Persons with developmental disability exposed to interpersonal violence and crime: approaches for intervention.

PURPOSE: Psychoeducational and psychotherapeutic interventions, by psychiatric advanced practice registered nurses and caregivers working with people with developmental disabilities exposed to interpersonal violence and crime, are recommended to help the individual resolve the intrapsychic trauma. CONCLUSIONS: Persons with developmental disabilities experience the full affective range of the effects of trauma and may benefit from a variety of interventions. What may be different in comparison to other survivors are the ways psychotherapeutic and psychoeducational interventions are adapted so that emotions, resultant actions, and ongoing concerns can be effectively expressed and addressed. PRACTICE IMPLICATIONS: Advanced practice registered nurses have an important role in addressing the sequelae of trauma by employing flexible, creative, and direct therapy with individuals. Additionally significant is provision of educational and supportive measures for the caregivers, who have the potential to generate an ongoing socially therapeutic environment.

The impact of stress management on nurse productivity and retention.

Throughout the history of nursing there is a seeming legacy of personnel shortage, lack of funds, and, based on the nature of the role and related services, heightened levels of stress involved in patient care. The future of the profession, and more imminently, patient care and the health of nurses, may be significantly impacted by repeated challenges where current levels of stress and burnout are contributing to organizational problems, burnout, and attrition. Employee stress and burnout commonly lead to myriad health-related problems that result in significant organizational consequences. There are many methods of stress management, and sometimes the best and most effective begin with simple recognition, validation, and visible and committed efforts by the nurse executive. Regardless of the technique or approach, what is clear is that there is a need for nurse executives to include the development and enhancement of comprehensive stress-management programming for employees as a priority item to avoid burnout and attrition.

Survivors' guilt following sudden traumatic loss: promoting early intervention in the critical care setting.

Survivors' guilt is a pervasive mental health issue that is often initially manifested by family members in the critical care unit. With increased awareness and enhanced targeted assessment, critical care nurses are in a unique position to begin the initial processes of adaptive coping and functional grief and bereavement in surviving family members. Because the trajectory of grief and bereavement are often complex and long term, the additional complication of survivors' guilt can lead to many psychosocial and physical manifestations and sequelae. However, with early identification and intervention relative to the underlying factors of survivors' guilt, including appropriate referral and psychoeducational intervention and resources, critical care nurses can enhance and extend their care to families in the throes of significant and sudden loss and intrapsychic trauma.