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How to Deal With PTSD Patients

Featured Author:

Terri Polick

Terri is a registered nurse and the proprietor of Nurse Ratched’s Place, a blog about psychiatric nursing. She is also a regular guest the popular podcast production, Insights in Nursing with Jamie Davis. Terri has been a nurse for over 30 years and is currently working as psychiatric bedside nurse. You can also follow Terri (AKA Motherjonesrn) on Twitter.

More articles from this author:

• Washington Hospital Center Strike
• How to Care for Patients Who Abuse Alcohol
• How to Handle Mental Health Patients

Medication

There are many medications that can help alleviate the symptoms of PTSD. Prazosin (Minipress, Vasofex) has been proven to help treat trauma-related nightmares. Hydroxyzine, an antihistamine, promotes sleep. Clonidine is helpful with alleviating hyper-arousal and general autonomic hyper-excitability. Benzodiazepines and beta-blockers like Propranolol,
Atenolol, and
Prazosin help relieve reactions to stress by blocking receptors associated with physiologic symptoms of anxiety. Selective Serotonin Reuptake Inhibitors (SSRIs), Tricyclic Antidepressants (TCAs), Monoamine Oxidase Inhibitors (MAOIs), and other antidepressants help improve concentration and uplift the patient’s mood.

Remember to avoid using narcotics when treating somatic pain associated with PTSD. Narcotics won’t relieve psychogenic pain and will only set the patient up for drug dependency.

Untreated PTSD

Untreated PTSD can create devastating consequences for patients and their family members. Patients with PTSD are at high risk for developing addiction issues and chronic depression. They also have poor concentration and difficulty retaining information, which becomes problematic as they try to go on with their lives. Other long-term side effects of PTSD include obsessive thoughts and an alarm reaction to noises resembling the sounds that the patient associates with the traumatic event.

A common example of an alarm reaction is when a combat veteran becomes startled by the noise of a car backfiring. Repeated instances of the alarm reaction tax the autonomic nerve system over time – which could result in decreased motor skills and coordination. The ultimate consequence of PTSD is when a patient takes his or her own life.

Patient Education

Patient education is often the first step to patient recovery, however it is important to remember that not everyone is ready to admit that they have PTSD. It’s not uncommon to see patients in denial about their illness, especially if they come from a military background. Although the military has made great strides in reaching out to soldiers with mental health issues, there is still an underlying culture within the military that views mental illness as a weakness.

It’s essential that patients learn stress management skills so that they can deal with their anxiety and alarm reactions appropriately. These skills help patients stay in the “here and now” when their minds start drifting back to traumatic events.

Proper patient education on how to use medications is necessary. For example:

• Inderal should not be taken when the patients pulse is below 60 beats per minute.
• Overusing benzodiazepines for the treatment of anxiety is very risky
• Overusing medications like Ativan and Valium can lead to substance abuse
• Give patients a list of local and national PTSD support organizations that can help after patients are discharged from a health care facility.

Nurses are playing a pivotal role in caring for patients with PTSD. The role is challenging, but knowledgeable nurses can change lives.

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