For healthcare professionals, emotionally challenging and highly stressful events are par for the course. In caring for people who have gone through accidents, have critical illnesses, and are living with terminal diagnoses, nurses are frequently exposed to potentially traumatic situations. Because stress levels and demands vary by unit, it is important to recognize that not every nurse is equally prepared for every clinical setting. For example, a new RN won’t have the same skills and experience as a nurse who has worked in the ICU for a few years.
When hospitals place nurses in the right unit, they effectively improve resilience, bolster safety, improve patient care outcomes, and reduce the risk of nurses experiencing trauma. In this article, we tackle how matching nurses to the right unit reduces trauma exposure.
Why Unit Placement Is a Mental Health Decision, Not Just a Staffing Decision
Hospitals often view nursing assignments as a means to balance patient care with available staff; when patient acuity and resources are top of mind, nurse unit assignments are not typically made with nurses’ mental health protection as a priority. However, when nurses are placed in a unit that requires a high level of competency and experience that they don’t yet possess, it can negatively affect patient safety as well as nurses’ productivity, resilience, and job satisfaction.
Poor nursing placement can lead to many negative outcomes, such as:
- A greater level of emotional exhaustion. When nurses are placed in units that require a higher level of competency or experience, they might feel overwhelmed and drained. This can lead to absenteeism and high turnover rates.
- Increased errors due to stress and overload. Fatigue, stress, and being overwhelmed can cause nurses to make errors that can compromise the safety of both patients and nurses. Emotionally exhausted healthcare workers are at an increased risk of incorrectly providing medication to patients, missing critical signs in patients, and having delayed responses to patient needs, which can result in patient harm or mortality.
How Mismatched Unit Assignments Increase PTSD Risk in Nurses
Not all hospital units are created equal. Some units require non-stop care for patients with complex medical needs, such as the ICU, and others need high levels of communication and de-escalation skills, such as psychiatric units. Different units require different levels of competency, experience, and technical know-how, as well as emotional resilience and coping mechanisms. Depending on a nurse’s training, experience, and preferences, a nurse may find one unit particularly difficult while finding themselves thriving in another. Some nurses might be able to handle fast-paced environments better, while others are more suited to one-on-one and hands-on patient care.
When placement prioritizes filling vacant staffing slots over properly assessing nurses’ competency, experience, preferences, and even previous trauma, healthcare organizations are potentially exposing their staff to increased stress and potential trauma. Nurses whose strengths do not match the setting they’re assigned to are at risk of feeling overwhelmed. It can also lead to nurses experiencing burnout, which is a core risk factor in PTSD in nurses. Nurses who find themselves not performing optimally due to a lack of competency, experience, and support are prone to processing distressing or traumatic experiences alone. This can also lead to the development of PTSD symptoms in nurses.
Healthcare organizations can benefit from assessing unit-based PTSD risk factors for their nursing staff. With trauma-informed staffing, nurses are assigned to units that match their training, experience, strengths, and interests, which can reduce exposure to unnecessary trauma, boost nurses’ resilience and safety, and improve productivity, attendance, and overall retention rates.
