Post Traumatic Stress Disorder PTSD

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Post Traumatic Stress Disorder (PTSD)

• Positive Interactions With Veterans with PTSD

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Purpose for Educational Teaching Unit

• This educational instruction unit will
• Become a basic class offered during the
  orientation of all new employees.
• Also be included in the competencies that all
  employees who interact with veterans with PTSD
  will be required to renew yearly.
• Enhance the current staff communication skills
  needed in successful interactions with veterans
  with PTSD.
• Improve interaction with and cooperation from
  veterans who have PTSD.

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Objectives of Teaching Unit

• To define PTSD.
• To identify potential causes for poor
  interactions and communication to develop between
  staff members and veterans with PTSD.
• Present an opportunity for role-playing between
  staff members to facilitate effective
  communication between staff members and the
  veteran with PTSD.
• To encourage behaviors on the part of the staff
  members which will be reflected in positive
  interactions between staff members and veterans
  with PTSD.

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Incidence of PTSD

• PTSD is experienced by 9 of the general
  population.
• The veteran population has a much greater chance
  of experiencing PTSD.
• At least 30 of the still living veterans who
  served in Vietnam are diagnosed with
  PTSD.(Dieperink et al., 2005)

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Causes for PTSD

• An experience of violence.
• Experiencing traumatic events such as death of
  another, serious physical harms, or the threat of
  either.
• Experiencing feelings of intense fear,
  helplessness, or horror.
• Man-made disasters such as a bombing.
• Natural disasters such as a hurricane.

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Reactions to stress

• Feelings of stress after trauma are normal.
• With PTSD, symptoms are more severe and last
  longer and can affect relationships, employment,
  and other parts of life.

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Trauma Exposure

• Associated with
• Dysregulation of the neuroendocrine,
  neurotransmitter, and autonomic and central
  nervous systems, which can cause considerable
  harm to health.
• Common responses of avoidance symptomatology of
  PTSD reduce the chance that people affected will
  seek medical help.
• Those with PTSD may also have restricted social
  networks and social isolation (Lee, 1997).

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Symptoms of PTSD

• The emotional numbing symptoms of PTSD lead to
  withdrawal and difficulties in expressing emotion
  (Riggs, Byrne, Weathers, Litz, 1998).
• Veterans with PTSD will leave a facility without
  treatment, rather than to have confrontational
  interactions where they feel neglected and
  uncared about.
• A veteran with PTSD may find it very difficult to
  leave his or her home to come to an appointment.
  
• The person with PTSD is intuitive, quick to
  react, and will often have severe amounts of
  anxiety about all things and has little resource
  to deal with stressors of any nature.
• Patients with PTSD often express difficulties
  with concentration, attention and memory (Neylan
  et al., 2004).

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Symptoms continued.

• Have sleepless nights or trouble falling asleep.
• Poor emotional ties, which leads to social
  isolation.
• Trouble dealing with stress.
• Increased response to stressors. Increased
  flight or fight reactions
• Poor employment history.
• Have difficulty in controlling painful memories.
  Relive the traumatic event.
• Avoid situations that remind him or her of the
  traumatic event.
• Irritability.

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Symptoms continued

• Hyper-vigilant and feel keyed up.
• Experiencing depression.
• Feeling numb.
• Fear for personal safety and the safety of
  others.
• Feelings of guilt, self-blame, and shame (Iraq
  War Clinician Guide National Center for PTSD
  Fact Sheet, 2004).

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How to Positively Interact with Veterans with PTSD

• Introduce yourself and have a positive attitude,
  explain what is going to happen if the veteran is
  there for a procedure.
• Make eye contact.
• Be formal unless given permission to be informal.
• Use a quite tone of voice and speak while looking
  at the veteran (many have hearing deficits).

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Positive Tools for Interactions

• Use the patients name, he or she is not a task
  or case.
• Let the veteran know that you appreciate the
  situation that he or she finds him or herself in.
• Listen carefully and make sure you understand.
• Acknowledge and express concern.

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More Positive Interactive Tools

• Listen, clarify, use common language, avoid using
  rules as reasons to not help.
• What have you heard? is a good question to ask.
  
• Offer respect.
• Appreciate what the veteran has gone through and
  will be going through.
• Offer choices when making appointments, try to
  coordinate all appointments on the same day.

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Positive Influences

• Look for the patients strengths.
• Welcome concerns and complaints.
• Do not hurry. Remain calm.
• The veteran is always right.

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References

• Dieperink, M., Erbes, C., Laskela, J.,
• Kaloupek, D., Farrer, M.K., Fisher,
  L.,
• Wolf, E. (2005). Comparison of
• treatment for post-traumatic stress
• disorder among three departments of
• veterans affairs medical centers.
• Military Medicine (170), 305-308.
• Lee, L. (1997). Social support, reciprocity, and
  
• well-being. Journal of Social
  Psychology
• (137), 618-628.

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References

• Iraq War Clinician Guide, 2nd edition
  
• (2004). War-zone-related stress
  reactions What families
• need to know. A National Center for
  PTSD Fact Sheet.
• Walter Reed Army Medical Center.
• Neylan, T., Lenoci, M., Rothlind, J., Metzler,
  T., Schuff, N.,
• Du, A., Franklin, K., Weiss, D.,
  Weiner, M. Marmar, C.
• (2004). Attention, learning, and
  memory in posttraumatic
• stress disorder. Journal of Traumatic
  Stress 17 (1), 41-
• 46.
• Riggs, D., Byrne, C., Weathers, F. Litz, B.
  (1998). The
• quality of intimate relationships of
  male Vietnam
• veterans Problems associated with
  posttraumatic stress
• disorder. Journal of Traumatic Stress
  11, 87-101.