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March 28, 2017

Nurses can experience PTSD when resuscitation fails, study finds

Daily Briefing

Nurses experience moderate levels of postcode stress and post-traumatic stress disorder (PTSD) symptoms when asked to recall an unsuccessful resuscitation, according to a study recently published in the American Journal of Critical Care.

Study details

For the study, researchers surveyed 490 critical care nurses and asked them to recall an unsuccessful resuscitation. Study author Dawn McMeekin, an advanced clinical education specialist at Baycare Health System, said researchers investigated "if participation in an unsuccessful cardiopulmonary resuscitation attempt created a heightened level of stress, referred to as postcode stress, and if coping behaviors individuals utilized influenced the development of a more chronic psychological distress as evidenced by PTSD symptom severity or stress as a result of a traumatic event."

The researchers also looked at the relationship between institutional debriefing and nurses' levels of stress.

Key findings

Overall, the researchers found moderate levels of postcode stress and PTSD among survey respondents, but the researchers said postcode stress and PTSD symptom severity were weakly associated, suggesting that nurses who experience postcode stress will not necessarily develop PTSD symptoms, according to HealthLeaders Media.

The researchers identified four coping behaviors that were significant predictors of PTSD symptom severity. Those behaviors included:

  • Behavioral disengagement;
  • Denial;
  • Self-blame; and
  • Self-distraction.

The researchers found no correlation between coping behaviors and postcode stress, according to McMeekin.

What's going wrong in your brain when you can't shake traumatic memories

Further, nurses who worked at a facility that practiced some form of debriefing after failed resuscitations had lower postcode stress scores than nurses who did not have institutional debriefing. However, according to McMeekin, "PTSD symptom severity was higher in those nurses with institutional debriefing." She added that she was "somewhat surprised" by that finding.


McMeekin said the findings "underscore the importance of maintaining a healthy work environment and nursing workforce," and called for more research into the effectiveness of various interventions. "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," she said.

Until further research is conducted, McMeekin said her "advice for nurse leaders would be to acknowledge the potential for psychological distress" following failed resuscitations, and to understand that "this may compound the burden of emotions and psychological stressors that nurses encounter in daily practice" (Thew, Health Leaders Media, 3/21; American Association of Critical-Care Nurses release, 3/1; McMeekin et al., American Journal of Critical Care, March 2017; MacDonald, FierceHealthcare, 3/6; Lofton, WV Public Broadcasting, 3/2).

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