one-minute self-survey, really one minute to see if and how you’ve been affected.

And then also a link to how you can learn more about a webinar, a free webinar where you can learn more about what is happening . . .and maybe happening to you. And importantly, the pathway out, how you can start your healing process today.

Until next time, I just wanna thank you so very much. I want to thank our guests today by virtue of their posts on social media, for which I’m so grateful.

Please and subscribe @drlorrelaws on social media.  Please consider joining my Haelen Nurse Community no Facebook. 

I’ll leave us with this parting quote from Mary Hughes, also from the UK who says, “all healthcare professionals are traumatized and burned out. We need to heal together if we can work together. I’m a nurse for 53 years and I hurt when the people I work with hurt, unite, don’t divide.”

Mary Hughes. Thank you. I got goosebumps.

Thank you for those poignant words.

From my healer’s heart to yours, please know that I am wrapping my heart around yours as you go through everything that you’ve endured and that as you start your healing and recovery process, I will be with you every step of the way.

And until next time, namaste 💕