Hello, and welcome to episode 24 of The Nurse Trauma healing. I’m Dr. Lorre Laws, your host, and today we’ll be discussing an important study that examines why nurses are afraid to go to work or be at work. As we all know, nursing is a profession that comes with its fair share of risks and challenges, and fear is something that many nurses face on a daily basis. Whether it’s the fear of making a mistake, the fear of not being able to provide the best care for their patients, or the fear of being exposed to infectious diseases, nurses have to navigate a complex web of emotions in order to do their jobs effectively.
Recently, a study was conducted on fear in nursing that highlighted the various factors that contribute to nurses feeling fearful in their roles. These factors included high patient acuity, lack of support from management, and a lack of resources. The study found that fear could lead to increased stress, burnout, and decreased job satisfaction among nurses.
When we examine this study through the lens of Polyvagal Theory and The Middle Range Theory of Nurse Psychological Trauma, we can see the fear that nurses are experiencing is a strong indicator of nurse-specific traumatization. Let’s unpack this important study together to see what is really going on and how nurses’ health is being negatively affected by fear and traumatization at work.
Before we launch into the study results, let’s quickly review Polyvagal Theory for listeners who recently joined our community.
Polyvagal Theory: What You Need to Know
Polyvagal theory, developed by Dr. Stephen Porges, focuses on the autonomic nervous system and how it responds to stress and threat. According to this theory, the vagus nerve plays a key role in regulating our physiological responses to stress, with the ventral vagus nerve promoting feelings of safety and social connection, while the dorsal vagus nerve is associated with shutdown responses and feelings of freezing or dissociation when faced with extreme stress or danger. Neuroception, a concept within polyvagal theory, refers to our subconscious ability to detect cues of safety or threat in our environment, even before we are consciously aware of them. Our “threat detector” is constantly scanning our surroundings for signs of danger, and when we perceive a threat, our body’s stress response is activated.
In the context of nurses being afraid to go to work, the concept of the “Threat Detector” is particularly relevant. Nurses who experience high levels of fear in their work environment may be constantly on high alert, perceiving various aspects of their job as potential threats to their safety, well-being, or ability to provide adequate care to their patients. This constant state of vigilance can lead to increased stress, anxiety, and even burnout, as nurses struggle to navigate a work environment that triggers their threat detection system on a regular basis.
You might be wondering why nurses respond differently to the same stressors and nurse-specific trauma exposures. This has to do with what I call “Your Repository”, which is where each person’s unique and unintegrated traumas are stored in the body (muscle, fascia, skin, neural plexuses are the top trauma storage lockers) until conditions are favorable for healing.
And guess what. Conditions are so NOT favorable for healing in today’s nurse practice settings.
Negative Impact of Fear & Nurse-Specific Trauma on Health
When nurses experience high levels of fear or nurse-specific trauma exposure at work, it can have profound impacts on their health across various domains, as seen through the lens of Polyvagal Theory. In the physical domain, constant activation of the body’s stress response system can lead to increased levels of cortisol, adrenaline, and other stress hormones, which can contribute to a range of physical health issues such as high blood pressure, weakened immune function, and increased risk of chronic conditions like heart disease and diabetes. In the mental domain, persistent fear and anxiety can lead to cognitive impairment, difficulty concentrating, and even symptoms of post-traumatic stress disorder, as nurses struggle to cope with the emotional toll of their work environment.
In the emotional domain, the ongoing experience of fear can lead to feelings of helplessness, hopelessness, and despair, as nurses grapple with the stress and uncertainty of their roles. In the relational domain, fear can impact nurses’ ability to connect with their colleagues, patients, and loved ones, as they may struggle to maintain healthy relationships and communicate effectively in the face of ongoing stress. Finally, in the spiritual-existential domain, nurses may question their sense of purpose, meaning, and connection to their work, as the constant threat of fear and anxiety erodes their sense of fulfillment and satisfaction in their roles.
Given that there are 18 million nurses on the planet, 83% of whom are suffering from burnout, 91% are experiencing one or more PTSD symptoms, and nearly 25% of whom meet the diagnostic criteria for PTSD, it’s fair to say that . . .
Nurse-specific traumatization is a silent epidemic and public health crisis.
Nurses are afraid to go to or be at work for a variety of reasons, including fear of patient harm, fear of the healthcare environment, fear of psychological harm, and fear of physical/personal harm. These fears are deeply rooted in the essential components of nursing practice, the culture of the healthcare environment, emotional consequences that impact daily life, and factors affecting personal health and safety.
Top Fears Nurses Experience
The top fears that nurses face, as highlighted in the study, can be understood through the lens of polyvagal theory and the impact on their health. These fears, including concerns about patient harm, the healthcare environment, psychological harm, and physical/personal harm, trigger the threat detection system in nurses, leading to heightened stress responses and potential health consequences. These fears can manifest, as we discussed earlier. For example, physically as increased cortisol levels and high blood pressure, mentally as cognitive impairment and PTSD symptoms, emotionally as feelings of helplessness and despair, relationally as difficulty connecting with others, and spiritually as a loss of purpose and fulfillment in their work. As nurses navigate these top fears in their daily practice, their threat detector may also be acknowledging other common fears related to age and race discrimination, sexual harassment and assault, retaliation, and other workplace challenges that contribute to their overall sense of fear and anxiety.
Other Nurse-Specific Trauma Exposures Reported by Type of Fear
The fears reported by nurses, including concerns about leadership, physical injury, causing harm to patients, knowledge deficits, illness contraction, humiliation, disaster response, job loss, physician reprimand, lack of protective equipment, bullying, and exposure to harmful substances, indicate that there is substantial nurse-specific trauma exposure in the workplace. Many of these fears are avoidable and can be addressed through organizational support, training, resources, and policy changes. Nurses are experiencing a global public health crisis of fear, trauma, and anxiety in the workplace, which requires urgent attention and action to ensure the well-being and safety of healthcare workers. Healthcare organizations, policymakers, and leaders must prioritize the mental, emotional, and physical health of nurses and create environments that promote safety, support, and resilience in the face of these pervasive fears and stressors. It is crucial to address these issues to ensure the retention and recruitment of a healthy and thriving nursing workforce that can provide high-quality care to patients and communities.
What to Do if You or Someone You Know is Struggling
This silent epidemic of nurse-specific traumatization cannot be ignored any longer. It is time for healthcare organizations, policymakers, leaders, and nurses themselves to come together and address these critical issues that are impacting the health and well-being of nurses worldwide. I invite all nurses to attend my Nurse-Specific Trauma Masterclass to learn how to prevent and address this silent epidemic that has nurses practicing and living in a state of fear and suffering. Together, we can create a healthier and more supportive work environment for nurses, ensuring that they can continue to provide the high-quality care that patients deserve. Join me in taking action to address this global public health crisis affecting nurses everywhere.
https://drlorrelaws.com/masterclass
From my healer’s heart to yours and until next time,
Namaste 💕
