How to Deal With PTSD Patients
Terri Polick | NursingLink
How Nurses Can Help
An effective treatment plan is crucial to helping PTSD patients. Since most patients with PTSD report sleep disturbances, leaving them tired the next day, a treatment plan should focus on helping the patient regain their restorative sleep. Some patients fall asleep easily and then wake up in the middle of the night, while others have nightmares making it nearly impossible for them to get any rest.
Image Rehearsal Therapy (IRH)
Many patients find it helpful to journal about their nightmares. Other patients use imagery rehearsal therapy to alleviate trauma related repetitive dreams. Image rehearsal therapy involves:
• Asking the patient to write down everything they can remember about the dream
• Help patients focus only on their dream if it resembles their traumatic event
• Encouraging the patient to write down every detail including what they touch, smell, hear, and feel.
• Have the patient rewrite what happens in the dream. For example, a rape victim might rewrite their dream to include a scene where they pound their assailant with a sledgehammer.
The ultimate goal of IRH is to help patients overcome the feeling of helplessness. Nurses must stress that while this technique does not remove the traumatic memory, it can eliminate the dream related to the trauma.
Cognitive therapy teaches PTSD victims that their thoughts influence their feelings and behaviors, and that by changing negative thoughts, individuals can lead healthier and happier lives. Teach patients who suffer from PTSD that they are having a natural response to unnatural events. This will help prevent patients from stigmatizing themselves because they are having difficulty coping with their emotions.
Then patients must be taught how to evaluate and change their negative thoughts as they occur. For example, if a patient starts feeling jittery because they are experiencing a stimulus that reminds them of a traumatic event, teach the patient to stop and examine their environment. By identifying what is triggering the response, a patient can objectively evaluate their situation. Many times patients repeat things to themselves such as “I am not in danger,” or “this is a different place and time. No one is going to hurt me” to help them cope.
It’s important that patients stay in the moment and not allow their mind to drift into the past. Relaxation techniques help to offset panic. Healthy coping skills make it easier to deal with PTSD symptoms.