PTSD in Utah's Rural ICU Nurses: A Needs Assessment

Post-traumatic stress disorder (PTSD), when experienced by rural intensive care unit (ICU) nurses, can negatively impact safe, effective, patient care (Badger, 2001; Mealer, Burnham, Goode, Rothbaum, & Moss, 2009). Hospitals share responsibility for supporting these nurses through work-related trauma, however, no literature exists to guide rural hospitals in this effort (Ong, Siddiqui, John, Chen, & Chang, 2016). The purpose of this project was to define the prevalence and nature of PTSD in a sample of rural ICU nurses, assess its perceived impact on patient care, and identify institutional PTSD-support gaps experienced by this population. METHODS: Rural and urban samples of ICU nurses completed a needs assessment survey, which was designed to gather demographics, PTSD symptom scores, its perceived impact on patient care, and the availability and importance of hospital-based PTSD support resources. Sample data was analyzed using descriptive statistics and comparisons between samples were performed by independent t-tests. RESULTS: While significant demographic differences existed between rural and urban samples, all subjects reported experiencing work-related trauma. Rural nurses had lower PDS-5 scores (p = 0.002), and perceived that nursing PTSD impacted patient care less negatively (p = 0.004) and less frequently (p < 0.001) than their urban counterparts. Rural and urban samples agreed upon the same six most important work-related stress management interventions, however, the availability of these interventions was not unanimously agreed upon by either sample. CONCLUSIONS: Perceptions of nursing PTSD's impact on patient care were significantly different between rural and urban samples, as were PTSD symptom scores. Further research should be done to understand these differences. Identified rural and urban nursing stakeholders were provided with project results, and asked how they could use them to improve institutional support of ICU nurses who experience work-related trauma. The sustainability of this project depends very much on the continued investment of these rural and urban nursing stakeholders. Advanced practice registered nurses are well suited to provide leadership and advocacy for rural and urban nurses following traumatic exposures in clinical environments, and could also help sustain this project at various sites.