Nurses and midwives: You don’t need to carry your trauma in silence

Welcome to the latest newsletter from Nurse & Midwife Support: Edition 22 — Post-traumatic stress in nursing and midwifery. In this edition we're talking about Post-Traumatic Stress Disorder (PTSD) and other trauma-related mental health issues.

PTSD has been a long-standing issue in nursing and midwifery, but rates have skyrocketed since the beginning of the pandemic. A workforce survey of 2300 NSW nurses by the Rosemary Bryant AO Research Centre showed that 15% of respondents experienced post-traumatic stress at a clinical level. 

Occupational post-traumatic stress can be isolating. Maybe you didn’t experience the trauma alone, but everyone around you appears to be getting along fine. By contrast, you are edgy, anxious, having nightmares. You’re filled with dread even in your safe and trustworthy spaces. Maybe you lecture yourself with negative self-talk. You chastise yourself for your lack of resilience. You keep going to work in an attempt to get better, but you don’t.

This is the time to get help. You might not think that what you’re experiencing rises to the level of PTSD. It doesn’t have to — you deserve support for all degrees of post-traumatic stress.

You can call Nurse & Midwife Support 24/7 on 1800 667 877. Our team of nurses and midwives are here to offer brief intervention telephone counselling and if necessary help to identify possible referral pathways to help you navigate your recovery.

It’s important that you know that while you may feel like you’re the only one going through this, you’re far from it. Many other healthcare workers are struggling with or have recovered from post-traumatic stress and other mental health issues. Back in February 2022, registered nurse Geoff* shared his story with us. We urge you to read it if you’re feeling alone with your struggles: Not the Only Canary in the COVID-19 Coal Mine: A nurse’s story of post-traumatic stress disorder. You can also check out this webinar with clinical psychologist Dr Rob Gordon on Managing our stress response and understanding trauma through COVID-19.

PTSD and other trauma-related illnesses are a collective problem for our workforce and it’s imperative that we approach solutions collectively. 

Organisations and managers have a responsibility to be proactive and implement both preventative strategies and supportive actions when nurses and midwives are exposed to situations likely to give rise to PTSD. It is incredibly important that nurses and midwives are supported and helped to find ways to heal and grow post traumatic exposure.

Phoenix Australia, Australia’s National Centre of Excellence in Posttraumatic Mental Health, explains the importance of Trauma-informed care:

Some people may appear outwardly affected, while in others, the signs may not be immediately obvious – but over time, they can become evident. A Trauma-informed Care approach promotes well-being by ensuring that the policies, procedures and environments in a workplace, school or healthcare setting, for example, are mindful of people’s trauma histories and support the physical, psychological and emotional safety of its workforce. Trauma-informed Care understands and considers the pervasive nature of trauma and promotes environments of healing and recovery rather than practices and services that may inadvertently re-traumatise. — Phoenix Australia, What is Trauma-informed care?

Phoenix outlines six principles of trauma-informed care in organisations:

• Trauma awareness: An understanding of trauma and its effects is integrated into all aspects of your organisation
• Promotion of safety: Creating a sense of security throughout the organisation, for both team members and clients.
• Rebuilding control: Team members and clients receive clear communication of their rights and participate in policy and process building.
• Focusing on strengths: A strengths-based approach emphasises “the understanding that (even challenging behaviour) represents a trauma-impacted individual’s best efforts to cope”.
• Promoting connection: Emphasising the importance of building connection with primary support people and organisations to ensure people can get the assistance they need.
• Belief in recovery: Maintaining hope and a belief in recovery, alongside a commitment to the ongoing management and prevention of trauma in the workplace.

Visit Phoenix Australia to for more resources, consultation and training programs on the topics of trauma-informed care and occupational trauma and stress.

This newsletter is underpinned by trauma-informed principles. We thank our guests sharing their wisdom on how we can approach this issue, individually and collectively.

Why are midwives vulnerable to PTSD, and what can we do about it?

Midwife and Nurse & Midwife Support Stakeholder Engagement Coordinator Celeste Pinney explores the specific attributes of midwifery practice that can increase the risk of PTSD and how midwives and their employers can work to prevent and manage post-traumatic stress.

“As midwives we develop close relationships with those we care for. Our capacity for feeling empathy is a core feature of good midwifery care, but it can also result in secondary traumatic stress.”

Celeste provides helpful, evidence-based suggestions to mitigate the experience of trauma in midwifery. 

Read Midwives are vulnerable to PTSD. What can we do about it?

Discussing trauma-informed care with Dr Finbar Hopkins

Dr Finbar Hopkins is a Wellbeing Consultant for a large metropolitan hospital in Melbourne. She is a registered nurse, mental health nurse and midwife with more than 30 years’ experience and works on a suite of education and training programs designed to improve the physical and emotional health of hospital staff.

She joined me on the Nurse & Midwife Support podcast to discuss the psychological cost of caring, the impact of Post-Traumatic Stress Disorder on nurses and midwives, and how we are beginning to see a much-needed shift in attitudes about asking for help.

“Asking for help is very stigmatised, or has been, I would say, pre-COVID. In my work now as a wellbeing consultant. I'm seeing nurses and midwives and other health professionals are much more readily coming forward with their mental health concerns. They are looking for support.”

We discuss how trauma informed care improves both workforce and client experience and her thoughts about posttraumatic growth.

Listen to Episode 44: Occupational PTSD in nursing and midwifery with Dr Finbar Hopkins

Revolutionary self-compassion

Mary Freer, author, social worker, founder and CEO of the Compassion Revolution also joins Celeste on the podcast. They talk about self-compassion, what it is, and what it isn’t.

“[When] I use that word compassion, I am talking about our quality of being able to notice the distress that we are experiencing, and that other people are experiencing, and to set about alleviating that distress. That's what compassion is... What we often think compassion is, is all about everybody else. So we'll think "I'm exhausted, I can't be compassionate." But compassion is also about what is happening for us and getting closer to ourselves, and understanding what we're experiencing.”

They discuss music, nature, massage and meditation, plus the tough stuff — boundaries and your go-to de-stressing strategies when you feel distress.

Listen to Episode 45: The Compassion Revolution with Mary Freer

We know many nurses and midwives enjoy a little friendly competition, so we’re asking you to let your ambitious side out in the Nurse & Midwife Support pet photo competition! 

Competition: We want to celebrate the pets and animals in your life with a photo competition! (win a prize!)

Nurses and midwives have been handling a lot in the last few years. Many of us are experiencing high levels of stress and even trauma. We’ve heard from many of you that your pets have been helping you through it. Animals are great stress relievers. We want to celebrate everything they do for us with a photo competition. We’re asking you to send in a photo of yourself and your beautiful pet or local wildlife. You’ll go into the running to win a wellbeing hamper. The hamper includes a beautiful cup, tea, French Vanilla almonds, a A6 notebook, silk eye mask and bath soak. We’ll share the photos with the Nurse & Midwife Support community.

Find out more and submit your photos here.

In the podcasts we touch on a relatively new treatment for PTSD called Havening. The Havening Technique was developed by US neuroscientist Dr Ronald Ruden. Briefly, it is a therapy around touch and remaking memories with the aim of decreasing cortisol production and increasing serotonin uptake. Havening attempts to turn down the dial on your Autonomic Nervous System. Find out more at Healthline: Havening: What it is and how it works.

Remember, if you feel distressed you can call Nurse & Midwife Support on 1800 667 877 or email us. We are a free, confidential, anonymous service for nurses, midwives and students nationwide — 24/7. Our team are experienced nurses and midwives who understand the pressures you are facing.