Ep 9: Jennifer Wild on preventing PTSD in nurses.

Posted December 12, 2022

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Show Notes —

PTSD can reduce the quality of life for a long time but it is a treatable condition. The earlier it is detected, the better it will be for the person being crippled by it. Furthermore, in a workplace that has a high risk of facing traumatic experiences, taking the steps to prevent PTSD should be a prime concern.

In this episode, Dr. Jennifer Wild tackles the important aspects of Post-traumatic Stress Disorder or PTSD. She shares the work that she’s been doing around the prevention of PTSD and some recommendations to help prevent PTSD and what to do after nurses experience something traumatic and stressful in the workplace.

Listen and learn in this episode.

KEY TAKEAWAYS FROM THIS EPISODE

Post Traumatic Stress Disorder (PTSD) is a crippling stress reaction and it consists of several symptoms. The core symptoms that drive all of the other clusters are the re-experiencing symptoms.

Re-experiencing symptoms are the repetitive, unwanted, intrusive memories of the worst moments of somebody’s trauma.

The Avoidant Cluster refers to people trying hard not to think about what happened and avoiding reminders and places that remind them of what happened.

Negative Alterations in Cognition and Mood Cluster refers to the changes in the way we think about ourselves and the world.

Memory symptoms also have a direct impact on the body.

The natural response is a resilience response that can include some of the symptoms of PTSD. A small proportion of people go on to develop persistent PTSD.

The Risk Factors of PTSD:

1. Fixed Risk Factors: Being a woman and having a history of mental health problems
2. Modifiable Risk Factor: Dwelling on the past

Once you can recognize that you are dwelling, the best thing to do is to get out of your head and shift your attention from your thinking to the outside world.

When the feeling of guilt lingers, one should shift the focus from what they didn’t do to what they did do that was helpful.

Sleep is very important for emotional memory consolidation and in enabling us to access parts of our memories that can help dampen down the trauma response.

In the immediate aftermath of trauma, kindness goes a long way.

Social support is one of the predictors of recovery.

Early detection and intervention can play a very important role in improving the quality of life of people with PTSD.

Today’s Guest:

Dr. Jennifer Wild is an Associate Professor at the University of Oxford and a Professor of Military Mental Health at the University of Melbourne. She has a program of research that focuses on preventing PTSD for high-risk occupations.

Nurse Wellbeing Mission run online and in-person workshops for nurses and midwives where we train people in four key skill sets of self-forgiveness. This helps to overcome mistakes, setbacks, and moral distress. Drop us an email to find out more: nathan@nursewellbeingmission.com

Visit our website at: https://www.nursewellbeingmission.com

Join our free Facebook group here:

https://www.facebook.com/groups/nursewellbeingmission

Transcription —

SPEAKERS

Nathan Illman, Jen Wild

Nathan Illman 00:00

Welcome to the nurse wellbeing mission podcast hosted by me Nathan Illman. This is the place where nurse and midwife wellbeing are at the top of the agenda. Each episode aims to help nurses and midwives around the world flourish through informative, inspiring and practical content and conversations. Great, so thanks, Jen for joining me on the podcast. today. We are here to talk about posttraumatic stress disorder and some of your research. I’m really excited to get into this stuff. Just to begin with, would you mind introducing yourself and just telling the listeners what your current role is and what your new role is, as well? Perhaps? Yeah, just a little bit about your research background, and maybe why you got into this research as well.

Nathan Illman 00:01

Welcome to the nurse wellbeing mission podcast. I’m your host, Nathan Illman. So today’s episode is such a fantastic discussion about something that is understood it to a certain extent, I think by the general public, and it’s very commonly discussed in the context of healthcare and nursing because of the kind of work that people do. So we’re talking about post traumatic stress disorder, PTSD. And in this conversation, I was delighted to reconnect with my old doctoral supervisor, Jennifer wild, her and I conducted some research several years back that looked at a certain aspect of trauma and sleep, and it was great to talk to her about the work that she has been doing around prevention of PTSD. So part of my mission is to enhance our understanding of an application of preventative mental health for nurses and Jen’s body of research has looked into this and has developed some really practical tools that can be used. And we get into all of that today. So this episode will be really helpful for anyone who’s interested to learn more about PTSD people who may be experiencing trauma or have experienced trauma in their nursing careers. This episode would be really helpful for hospital staff, people who work in management and people who work in wellbeing services within hospitals to really understand a little bit more about what are the recommendations for A to help prevent PTSD and B also kind of what to do after nurses experienced something traumatic or highly stressful. So without further ado, I bring you my guests for today, Associate Professor Jennifer Wild.

Jen Wild 02:28

My name is Jennifer Wild, and I am an associate professor at the University of Oxford with a program of research that focuses on preventing post traumatic stress disorder for high risk occupations like emergency workers, including frontline health care workers, I also have a role of Professor of Military Mental Health at the University of Melbourne. And that will primarily be focusing on preventing PTSD and developing programs to lead to early recovery from this disorder and other problems for military members for the Australian Defence Force.

Nathan Illman 03:00

Fantastic. Thanks. So we’re going to talk about your program of research today, looking at Post Traumatic Stress Disorder, it might be helpful because obviously, this term is something that it’s in the kind of public consciousness, isn’t it PTSD, but I think it can be helpful to actually define what we mean here, because I think sometimes people may use it for for things that we might not consider as actual post traumatic stress disorder or PTSD. So don’t just get give us a definition of PTSD. And what why cause PTSD.

Jen Wild 03:28

So Post Traumatic Stress Disorder, or PTSD is a crippling stress reaction. And it consists of a number of symptoms, and the core symptoms that drive all of the other clusters are what we call the re experiencing symptoms. So these are the repetitive, unwanted intrusive memories, the flashbacks and nightmares. It’s the brain in overdrive, remembering and over-remembering the worst moments of somebody’s trauma. And this cluster of symptoms drives the next cluster, which are the avoidant clusters. So this really refers to people trying really hard not to think about what happened, avoiding reminders, avoiding places that remind them of what happened. And the memory symptoms drive the third cluster, which are called negative alterations in cognition and mood. And that really just refers to changes in the way we think about ourselves in the world. So people can start to feel quite unsafe in the world and think it’s very dangerous, they might also blame themselves for what happened and think quite negatively about themselves, they might feel like they’re permanently changed as a person that no longer the same person. And then finally, the memory symptoms have a direct impact on the body. So when somebody might have flashback, for example, or an augmented memory or a bad dream, their body will be flooded with adrenaline, and they’ll have difficulty concentrating. They’ll have difficulty sleeping, they’ll feel very on edge, very hyper alert, and feel unsafe. So those are the kind of four clusters and we diagnose PTSD if somebody has experienced what we call criterion a trauma, so this isn’t about out having a horrendous divorce or a very difficult move or being fired from your job, for example, it really is a traumatic event that involves threatened injury to yourself or somebody else, or witnessing such an injury or threat to life, or sexual assault or physical assault, that kind of really crippling traumatic events that we never want anyone to go through. So those kinds of trauma are linked with the possibility of developing PTSD. And once somebody has the PTSD symptoms, we then only diagnosis if those symptoms are actively interfering with somebody’s life, because they don’t always and we’ve certainly seen quite a few people work with a range of PTSD symptoms they seem to get by. And they would say that those symptoms aren’t necessarily impacting on their life. But for most people who have a full array of PTSD symptoms, they genuinely are having a big impact on their life.

Nathan Illman 05:51

Thanks, is this probably important for part of our discussion later around the chronicity of that diagnosis as well. So Dr. Just talk about the difference between someone’s initial reaction. And so when when you might diagnose PTSD when it’s appropriate to do that.

Jen Wild 06:07

So when somebody goes through a really unpleasant, traumatic event, it’s normal in the aftermath to have unwanted memories about what happened. And for it to be difficult to sleep, for example, and you might not want to talk about what happened, you might push the memory out of mind that’s really normal, and actually kind of to be expected in the first couple of weeks after trauma. If those kinds of symptoms persist for more than four weeks. So they persist for more than a month. And they’re interfering with somebody’s life. That’s when we say that’s post traumatic stress disorder. And we really encourage treatment at that point, because treatments are extremely effective for PTSD in it. And it means that you’ll have a faster recovery, there is natural recovery with PTSD. So about 60% of people who develop PTSD will recover within about five years. But that’s quite a long time to have these symptoms. So we do encourage early treatment.

Nathan Illman 06:58

Yeah, I guess it’s important to highlight isn’t it before we carry on discussing this is that most people won’t develop PTSD, even after a stressful events. So there’s a real natural resilience or tendency towards resilience that kind of protects us against that it’s a kind of smaller percentage of people and then like you say, even then some people would actually go on to naturally recover from PTSD, even though it might take several years.

Jen Wild 07:21

So that’s exactly right. The natural response is a resilient response. And resilience can include some other symptoms of PTSD, it just is entirely normal for you to have memories of what happened after you’ve been through something horrible. A small proportion of people go on to develop persistent PTSD.

Nathan Illman 07:39

I think that’s a really important message, isn’t it to come from any conversation about PTSD for it’s gonna be nurses listening to this is that if something recently has happened to you, in your personal or professional life, or even in the past, you know, some of those symptoms that can be quite normal to have that it’s just if it’s lasted a longer time, there’s more intensity, it’s impacting your day to day functioning, then getting treatment is is really important and very effective. Like you say, why don’t you tell us a little bit about the treatment that you do and the treatments that you I mean, you’ve obviously helped design some treatments as well. So why don’t you tell us about that.

Jen Wild 08:09

So the team that I work with, we’ve developed, which stands for supporting hospital and paramedic employees during and after COVID. And this is a brief accessible intervention that nurses can access on their phone, and they have a wellbeing coach, and it’s six sessions long. So it’s one telephone call a week for up to six weeks, we have a 94% reliable recovery from post traumatic stress disorder. So it’s really really quite high, very effective. And this is independent of whether or not the trauma was recent, or it happened 10,15 years ago. Program helps to teach tools that are extremely effective for reducing unwanted memories for overcoming an unhelpful style of thinking called dwelling, which is when we overthink past events, and also for dealing with really low mood. So there is a tool that is really quite helpful for that as well. So what we see is really high rates of recovery from PTSD with this programs 20 minutes a week, it’s very what we call symptom driven, and that each call will focus on the symptoms that the nurse might have and want treatment for. And by the end of the call, they will have learned a tool that they can incorporate into everyday life to deal with their symptoms.

Nathan Illman 09:20

Sounds really practical. So I’m probably asked you a little bit more about that as we go on. But I suppose it’d be helpful to think a little bit about some of the risk factors as we were kind of talking about before, maybe if you could talk a little bit about that. So what are the what are the factors that might predispose someone to be more likely to develop post traumatic stress disorder? I mean, obviously, that could be where you work. So working as a nurse, for example, but can you just talk to us a little bit more about about risk factors.

Jen Wild 09:46

So risk factors for post traumatic stress disorder in the health care professions really boil down to whether they’re what we call fixed risk factors, those are much more difficult to change. And modifiable risk factors which we change with training. So I’m really interested in the modifiable risk factors and I will talk you through both of them. So the fixed risk factors are being women increases the risk of developing PTSD. Another fixed risk factor is past history of mental health problems and a modifiable factor is dwelling about the past. And this is a really harmful way of thinking that is a robust predictor of post traumatic stress disorder. Now, we conducted a study about 10 years ago, where we looked at 500 frontline workers as they joined the service, and we followed them for two years. And then we were able to determine what predicted posttraumatic stress and what predicted depression when they joined the service by two year follow up. And it was really fascinating. So we controlled for previous mental health problems we controlled for trauma, exposure, and gender. And what we found that the most robust predictor of PTSD was what we call dwelling or rumination. So people who joined the service who were likely to dwell about the past were much more likely to develop an episode of PTSD. Once people had developed an episode PTSD, they were much more likely to experience significant weight gain clinically significant sleep problems, more time off work and poor quality. So then we developed a program to modify those predictors of PTSD, the ones that we could change. So dwelling is something we can change. And that could explain why our program is very effective.

Nathan Illman 11:31

I really love that research. And it’s so wonderful how you isolated that is something that’s predicts PTSD, and then you’re just able to target it with such nice practical tools, I think will be really helpful for listeners is to just dig into a little bit more detail around there. So could you give us an example of a typical example of someone who dwells on things, you know, where they might dwell? Well, that what that kind of looks like or sounds like for them? Yeah, just talk us about, talk us through that. And then we’ll talk about the particular intervention that can help with the dwelling,

Jen Wild 12:03

Sure. So we are dwell, I should make that clear. At the outset, it’s a very common unpleasant for thinking, and some of us are just better at disengaging from it than others. So a typical episode of dwelling might be if you go through a breakup, maybe your partner ends the relationship with you, and this might have happened in the past, and you start to think about why did they do that? Why did they do it? Then just before my birthday, why were they so inconsiderate? What is it about me that made them break up with me? Why can’t I make my relationships last was that kind of thinking in relation to a kind of work event? Something that we’ve seen quite commonly might be where a patient dies, and a nurse might overthink their treatment of that patient? And wonder and question whether or not they did enough to help them why they couldn’t offer more care under the circumstances? What if they had offered a different kind of medication that had been prescribed but that have been better? So it’s that kind of over it? The what if? Or the why I call it why thinking it’s when we typically think And why’s the kind of questions that don’t have obvious answers. So when we’re plagued with those kind of questions, they don’t have obvious answers. And we keep thinking like that repetitively. That’s what dwelling is.

Nathan Illman 13:20

And I mean, like you said, we all do this, I guess, you know, I’ve had this personal experience, I can just think of sometimes, you know, maybe you’re doing work with a client and something doesn’t go too well. And you’re asking yourself, why did I do that? Why did I say that? Why didn’t I say that? And it can often form in our mind is quite being self quite self-critical content, and then kind of associated with negative emotions, I suppose. So they aren’t really curious about actually is obviously the process, I suppose, if you like is the dwelling or thinking about it? What’s the relationship between that and perhaps say self-compassion, for example, to be see that there’s people who tend to dwell a lot have lower self compassion? Do you? Is there any research has demonstrated that I think that’s

Jen Wild 13:57

a really excellent question, Nathan. I think a lot of the rumination is self criticism, but it’s also these open ended questions which don’t have an answer. So why did I do that? Or why was that the treatment plan? Why did the patient call out when they did? Why weren’t their family there by their bedside? It’s those kinds of questions that are really tough to answer. I think compassion is such a helpful treatment component. And I, we use it when we’re working with nurses and other health care professionals, too. We want them to kind of build for example, short breaks into their day, and on that five or seven minute break, do an activity where they’re extending compassion to themselves. So we kind of use this idea that the compassion you extend to other people, let’s experiment with extending that to yourself. So what would you say to a friend in this situation and holding that mindset or that mode of thinking in mind? What could you say to yourself instead of another type of thinking, it’s not necessarily the way that we target dwelling? So wait target dwelling in a kind of more systematic way. But we are continually working with compassion throughout each of the phone calls each of those six sessions that we have with the nurses.

Nathan Illman 15:10

Fantastic. So let’s talk a little bit about the way you work with the dwelling then, I mean, I suppose if you can outline just practical tips for people who are listening, if they’re thinking I am someone who dwells on things, what could someone go off and do right now? What would be a helpful way for them to work on that dwelling,

Jen Wild 15:28

I think the most important thing you can do is recognize A recognize that it’s there. So recognizing it involves identifying the kind of signs of dwelling. So if you’ve been thinking about the same thing for more than 30 minutes, it’s there’s a strong possibility you’re dwelling. If you have questions running through your mind, and there’s no obvious answer, there’s a strong possibility that you’re dwelling. And if you’re starting to feel quite low as a result of your thinking, strong possibility that that thinking is a form of dwelling. So once you can recognize that it’s there, the best thing to do is to get out of your head. So we need to shift our attention from our thinking to the outside world, the easiest way to do that is exercise. And you know that that just is if you start to exercise, you end up focusing your attention on the exercise. And that immediately interrupts that line of thought. So that’s all very well and good if it’s the middle of the day. But obviously, a lot of the people that we work with, say, Well, I’m lying in bed at night. And these thoughts come into my mind, and that’s when they noticed that they’re dwelling. So then what we would suggest is great that you can start that your dwelling and now we have to shift your attention to something else. So that might be playing like Tetris on your phone, for example, it might be picturing an image in your mind’s eye that’s completely different to what you’re you’ve been dwelling about. So it could be an image of a rose or sunshine, but really something to shift that attention out of your head if you need to, if it’s a really severe episode of dwelling, get up and just walk downstairs, just the act of getting up will shift your attention out of your head. So that’s what we would suggest that when we’re working with nurses, what we aim to do is prevent the episode from starting in the first place. And so that means we have to get really good at spotting our triggers for dwelling. And so we spend some time thinking about what are the likely situations that you’re going to dwell in? What do you notice going on in your body? What sort of body sensations might trigger an episode of dwelling? What might be related to dwelling? Maybe you’re more tense? What are the feelings that might be associated with dwelling? That might be feeling overwhelmed? For example, feeling guilty, feeling tired? That might be linked to an episode of dwelling? What are the thoughts that might trigger an episode of dwelling? And this is where self criticism comes in? So you might find that you’re thinking more negatively or you’re thinking self critical thoughts? And where’s your focus of attention? Are you focused on the task at hand and the outside world? Or is your focus more internal on your thinking? So we identify all of the triggers, and then we come up with an action plan. And this is based on Ed Watkins work from the University of Exeter, Exeter, so we come up with a plan, like if I spot X, Y trigger, then I will do X Y action that might be exercise or calling to mind to positive image on me experiment with what works. And so by the end of our six sessions, people are really good at intervening at the level of triggers, so that the rumination where the dwelling doesn’t start in the first place.

Nathan Illman 18:21

That’s fantastic. And I know there’s if then plans are really helpful, aren’t they? I think just for in general, if we want to change the behavior, we’re anticipating barriers as well to something and if that happens, and I’m going to do this, that sounds fantastic. I know from personal experience, when you start to get people to notice patterns of thought as a sort of process and give it a label, it can quite immediately be empowering concept. We often before you’ve had any of this kind of training, it’s just everything’s a bit of a jumble isn’t it, we don’t really separate our thoughts out or different ways of thinking. And then once you start to be a keen detective and looking at your own thinking processes, people can get a lot of benefit out of just kind of giving something a label. So I’m dwelling again, that’s fantastic. And there’s the success rates. So encouraging with your program,

Jen Wild 19:05

I would say one of the kind of emotional states that we’ve noticed that can reinforce dwelling or kind of be related to triggering dwelling is guilt. So if someone feels quite guilty about something, they really believe they should have prevented a death or they should have prevented a trauma, then that can increase the sense of guilt. And so what we do in that situation, whilst identifying triggers to dwelling and coming up with an action plan is also to shift the focus from what I didn’t do to what I did do. So what did I do that was helpful and it might not just be in the moments that have been going to their mind, but it might relate to the life of the person they’re thinking about, or the hospital stayed whole hospital stay of the patient, they treat it. And so that’s important too, just to share with you as well.

Nathan Illman 19:49

Broadening people’s perspective on the event and their recollection of it. And yeah, that’s fantastic. So I think that I mean, we were talking about this before we started recording, I think it’d be really important to just touch on even even if briefly is sleep because I know that I was looking at a research study the other day that was showing that poor sleep was then sort of predictive of people developing PTSD. And there’s obviously an interaction between the sleep and other other things. So can you just comment on that just talk about the role of sleep beforehand, maybe for people who are experiencing insomnia or not sleeping well now, which is very common in nurses. And what happens with sleep after people have experienced something highly stressful?

Jen Wild 20:26

Yeah, it’s fascinating the role of sleep and a lot of different mental health problems. And there’s been some conflicting research on sleep. And I will describe where my thinking has landed. So there’s been some studies that well, there’s been one study that said that sleeping so what, that what they did in this study was they deprived they exposed people to trauma, not many, like 15, people exposed 15 people to trauma, and then they kept some of them away, and they let some of them sleep. And then they measured their unwanted memories of the next few days. And what they found was that the people who were allowed to stay awake and were encouraged to stay awake had fewer unwanted memories over the next three days. And then they concluded that therefore sleep deprivation interrupts memory consolidation, and therefore reduces the frequency of unwanted memories. I think it’s a bit of a premature conclusion. The the other study, very similar design a few more people, and they exposed people to trauma, meaning that they showed traumatic film footage, and then they kept some awake, and they let some of them sleep. And what they found was that the people who slept had fewer unwanted memories, meaning that their trauma memory was more consolidated and less likely to be easily triggered. And that’s the camp that I think I’m more aligned with just based on the hundreds of clients that I’ve seen with PTSD, I would say that most people that I see don’t actually sleep on the night of their trauma, it’s very, very difficult when you go through something horrendous to dash home and have a really good night’s sleep. And they typically continue to have some sleep difficulties after their trauma, exposure, and lots of unwanted memories and difficulty accessing information in their memory that could help to update the trauma. So I think from my perspective, sleep is really, really important for memory consolidation, very important for emotional memory consolidation, and very important and enabling us to access parts of our memory that can help to dampen down the trauma response. So we want to make sure that if we’re in a stressful occupation, we actually are getting good night’s sleep. And of course, that’s tricky when you have shift work. So we look at sleep, we don’t. And we, you know, we will give kind of basic pointers on how to improve sleep in the program. But we don’t have a specific sleep intervention, what we find in our research is that helping people to reduce unwanted memories, then we see an improvement in sleep. So once we can help the memory to settle, then sleep typically improves. So I think we’ve published a study on that a few years ago.

Nathan Illman 22:56

Yeah, fantastic. Thanks. So I’d like to just talk about the role of organizations and and what they are doing to help and support their staff. So there’s a big literature on critical incident stress debriefing, and I think it’s an umbrella term psychological debriefing, which is basically providing some immediate support to people after they’ve witnessed or experienced something traumatic. Do you want to just talk a little bit about what that is, and comment on its effectiveness and where we’re at sort of where we’re at with research on that, and whether or not is actually something that should be offered to nurses or other health care staff?

Jen Wild 23:38

Yeah, so critical incident stress debriefing, or CISD is a single session group intervention, where people who have been exposed to the same trauma are gathered together, and they hear about other people’s experiences of that trauma and research that my team’s conducted. Not me specifically, but one of my collaborators found that CISD interrupts the natural recovery from PTSD. And we think that’s because people are vicariously traumatized by hearing about other people’s perspectives of the trauma so they can have a more severe prospective or experienced details that the person who also went through who’s in the group hadn’t thought of or hadn’t heard of, and so it interrupts the natural course of recovery. So UNK ailleurs, conducted research where she found that if you have really high symptoms of PTSD, kind of in the immediate aftermath of trauma or loss and love, and other people had low symptoms, the CISD was unhelpful, actually harmful to the people with high symptoms. So they had zero change in their symptoms over time, whereas the people who had high symptoms but didn’t have CISD had natural recovery were more likely to have natural recovery and people with low symptoms of PTSD who had nothing or who had CISD kind of performed the same so it’s not harmful if you don’t have many symptoms, but it is harmful if you have a lot of symptoms in the immediate aftermath and A study that came out in I think 2001 in The Lancet, which was a meta analysis of all studies of CISD concluded that at best, it’s neutral, and at worst, it’s harmful. So it’s not something that we recommend. CISD is a form of psychological debriefing. There are many different types of forms. And we have to remember that psychological debriefing is different to occupational debriefing. So of course, if there is an event at work with a patient, there would be an occupational debrief around that to better understand what happened and to learn from any mistakes that may have been made. That’s not psychological debriefing. There are many forms of psychological debriefing, and I’m most familiar with the CISD. The NICE guidelines do not recommend CISD as an intervention for PTSD or as a preventative intervention, and what is recommended in the immediate aftermath. So if somebody does go through trauma, and they have really severe PTSD symptoms, within a week or so the guidance is to offer individual treatment immediately. So don’t wait for a month. But actually, you can offer individual treatment because the sentence can be very distressing.

Nathan Illman 26:03

Yeah, and I guess my understanding of the literature is that obviously, like you said, providing that kind of occupational debriefing is important and very relevant. Basically, after someone’s witness something not getting or not forcing them to recount in explicit, lengthy detail exactly what happened, people shouldn’t be aiming to do that. I think it’s offering social support is really important, isn’t it so that social support can come from colleagues, you know, hopefully, you hopefully you’d have a supportive supervisor, team leader, matron or whatever, in that hospital setting or the other setting where they can ask you, are you okay, how are you doing? And asked him, you know, what do you need, rather than sitting people down and saying, right, everyone, tell us what happened, tell us exactly what the emotions that you’re feeling. So it’s bit I suppose it’s a bit more informal, right, that’s probably what’s going to help most,

Jen Wild 26:53

I think, in the immediate aftermath of trauma, kindness goes a long way. So I think just taking a moment to think about what you need, and what you need in different situations for what you need at work, what you need at home, what you might need from your friends, and having a go at communicating that will most support your recovery. So not avoiding friends, but you might reach out to them and say, maybe you have to reduce your social engagements or, you know, go out with some, you know, letting your friends know, some awareness that they you know, just to ask you how you are or, you know, sometimes people get really clear that they need help cooking, or they’d like somebody to come around and cook for them or something like that. So being able to communicate your needs. And kindness at work really does go a long way. And when people do have supportive work environments, or colleagues who have made them a cup of tea, it really does feel like they’re being supported. And that means the world to them, and I think does support recovery.

Nathan Illman 27:54

it comes back to the idea of compassion, doesn’t it? I think compassion for others, actually just looking someone in the eye, giving them the time to ask if they’re okay, offering to make a cup of tea, that small act could be really instrumental in that person’s experience. After that highly stressful event. I spoke to a nurse not long ago, a few months ago, he told me about an experience which stuck with her and not sure whether it was PTSD. I wasn’t sort of assessing her or anything. It was just an informal conversation. But she talked about very early on in her career, a situation that happened in a neonatal unit where baby died, and it was something had gone wrong. And she was very junior, she felt very guilty about it. And immediately after what happened was like an occupational debriefing, but one in which one which was done in quite a cold kind of way that was almost looking to point blame, basically. So it was what happens, who why wasn’t that person there, and this person didn’t receive any of that kind of compassion. The person didn’t empathize and acknowledge Well, this is a student on placement or very junior early in their career. And she said to me, I felt that all I needed was for my my supervisor, manager just to say to you, okay, this isn’t your fault individually. And but instead that happened, and she said, it just troubled her for years. It affected the way she interacted with her own kids and things. Yeah, it just shows that people listening to this, if you’re in a leadership position, just giving people even a few minutes is really important, isn’t it?

Jen Wild 29:22

It means a lot to them, and can help them to feel really supported and social support is one of the predictors of recovery.

Nathan Illman 29:30

Yes, yeah, absolutely. So we’ll finish up in a moment, Jen, before we go bigger just to hear about so your future directions with this kind of research, what you hope to look at what you hope to find what are the programs you’re going to be working on?

Jen Wild 29:44

So I plan to take this to the Australian military. I’m very passionate about preventing difficulties that are preventable. So I think PTSD is a preventable condition. We know what the predictors are, I’ve been able to demonstrate that we can prevent it in some occupations. So I’d like to prevent it in the broader at risk occupations like the military. I think early promoting early recovery is really important as well. I think in our study that we published recently, in the British Journal of Clinical Psychology, our nurses who had PTSD had actually had it for quite some time, a really long time. And that’s difficult. It’s reducing quality of life for years and years. And it is a treatable condition. So I think earlier detection and intervention is something that I’m keen to promote and develop programs for, and then a better understanding of who’s going to become unwell over time. So we have a pretty clear understanding and some occupations. But I think there’s more work to be done. And there’s a lot of data out there. And it’s important that we utilize what we have access to, to develop algorithms to improve personalized prediction.

Nathan Illman 30:53

Yeah, it’s a really important area of research. And I just love how focusing on prevention. It’s, it’s good to see. Well, I want to thank you very much for your time and it’s been really enjoyed this discussion. I was looking forward to reconnecting with you. Yeah. Thanks for all the work that you’re doing. I’m sure by now it’s been helping. Probably 1000s of people.

Jen Wild 31:12

Thanks, Nathan. And thanks for inviting me.