Final PTSD Paper

Post-Traumatic Stress Disorder: Law Enforcement Rebecca Brooks NUR 114 AB- Tech Community CollegeUnderstanding PTSD Exposure to traumatic events can pose a threat to police forces as they are on the front line of defense in the civilian world. A study supported by the National Institute for Occupational Safety and Health determined the symptoms of PTSD found in the frequency, recency, and type of police specific traumatic events (Hartley, 2016). While reviewing the data from this study, I learned that of the 359 police offers to participate in this study, woman tended to show an increased PTSD score in relation to increased frequency of specific events (examples such as public shooting or aggression shown from domestic violence) (Hartley, 2016). Men on the other hand developed a high PTSD score relating to exposure to dealing with assaulted victims. These data sets are important for understanding how this profession is coping with their line of work and will also help to better treat their symptoms (Hartley, 2016). While reading statements from officers working in this field, many believe these symptoms are a part of the job instead of a medical disorder that they can find treatment for. This tells me that there is a large population, not only in the law enforcement field, that could benefit from PTSD treatment and education.An important thing to remember when interacting and treating patients experiencing PTSD, is that their “fight or flight” response is heightened (Veterans, 2018). This response system initiated by the body is its way of responding to a situation that could put the individual in danger. This is important to remember because these patients may act in an aggressive behavior and threaten the safety of themselves and those providing medical attention. To make our patients feel as if they can trust us, we need to monitor our nonverbal communication and body language before we begin any assessments. Nurses should remember to position their bodies in a neutral position and refrain from pointing or using hand gestures (Veterans, 2018). The most difficult aspect of nonverbal communication may be facial expressions. It is important that all members of the medical team remember to stay professional in order to avoid miscommunication. The nurse should always make an effort to explain and describe all actions and movements when in the room with a PTSD patient (Veterans, 2018). By doing this the client feels less threatened and relaxed which will make assessments and procedures more tolerable for them. One must inform the patient that as the nurse your job is to provide a safe environment for them and to help their situation. Since members of the police force have been trained to protect and prevent harm, they will suspect those who encounter them of trying to jeopardize that safety. This population of people will be on edge and more worried about being in a safe environment than seeking medical attention. A nurse could assess for PTSD in a patient by using the Symptom Scale Interview. Each assessment includes 17 questions and the interviewer cannot probe for answers. These questions take approximately 20 minuets to administer and the presence/ severity of the symptoms over the previous two weeks are assessed (Exposure, 2018). Another assessment that can be given is treatment- outcome posttraumatic stress disorder scale. This assessment is an eight item interview based questionnaire that gathers information regarding re-experience, avoidance, numbing and hyperarousal (Exposure, 2018). It is important to assess anxiety levels and develop a therapeutic relationship.The United States Department of Veterans Affairs published an article on PTSD which included strategies for nurses to educate and instruct patients on how to manage their symptoms. One example is the grounding technique, also called increasing situational awareness (Veteran, 2018). This technique can be useful in addressing flashbacks and reflections on the traumatic event experienced by the patient. Grounding may be helpful for a client to reflect more on the event that took place instead of focusing on the emotions they were feeling. A way to execute this therapy would be to have the police officer keep a journal of memories, not how they felt, but to document the situation. This will help to differentiate the reality of the situation from the emotional connections that were made as a result.The University of Texas at Austin completed a study and found that exposure therapy was success with their patients. This type of therapy is thought to be the most successful at reducing anxiety by helping individuals gradually confront their trauma related thoughts (UTAustin, 2019). The Clinical Practice Guideline for the treatment of posttraumatic stress disorder stated that this type of therapy is used to break a pattern of fear or avoidance (Exposure, 2018). By either visualizing or being face to face with the traumatic situation, the patient will be able to address their emotions and reduce feelings of fear. In combination with relaxation techniques taught by the nurse, the patient could better cope with the emotions being felt from this type of therapy. There are three FDA regulated drugs used to treat PTSD and they are selective serotonin reuptake inhibitors (SSRIs) (Alexander, 2017). The importance of this type of medication is to inhibit or hinder the body from removing serotonin, a chemical that regulates mood, sleep, anxiety and appetite (Alexander, 2017). There are side effects that the patient needs to be educated on such as weight loss, sexual disfunction, insomnia, and others (The, 2019). All FDA regulated medications are required to have black box warnings, indicating the increased risk for suicidal thoughts (The, 2019). This does not indicate that the drug is unsafe, but that the patient prescribed should be monitored for unusual behavior. The police suicide epidemic has increased so drastically over the years that President Donald Trump signed a bill for $7.5 million to fund police suicide prevention (Sisak, 2019). These efforts included mental health screenings and training to identify officers at risk. According to a Massachusetts nonprofit organization known as Blue Help, there were at least 122 law enforcement suicides in the United States in 2019 (Sisak, 2019).Finally, it is always beneficial for the individual who is experiencing PTSD to have a safe environment were others can understand and empathize with their emotions. It is important for communities to educate themselves to be better equipped to engage with these people. A great place to start is at the hospital; In-services could be held to teach communication mechanizes which would decrease the stress levels of PTSD patients and increase their comfort levels. Patience is needed when socializing or treating a patient with posttraumatic stress disorder because there is not a “quick fix” and all patients will experience the disorder differently. It is important to remind the client that treatment is supposed to benefit them and that they are in a safe environment. As a nurse or member of a medical team, it is crucial to know the signs and symptoms of someone experiencing PTSD in order to properly assess and treat them. Some signs and symptoms include fatigue, insomnia, breathing difficulties, anti-social acts, emotional outburst and increased alcoholism. Education of PTSD and early signs should be taught in police force training to teach those working in the field of the potential threat and options to treat it. ReferencesAlexander, W. (2017, January). Pharmacotherapy for Post-traumatic Stress Disorder In Combat Veterans: Focus on Antidepressants and Atypical Antipsychotic Agents. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278188/Exposure Therapy in PTSD. (2018). Retrieved from https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapyHartley, T. A., Violanti, J. M., Sarkisian, K., Andrew, M. E., & Burchfiel, C. M. (2016, February). PTSD symptoms among police officers: associations with frequency, recency, and types of traumatic events. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734407/.Sisak, M., & Mustian, J. (2019, August 15). Police departments confront ‘epidemic’ in officer suicides. Retrieved from https://www.pbs.org/newshour/nation/police-departments-confront-epidemic-in-officer-suicidesThe most commonly prescribed type of antidepressant. (2019, September 17). Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825UTAustin. (2019, March 18). New research identifies potential PTSD treatment improvement. Retrieved from https://www.eurekalert.org/pub_releases/2019-03/uota-nri031819.phpVA.gov: Veterans Affairs. (2018, September 26). Retrieved from https://www.ptsd.va.gov/professional/treat/care/toolkits/police/managingStrategies.aspv

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