Nursing Our Healer’s Heart
By Lorre Laws, PhD RN (www.iff-books.com)
A Recovery Guide for Nurse Trauma & Burnout
Nurse-Specific Traumatization: The Silent Epidemic
In the demanding field of healthcare, nurses play a crucial role in providing patient care. However, many nurses are experiencing trauma and burnout that are unique to their profession. This nurse-specific traumatization is often a result of avoidable exposures secondary to inadequacies within the healthcare system and organizations. Unfortunately, these traumatic experiences are frequently misdiagnosed as burnout or compassion fatigue, leading to a silent epidemic that is driving nurses worldwide away from their profession.
The mass exodus of nurses from their profession represents a public health crisis. By the end of 2030, the world will have just half the number of nurses it needs. Those who stay in the profession are often pushed to their breaking point, leading to severe burnout, compassion fatigue, injuries, and issues with absenteeism and presenteeism.
After conducting five years of research across four disciplines, Dr. Lorre Laws, a nurse scientist and trauma-burnout expert, authored Nursing Our Healer’s Heart: A Recovery Guide for Nurse Trauma & Burnout. Intended to meet nurses in their living spaces with compassion, guidance, and a roadmap for healing, Dr. Lorre addresses individual and nurses-specific traumas. Nurses, by virtue of being human, have endured individual traumas such as acute, chronic, complex, developmental, and neglect. The unhealed or unintegrated traumas that every human carries within accompanies them to the workplace. Nurses are no exception.
Yet nurses, like other first responders, are among the high-risk professions for trauma exposures. Unlike other professions, 86% of nurses report have few to no resources to help them navigate work-related traumas such as secondary/vicarious trauma, legacies of historical oppressions and traumas, workplace violence (physical, verbal, emotional, gaslighting, bullying, hazing, extortion, and coercion), insufficient resource traumas (short staffing, inadequate supplies, etc.), system-induced traumas, and traumas from disasters.
Many of these exposures are avoidable nurse-specific traumas that are secondary to any number of healthcare systems or organizational inadequacies. Nurses do not feel safe, heard, valued, or supported in their roles. They are making their voices heard by tendering resignation notices worldwide. Recruiting and training new nurse replacements is not the answer, for they too will be traumatized. Needed is an actionable framework to guide nurses in insulating their nervous systems from the effects of the nurse-specific traumas they experience every day in their professional roles. Given that 83% of nurses report burnout, 91% report having one or more PTSD symptoms, and nearly 25% of nurses meeting the diagnostic criteria for PTSD, solutions are urgently needed.
Dr. Lorre Laws has developed a four-step evidence-based process, the Your Innate Care Plan (YICP), to guide individual nurses and the global nursing community in their healing journey. Central to the YICP is Dr. Stephen Porges’ Polyvagal Theory, which provides guidance regarding the importance of learning the language of one’s nervous system, vagus nerve, and unintegrated traumas that are stored in the body.
The YICP, simply stated is this: 3As plus B leads to 3Rs
The initial 3As are foundational to trauma-informed wellbeing. Traditional self-caring activities are not trauma-informed and do not consider the impact of unintegrated trauma, triggers, or nervous system dysregulation. Unless a self-caring practice is built upon a strong nervous system that is regulated in its Window of Tolerance, the self-care practice comes toppling down like a house of cards. To ensure that a strong nervous system underpins all self-caring activities, the YICP starts with these 3As:
The first A is Awareness of one’s inner landscape as the mindful observer, honing the ability to observe but not become the traumatic event or symptom. The second A is Attending, which describes how a nurse can nurture and nourish their nervous system, even on the busiest and most challenging of days. Nursing Our Healer’s Heart offers over 100 practices from which nurses create their own unique care plan that aligns with their unique lived experiences and leverages their own innate capacity for healing. Lastly, the third A of Alignment examines incongruencies and dissonances between the nurses’ inner and outer worlds and brings them into harmony that aligns with their values, goals, and purpose.
From that inner and strong foundation, traditional self-caring practices are added in the fourth step, B for Balance. This last step is the most familiar as it highlights the importance of traditional self-care practices such as personal responsibility, physical and mental wellbeing, relational health, environmental and contextual health, financial wellness, relaxing and recharging, and living in alignment with one’s beliefs, values, and purpose.
The 3Rs of Regulation, Restoration, and Reconnection represent the YICP outcomes. The first R of Regulation reflects how nurses are now regulated in their nervous system and thriving in its Window of Tolerance. The second R of Restoration speaks to restoring the nurses’ Healer’s Heart – their why for that which matters most to them, including why they chose the nursing profession. Lastly, the third R of Reconnection describes the inner healing and sense of connection within and then with others.
Once the nurse is proficient in applying YICP for the various nervous system circuits and hybrids, they learn about collective conditioning that is expressed through various archetypes and resistance patterns. The Archetypes, described as the longstanding collective nervous system adaptations and unintegrated traumas that are unknowingly transmitted and embedded within the structures and systems that form the tapestry of daily lives, are introduced. The archetypes are: The Volcano, The Over Worker, The Controller, The Distractor, The Deferrer, The Projector, The Pleaser, The Forsaker, and The Ostrich.
Using archetypes aids the reader in understanding their colleagues’ behaviors through the compassionate, trauma-informed lens of “what happened to you?” versus a judgmental “what’s wrong with you!” one. An archetypal mixology is presented to guide nurses to see which of their colleagues’ circuits and hybrids may be online in times of stress and strife along with supportive strategies to use.
Just as the archetypes are collective conditioning, so are the resistance patterns that we unknowingly use to deal with their emergence: The Hamster Wheel, The Brick Wall, and The Break Down. These resistance patterns are aligned with fight, flight, and freeze responses.
Importantly, nurses are provided a Trinity of Integrative Nursing Principles to guide change and trauma-informed safety and support for nurses and those in their care. These principles can be used as a launching point for challenging conversations and needed policy changes that ensure that nurses are safe and professionally well in their occupational roles. It is a well-established fact that when nurses are safe, well, and thriving that it contributes to improved patient safety, outcomes, care quality, and the organization’s financial wellbeing.
By working from their healing scars rather than their gaping wounds, nurses can come together to usher in a new era of nursing; Nursing 2.0 The Nurse Safety and Professional Wellbeing Edition.
Nursing Our Healer’s Heart is a gentle exploration of nurse-specific traumatization, which affects 96% of nurses, along with an actionable recovery plan for nurses to heal together as they begin to thrive instead of just survive in their practices.
Nursing Our Healer’s Heart by Lorre Laws, PhD RN is available from www.iff-books.com and from wherever books are sold.