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Late in 2014, Julie Prince’s life started to unravel.
After a shift at the hospital where she worked as a nurse in the labour and delivery unit, she would spend hours sobbing on the couch, haunted by images of dead babies.
Prince had worked as a nurse since 2002 in neonatal intensive units in seven hospitals in the United States and Ontario, and later in a labour and delivery unit in southwestern Ontario. Only a dozen years into a career she loved, she felt oppressed by the accumulation of death she had witnessed.
“I’ve always loved babies. But going into it, I didn’t realize how sad it would be,” she said.
Julie Prince in Leogane, Haiti, in March 2010 after a devastating earthquake.
By the end of the year, Prince could not even drive past the hospital. She was diagnosed with depression and elements of PTSD a few months later.
Earlier this month, Ontario passed a bill that recognizes PTSD as an occupational illness for Ontario first responders, covering police, paramedics, corrections workers, dispatchers and First Nations emergency response teams.
That adds up to about 73,000 workers.
Who it doesn’t include are the province’s nurses, unlike similar legislatio in Manitoba.
Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, says there are about 140,000 nurses in this province, and they deserve to be covered.
Nurses are exposed not only to the trauma of what they witness, but also to the violence of patients, says Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario.
Nurses are exposed to the traumatic things they witness — suffering, dying patients, massive bleeding, wounds caused by trauma, exposure to horrific infectious diseases.
Grinspun says she was involved during the deadly SARS outbreak of 2003. “I know for a fact that two nurses never went back to work. But the great majority continue to work. Very few just leave. Many are living with chronic PTSD.”
Meanwhile, nurses are also punched, beaten, stabbed and verbally abused by patients.
The Ontario Hospital Association reported more than 6,400 incidents of workplace violence in the province’s hospitals in 2015, said Erna Bujna, a health and safety specialist with the Ontario Nurses’ Association.
Earlier this month, a patient attacked a female registered nurse at the Waypoint Centre for Mental Health Care in Penetanguishene with two screwdrivers taken from a shop in the vocational services area. The nurse suffered a stab wound to the back as well as facial injuries. The nurse manager who tried to intervene sustained puncture wounds and a broken nose, and two other staff members were injured while trying to restrain the patient.
In Ottawa, a registered practical nurse was assaulted in September 2015 in The Royal’s recovery unit at its Carling Avenue campus. Few details have been released, but the hospital said it conducted an immediate debriefing and offered employee assistance to the workers. Three workers at The Royal were beaten in a June 2012 by a male patient being treated for schizophrenia.
And yet, nurses seeking Workers Safety and Insurance Board benefits for PTSD must prove that their condition is related to their workplace. “Nurses should not have to continually relive these horrific and traumatic events to prove entitlement to WSIB benefits,” Bujna told the province’s standing committee on social policy last month.
Bujna believes there are two reasons why nurses are not included in the province’s new PTSD bill. First, WSIB is funded by employers. If hospitals have to pay more, it will end up costing the province.
“In my opinion, the government is trying to control the number of allowed WSIB claims so health care employers won’t have to take responsibility for preventing the illnesses, and (it) keeps their WSIB costs down.”
Related
Second, nursing is a female-dominated profession, and Bujna said she sees sexism in leaving nurses out. “There is just greater attention on male-dominate workplaces.”
In response to an inquiry about why nurses are not included in the legislation, Labour Minister Kevin Flynn’s spokesman, Craig MacBride, said Flynn recently met with nurses on this issue and last year created a Leadership Table on Violence in Healthcare with Minister of Health and Long-Term Care Eric Hoskins.
Bill 163 is “intended to respond to the needs of those who need it most – first responders, including nurses in correctional facilities, who are at least twice as likely to suffer from PTSD because of their work.”
MacBride said all Ontario workers are covered for PTSD through the WSIB. “Bill 163 simply creates a more responsive process for those who are most likely to face traumatic experiences on a regular basis.”
But nurses are asking: If they’re not first responders who face traumatic experiences, then who is?
“There is no question our nurses are also first responders, and in our female-dominated health-care workplaces they experience and witness as much — if not more — traumatic events than the men in the male-dominated workplaces that were covered by this law,” Bujna said.
Nurses are with their patients for 12 hours at a time, especially in ICU settings and sometimes childbirth, Prince said. It leads to a whole other level of bonding and exposure than other first responders, she says.
When Prince heard the nurses were being excluded from the legislation, she wrote a blog that told the poignant story of her descent into crippling depression and anxiety.
She had worked in neonatal intensive units, not only with premature babies weighing only a pound or two, but fragile newborns born with genetic syndromes. Prince came to see her role as going through a journey with these families, building a relationship with the people who were in her unit for as long as eight months.
Julie Prince holding the hand of a baby born at 24 weeks gestation. The little girl, who survived, “just keeps on fighting,” says Prince.
Many babies did not survive. Prince collected mementos for the parents, tiny footprints, boxes containing the baby’s quilt, a tiny knit hat.
“It is a privilege to walk with people through death,” she said.
When a baby is withdrawn from life support, it’s the nurse who hands over the baby to the parents to be held for the last time, Prince said. It’s the nurse who takes the baby back from the parents and brings the baby to the morgue and lays its body wrapped in blankets on a cold metal shelf. Sometimes, the family decides not to be there when a baby is taken off life-support.
And while people associate the maternity ward with happy moments, Prince found that working in labour and delivery brought “a whole other level of intensity and stress.” There were miscarriages and difficult births. She coached women to deliver babies that had died in utero.
“I want people to recognize what nurses do on a daily basis and the repeated traumas and sorrow that they are exposed to,” said Prince. “I want the government to acknowledge that the risk of trauma exposure and PTSD is clearly there, and when nurses do need the assistance, for it to be available.”
Prince could feel herself getting burned out. By mid-December 2014, she said, she was plagued by overwhelming grief and anxiety. “I didn’t want to take care of anyone anymore.”
PTSD was never mentioned as a risk for nurses while she was in nursing school. Debriefing has been studied as a valuable tool to help defuse stress. Fellow nurses know when a colleague has had traumatic or sorrowful day. But “there is literally no time to debrief,” Prince said.
“Somehow we have to establish a culture among nurses that encourages this and that makes room for this. We need administration in hospitals to recognize what their nurses face on a daily basis. We need them to prioritize the mental health of their own.”
Prince doesn’t regret a moment of her nursing career. “Every loss has been a deep, deep privilege.”
She now works with a Community Care Access Centre as a nursing care co-ordinator. Her PTSD treatment has been successful, but it was hard work, she said. Part of that was the “exposure therapy” of returning to the hospital. I took her more than a year to return to the childbirth unit to hand in her badge.
“My colleagues had no clue,” she said.
jlaucius@postmedia.com
查看原文...
After a shift at the hospital where she worked as a nurse in the labour and delivery unit, she would spend hours sobbing on the couch, haunted by images of dead babies.
Prince had worked as a nurse since 2002 in neonatal intensive units in seven hospitals in the United States and Ontario, and later in a labour and delivery unit in southwestern Ontario. Only a dozen years into a career she loved, she felt oppressed by the accumulation of death she had witnessed.
“I’ve always loved babies. But going into it, I didn’t realize how sad it would be,” she said.
Julie Prince in Leogane, Haiti, in March 2010 after a devastating earthquake.
By the end of the year, Prince could not even drive past the hospital. She was diagnosed with depression and elements of PTSD a few months later.
Earlier this month, Ontario passed a bill that recognizes PTSD as an occupational illness for Ontario first responders, covering police, paramedics, corrections workers, dispatchers and First Nations emergency response teams.
That adds up to about 73,000 workers.
Who it doesn’t include are the province’s nurses, unlike similar legislatio in Manitoba.
Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, says there are about 140,000 nurses in this province, and they deserve to be covered.
Nurses are exposed not only to the trauma of what they witness, but also to the violence of patients, says Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario.
Nurses are exposed to the traumatic things they witness — suffering, dying patients, massive bleeding, wounds caused by trauma, exposure to horrific infectious diseases.
Grinspun says she was involved during the deadly SARS outbreak of 2003. “I know for a fact that two nurses never went back to work. But the great majority continue to work. Very few just leave. Many are living with chronic PTSD.”
Meanwhile, nurses are also punched, beaten, stabbed and verbally abused by patients.
The Ontario Hospital Association reported more than 6,400 incidents of workplace violence in the province’s hospitals in 2015, said Erna Bujna, a health and safety specialist with the Ontario Nurses’ Association.
Earlier this month, a patient attacked a female registered nurse at the Waypoint Centre for Mental Health Care in Penetanguishene with two screwdrivers taken from a shop in the vocational services area. The nurse suffered a stab wound to the back as well as facial injuries. The nurse manager who tried to intervene sustained puncture wounds and a broken nose, and two other staff members were injured while trying to restrain the patient.
In Ottawa, a registered practical nurse was assaulted in September 2015 in The Royal’s recovery unit at its Carling Avenue campus. Few details have been released, but the hospital said it conducted an immediate debriefing and offered employee assistance to the workers. Three workers at The Royal were beaten in a June 2012 by a male patient being treated for schizophrenia.
And yet, nurses seeking Workers Safety and Insurance Board benefits for PTSD must prove that their condition is related to their workplace. “Nurses should not have to continually relive these horrific and traumatic events to prove entitlement to WSIB benefits,” Bujna told the province’s standing committee on social policy last month.
Bujna believes there are two reasons why nurses are not included in the province’s new PTSD bill. First, WSIB is funded by employers. If hospitals have to pay more, it will end up costing the province.
“In my opinion, the government is trying to control the number of allowed WSIB claims so health care employers won’t have to take responsibility for preventing the illnesses, and (it) keeps their WSIB costs down.”
Related
Second, nursing is a female-dominated profession, and Bujna said she sees sexism in leaving nurses out. “There is just greater attention on male-dominate workplaces.”
In response to an inquiry about why nurses are not included in the legislation, Labour Minister Kevin Flynn’s spokesman, Craig MacBride, said Flynn recently met with nurses on this issue and last year created a Leadership Table on Violence in Healthcare with Minister of Health and Long-Term Care Eric Hoskins.
Bill 163 is “intended to respond to the needs of those who need it most – first responders, including nurses in correctional facilities, who are at least twice as likely to suffer from PTSD because of their work.”
MacBride said all Ontario workers are covered for PTSD through the WSIB. “Bill 163 simply creates a more responsive process for those who are most likely to face traumatic experiences on a regular basis.”
But nurses are asking: If they’re not first responders who face traumatic experiences, then who is?
“There is no question our nurses are also first responders, and in our female-dominated health-care workplaces they experience and witness as much — if not more — traumatic events than the men in the male-dominated workplaces that were covered by this law,” Bujna said.
Nurses are with their patients for 12 hours at a time, especially in ICU settings and sometimes childbirth, Prince said. It leads to a whole other level of bonding and exposure than other first responders, she says.
When Prince heard the nurses were being excluded from the legislation, she wrote a blog that told the poignant story of her descent into crippling depression and anxiety.
She had worked in neonatal intensive units, not only with premature babies weighing only a pound or two, but fragile newborns born with genetic syndromes. Prince came to see her role as going through a journey with these families, building a relationship with the people who were in her unit for as long as eight months.
Julie Prince holding the hand of a baby born at 24 weeks gestation. The little girl, who survived, “just keeps on fighting,” says Prince.
Many babies did not survive. Prince collected mementos for the parents, tiny footprints, boxes containing the baby’s quilt, a tiny knit hat.
“It is a privilege to walk with people through death,” she said.
When a baby is withdrawn from life support, it’s the nurse who hands over the baby to the parents to be held for the last time, Prince said. It’s the nurse who takes the baby back from the parents and brings the baby to the morgue and lays its body wrapped in blankets on a cold metal shelf. Sometimes, the family decides not to be there when a baby is taken off life-support.
And while people associate the maternity ward with happy moments, Prince found that working in labour and delivery brought “a whole other level of intensity and stress.” There were miscarriages and difficult births. She coached women to deliver babies that had died in utero.
“I want people to recognize what nurses do on a daily basis and the repeated traumas and sorrow that they are exposed to,” said Prince. “I want the government to acknowledge that the risk of trauma exposure and PTSD is clearly there, and when nurses do need the assistance, for it to be available.”
Prince could feel herself getting burned out. By mid-December 2014, she said, she was plagued by overwhelming grief and anxiety. “I didn’t want to take care of anyone anymore.”
PTSD was never mentioned as a risk for nurses while she was in nursing school. Debriefing has been studied as a valuable tool to help defuse stress. Fellow nurses know when a colleague has had traumatic or sorrowful day. But “there is literally no time to debrief,” Prince said.
“Somehow we have to establish a culture among nurses that encourages this and that makes room for this. We need administration in hospitals to recognize what their nurses face on a daily basis. We need them to prioritize the mental health of their own.”
Prince doesn’t regret a moment of her nursing career. “Every loss has been a deep, deep privilege.”
She now works with a Community Care Access Centre as a nursing care co-ordinator. Her PTSD treatment has been successful, but it was hard work, she said. Part of that was the “exposure therapy” of returning to the hospital. I took her more than a year to return to the childbirth unit to hand in her badge.
“My colleagues had no clue,” she said.
jlaucius@postmedia.com
查看原文...
