New Jersey Nurse - April 2021

Page 12 New Jersey Nurse & Institute for Nursing Newsletter April 2021
Trauma, COVID-19 and Collective Resilience
A Way Forward for Nursing
“It was bad, really bad. Traumatizing. I didn’t recognize
my ED. Beds and equipment were everywhere. The
noise never stops, alarms, ventilators. I was in a war
zone.”
Like the fiercely precipitous arrival of COVID-19, stress
and trauma have disrupted our lives and practices. The
consequences may be invisible yet toxic, in different ways.
Although stress is alleviated once a stressor is removed,
trauma lingers on after we are exposed or witness actual
or threatened death or serious injury (APA, 2013).
War, assault, death, and mass casualties are traumatic
events. Throughout the pandemic nurses have struggled Donna Gaffney
with some if not all types of trauma; alien landscapes,
hazardous responsibilities, and witnessing deaths in unprecedented numbers.
Unlike stressors, traumatic events precipitate a cascade of physical and
emotional responses, lasting well after the event ends. These reactions are
normal in the aftermath of trauma, and can vary, depending on the situation, life
experiences, and coping skills. Memories of traumatic events, both durable and
accurate, are accompanied by physiological arousal affecting sleep, concentration
and day-to-day activities. Nurses working in the most harrowing COVID settings
are likely to have traumatic memories, at least for a while. When such memories
cause long term distress, posttraumatic stress disorder is a possibility.
Previous traumas can contribute to new symptoms. When nurses bear witness
to critically ill patients and overwhelming clinical settings, it takes a toll, no matter
how well prepared they are. Nurses in many practice environments, not only ICU
or emergency departments, have been impacted by this public health crisis. A new
study by the International Council of Nurses (2021) found that almost 80% of their
affiliate associations reported that nurses working during the COVID-19 response
experience mental distress. The pandemic has triggered collective trauma within
the entire nursing profession.
Collective trauma refers to traumatic events that affect an entire community,
society, or profession, and we’ve seen it before. In the early months after 9/11,
researchers emphasized the potential for resilience: “When the trauma happens
on this large of a scale, it is an opportunity to capitalize on the collective grief and
trauma that we all feel, and destigmatize it. . . . I believe in our ability to cope. I
believe in resilience.” (Yehuda, Korn, 2001). Today nursing colleagues are coming
together from many settings. There is a path to healing.
“I’m in awe of my coworkers. We have each other's backs. I’ve never felt closer.”
Hirschberger describes healing that “begins with a collective trauma,
transforms into a collective memory, and culminates in a system of meaning that
allows groups to redefine who they are and where they are going.” (p.1, 2018).
Resilience is the capacity to overcome adversity, not only bouncing back, but
moving forward. It is forged over time, in community. Humans are relational
beings; our interdependence on each other is indispensable for well-being and
resilience. Collective resilience is fostered by shared beliefs—making meaning of
the pandemic and its challenges. It’s possible to gain a positive, hopeful outlook,
rising above distress and hardship by redefining values and transforming priorities
and purpose, and deeper bonds (Walsh, 2020).
Communal coping occurs in the face of shared trauma, by linking emotional
connection and collaborative problem solving. Nurses are describing meaningful
interactions with their colleagues— expressions of gratitude, offering help, physical
and emotional presence. New research confirms the effectiveness of these “rich,
reciprocal, and attuned experiences of emotional connection” (Bender, 2021).
Nurses also share their sadness, frustration, and grief. There is even a place for
humor and light-heartedness in these emotionally connecting activities—posting
memes, group competitions, and music playlists (Bender, 2021).
Resilience can be strengthened in unique ways. Getting involved, through
advocacy or activism, contributes to the profession and the community. Yet
there is an even greater benefit—taking action is a potential antidote to vicarious
trauma. Writing and sharing stories of one’s challenges also empowers and heals
(Pennebaker & Smyth, 2016; DeSalvo, 2000).
Coping with trauma and stress means taking time to learn effective strategies
that promote well-being and healing. It also means sharing those strategies with
each other. Building collective resilience can be the way forward.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). Arlington, VA: Author.
Bender, A., Berg, K., Miller, E. et al. (2021). Making sure we are all okay: Healthcare
workers’ strategies for emotional connectedness during the COVID-19 pandemic.
Clinical Social Work Journal.
DeSalvo, L. 2000. Writing as a way of healing. Boston: Beacon Press.
Hirschberger G (2018) Collective trauma and the social construction of meaning. Front
Psychol. 9:1441.
International Council of Nurses. (2021, January 13). The COVID-19 Effect: World’s nurses
facing mass trauma, an immediate danger to the profession and future of our health
systems. Geneva: Author.
Korn, M. (2001). Posttraumatic stress disorder—an interview with Rachel Yehuda, Ph.D.
Med Gen Med, 3, (4).
Pennebaker, J.W. & Smyth, J.M. (2016). Opening up by writing it down. NY: Guilford
Press.
Walsh, F. (2020). Loss and resilience in the time of COVID-19: Meaning making, hope,
and transcendence. Family Process, 59(3), 898-911.
BIO
Donna Gaffney, DNSc, PMHCNS-BC, APRN, FAAN, is collaborating with
nonprofits and universities during the pandemic. She created the webinar series
Healing Ourselves While Healing Others, for Rutgers University and adapted it for
Northeastern University School Health Academy. Donna offers prop-bono therapy
through the Emotional PPE Project, and is a facilitator for the New Jersey Nursing
Initiative’s Virtual Schwartz Rounds.