PTSD in Nurses: Overview and FAQ

PTSD in nurses impacts job turnover, patient safety, and the overall well-being of the nursing workforce. Why might nurses be at an increased risk for PTSD, and how can you spot it in coworkers and yourself?

PTSD, or post-traumatic stress disorder, is a condition that can develop after someone experiences traumatic events. It’s commonly associated with combat veterans and firefighters. But due to their exposure to life-or-death situations, human suffering, and workplace violence, nursing staff are at risk as well. Nearly 42% of nurses report witnessing or experiencing an extremely traumatic event in their career.

In the general population, about 6.8% of people will develop PTSD in their lifetime. What’s the prevalence of PTSD in nurses? During the height of the COVID-19 pandemic, a sample of over 40,000 nurses revealed that 29.1% had symptoms of PTSD. Other studies reveal that up to 95.7% of nurses experience at least one symptom of the disorder, and that 17.1% of nurses may have been diagnosed.

The Impact of PTSD on Nurses

Alongside nurse burnout and moral injury, PTSD contributes to nurses leaving the bedside and the profession as a whole. The consequences go beyond individual distress — PTSD can also affect the entire healthcare system.

For an individual nurse, PTSD symptoms can make it harder to perform daily tasks. Nurses may feel detached from patients and coworkers, eroding the sense of connection that drew many to nursing in the first place. Over time, nurses may experience compassion fatigue, strained personal relationships, and serious health problems like depression, anxiety, and substance dependency.

PTSD has been linked to the desire to quit, as well as issues with concentration and cognitive ability. Nurses with PTSD are more likely to experience medication errors and sentinel events — putting both patient safety and professional licensure at risk. This creates a dangerous cycle: PTSD symptoms may make it more likely to commit an error, increasing shame and self-doubt.

At the system level, PTSD contributes to higher turnover rates, staffing shortages, and increased recruitment and training costs for hospitals and health systems. PTSD is not just a personal struggle for nurses, but also one that ripples out to affect patients, other staff, and the healthcare system as a whole.

Risks and Symptoms of PTSD in Nurses

Certain environmental and personal factors can increase a nurse’s chances of developing PTSD, and some may be more predisposed to it than others. During the COVID-19 pandemic, a large review synthesized results about PTSD in nurses. Factors that increase the risk of developing PTSD as a nurse include the following:

• Intensive workloads
• Lack of access to personal protective equipment
• High exposure to COVID-19 patients
• Female gender
• History of prior mental health diagnoses
• Working in certain specialties, such as pediatrics, intensive care, and hematology/oncology
• Exposure to moral injury may contribute

What symptoms should you look out for in yourself and others? Most people associate PTSD with flashbacks with PTSD, but many symptoms are subtractive, characterized by a loss of functioning. These can be more difficult to spot in yourself and others.

PTSD symptoms are grouped into four categories:

1. Reexperiencing the trauma: Involuntary memories, flashbacks, or nightmares, often triggered by tactile associations such as smells or noises. Reexperiences may come with somatic symptoms such as muscle tension, sweating, and increased heart rate. It’s normal to relive a traumatic event in the immediate aftermath, but when these events last longer than three months, this may indicate PTSD.
2. Avoidance: Wishing to stay away from certain patients, or avoid thoughts of the event through substance use.
3. Problems with mood and cognition: Trouble concentrating, moodiness, distorted feelings of blame, and loss of interest in activities that used to bring joy. Some nurses feel that they have been permanently altered by trauma, feeling detached and estranged from themselves and others.
4. Changes in reactivity: Being in an unnecessary state of fight, flight, or heightened emotions, with signs such as hypervigilance, anger, irritability, being easily startled, and difficulty sleeping.

Can You Protect Yourself from PTSD in Nursing?

PTSD isn’t linear — most people who experience trauma are not afflicted by it in the long term. A mix of individual resilience, workplace culture, and available resources determines whether trauma develops into PTSD. Here are some of the protective factors:

• Job satisfaction: Nurses who feel supported, valued, and engaged in their roles may be less likely to develop PTSD symptoms.
• Peer and team support: Having colleagues and loved ones who listen and validate can reduce isolation after traumatic events.
• Access to mental health resources: Early counseling, debriefings, and Employee Assistance Programs (EAPs) can help prevent trauma from becoming entrenched.
• Healthy coping strategies: Nurses who rely on mindfulness, exercise, journaling, or spiritual practices have better outcomes than those who rely on avoidance, substances, or unhealthy habits.
• Training and preparation: Nurses who are educated about the impact of workplace trauma are more capable of responding when it happens to themselves or others.

Nurses may not be able to shield themselves from trauma fully, but building personal resilience and advocating for supportive work environments may help. Protecting nurses’ mental health must happen on the individual and system levels.

What to Do If You or a Peer Are Exhibiting Signs of PTSD

Where can you get help for nurses with PTSD? If you notice symptoms, taking action early can make a significant difference.

1. Acknowledge and normalize the experience. Experiencing trauma as a nurse is common, and seeking help is a sign of strength, not weakness. Avoid minimizing the distress.

2. Seek professional support. Licensed mental health professionals can diagnose PTSD and provide evidence-based treatments such as cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), or trauma-focused counseling.

3. Use peer and workplace resources. Many healthcare facilities offer EAPs, mental health hotlines, or peer support groups specifically for nurses. Programs like the American Nurses Association’s Healthy Nurse, Healthy Nation (HNHN) initiative provide resources for coping with stress, trauma, and burnout.

4. Use support networks:

1. • The National Center for PTSD offers information, coping strategies, and provider directories.
   • The SAMHSA National Helpline (1-800-662-HELP) provides 24/7 confidential support and treatment referrals.
   • The American Psychiatric Nurses Association (APNA) offers educational resources, peer networking, and wellness support for nurses.

5. Consider a job change or a break. If your workplace continues to expose you to trauma or you feel unsupported at work, it may be time to explore other options. There are many ways to be a nurse.

PTSD and Nursing: FAQ

Can you be a nurse with PTSD?

Yes, nurses can work while having a mental health diagnosis, and there is no requirement to disclose this during job interviews. One study found that one in five healthcare workers takes psychotropic medication.

Can I get PTSD disability as a nurse?

PTSD disability benefits will depend on your situation, but depending on the severity, you may be able to use benefits under the Federal Medical Leave Act (FMLA). See your unit manager or human resources representative for more information.

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