Hard job, huge toll

Depression rate among nurses twice the national average, studies show.
Photo illustration by Shutterstock
Story by Jamie Lampros
(Standard-Examiner correspondent)
Mon, Aug 6, 2012
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Nearly one in five hospital nurses is fighting depression — and that’s becoming a concern for their employers.

According to a University of North Carolina study, nurses suffer from depression at twice the rate of the national population.

The study, funded by the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative, and published in the May/June issue of Clinical Nurse Specialist, also looked at how nurses’ depression might affect the quality of care they provide patients.

More than 70 percent of nurses surveyed reported working with some pain or health problem that negatively affected their productivity in the previous two weeks.

Nurses also reported having difficulty concentrating and being accident-prone.

“High-stress environments are likely to contribute to more health problems for nurses, including mental health issues,” said Susan Letvak, one of the study’s lead authors. “Mental health issues are less likely to be disclosed to employers than physical problems.”

Dr. Brent Blaisdell, an employee assistance program manager for Intermountain Healthcare, said many of the nurses he knows put so much effort into helping and treating others that sometimes they neglect their own self-care — which can often lead to emotional difficulties such as depression.

“We are lucky to have an amazing core of very hard-working, intelligent and caring nurses in our community,” he said. “However, just as in other communities around the nation, our nurses are involved in a very demanding career that can place a lot of stress and strain on a nurse’s mental, emotional and physical capabilities.”

Depression often affects a person in three ways, Blaisdell said: emotionally, mentally and physically.

Therefore, someone struggling with depression may be more prone to physical pains and negative emotions while on the job.

According to the study, working while depressed can lead to medication errors and patient falls.

Helping each other

“Our career field is full of life and death issues and, indeed, these issues create a high-stress environment,” said Leslie A. Christiansen, emergency department director and registered nurse at Davis Hospital and Medical Center. “Yet one can safely say that a majority have outlets that help them deal with these in a positive manner — mine is chocolate — or what we would have is a mass exodus from our profession.”

Christiansen said her firm belief is that nurses have a shared bond with peers, and with that bond comes a responsibility to be keenly aware when those peers struggle.

“And it becomes incumbent upon each of us to help each other,” she said. “Due to personality differences, there will always be those that seek assistance through medication to help them with these issues, but my professional observation is that we have a small population that are dealing with more than depression connected with their profession. Any type of health issue, including depression, not handled appropriately will always have a negative impact on a person’s life.”

‘Compassion fatigue’

Elizabeth Later, chief nursing officer at Ogden Regional Medical Center, said one of the biggest factors for depression in nurses is a concept called “compassion fatigue,” in which caregivers experience the trauma of others and internalize it.

If not dealt with, she said, it can lead to burnout and depression.

In addition, the increasing demands of sicker patients in hospitals can be overwhelming if the nurse doesn’t have the professional and personal resources to deal with the workload and the issues he/she encounters.

“Nurses who have not been able to find work/life balance or are struggling with compassion fatigue are unable to reach inside and find the strength they need to help others navigate through difficult times,” Later said. “They often lack empathy and are unable to adequately organize and deliver care because they’re distracted by their own issues.”

The study concluded that it is important to devote more attention to depression screening for nurses, as well as early treatment.

All three local experts said they have social workers on hand to help nurses deal with stress.

They also reported having debriefings after difficult situations involving patients, and training nurses to recognize the signs of depression.

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