First steps in creating a national action plan on post-traumatic stress injury/disorder

January / February 2017   Comments

Just like firefighters, paramedics and police officers, nurses face work conditions that can be traumatic and violent, which can affect their mental health and well-being. That’s why Public Safety Canada (PS) and the Public Health Agency of Canada (PHAC) invited CNA and other key mental health stakeholders to a roundtable last September to help shape the development of a national action plan on post-traumatic stress injury (PTSI).

The plan has been a priority of the Liberal government since it took office. The mandate letter to Minister of Public Safety and Emergency Preparedness Ralph Goodale included a call for him to “work with provinces and territories and the Minister of Health to develop a coordinated national action plan on post-traumatic stress disorder [PTSD], which disproportionately affects public safety officers.” A commitment was made in the 2016 budget to ensure “public safety officers have the support and treatment they need when facing post-traumatic stress disorder.”

The differences between PTSI and PTSD was an item of discussion at the roundtable. PTSI is the term being suggested by some health-care providers, who perceive injury as a more accurate and less stigmatizing word than disorder. Others suggest keeping both terms and using PTSI as a way to acknowledge the trauma a patient has experienced when not all the criteria for a diagnosis of PTSD have been met. The group also discussed the impact of a major change in the DSM-5, in which PTSD now falls under trauma- or stress-related disorders and is no longer considered an anxiety disorder.

CNA senior nurse advisor Lisa Ashley was among those who met with assistant deputy ministers from PS and PHAC. She shared the association’s recommendation for creating professional development programs on PTSI/PTSD for RNs, NPs and other health-care providers. CNA is also requesting that nurses be represented on the federal government’s advisory group on mental health for veterans and in PS’s work on occupational health.

“CNA will ensure nursing is at the federal table and others to advance research and address gaps in access to health and social services in people’s communities,” Ashley says.

Ontario, Manitoba and Alberta have enacted legislation recognizing PTSD as a workplace illness for first responders, including firefighters, paramedics and police officers. However, existing and future legislation needs to be extended to cover nurses and other health-care providers, Ashley says, so they can access prevention and treatment programs.

Research evidence shows that nurses working in emergency departments and critical care, intensive care and neonatal intensive care units are at increased risk of developing PTSI/PTSD. However, there is a lack of data on the nursing workforce as a whole. Ashley says better tracking in all the health professions is needed. In their day-to-day practice, many nurses witness death and injury, see high patient mortality and morbidity, experience ethical dilemmas and workplace violence and work in tension-charged environments. Their risk for PTSI/PTSD further increases when supports are not in place.

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