PTSD

The nurse managing PTSD performs comprehensive trauma assessment, implements trauma-informed care principles across all clinical settings, manages acute trauma responses, and coordinates evidence-based treatment. Advanced assessment includes identifying PTSD subtypes: classic PTSD (predominantly re-experiencing and avoidance), dissociative subtype (prominent depersonalization or derealization -- affects 15-30% of PTSD patients; associated with childhood trauma, higher symptom severity, and may require modified treatment approach), and delayed-onset PTSD (symptoms emerge 6+ months after trauma, often triggered by life changes or new stressors). Complex PTSD (C-PTSD), recognized in ICD-11 but not DSM-5, encompasses the standard PTSD criteria PLUS disturbances in self-organization: emotional dysregulation (difficulty modulating emotional responses), negative self-concept (persistent feelings of worthlessness, shame, guilt), and interpersonal difficulties (difficulties in sustaining relationships, feeling distant from others). C-PTSD typically develops from prolonged, repeated trauma (childhood abuse, domestic violence, captivity). The nurse implements trauma-informed care at the organizational level: universal screening for trauma exposure, creating physically and psychologically safe environments, avoiding re-traumatization through clinical procedures, recognizing and responding to trauma responses in patients and staff, and promoting recovery through empowerment and choice.