Nurses regularly face events that would shock most people: a child’s death, a failed resuscitation, violence on the ward, a colleague infected during an outbreak, or a mistake that harmed a patient. This year, nurses in DR Congo have been attacked while responding to Ebola, and nurses in Kenya have been infected caring for a patient. Distress after events like these is normal. Support from colleagues and employers can help prevent lasting harm.
Normal reactions
In the days and weeks after a traumatic event, many people experience:
- Replaying the event, intrusive images or dreams.
- Feeling numb, tearful, irritable or on edge.
- Difficulty sleeping or concentrating.
- Guilt (“I should have done more”) or self-blame.
- Avoiding reminders, such as a particular bed or unit.
For most people, these reactions ease over a few weeks with rest and support.
Supporting a colleague: psychological first aid
WHO’s Psychological First Aid approach can be summarised as Look, Listen, Link:
- Look: notice colleagues who seem distressed, withdrawn or not themselves. Check they are safe.
- Listen: offer a private, quiet moment. Ask how they are, and listen without judging or pushing for details. “That was a really hard shift. How are you doing?”
- Link: help with practical needs (a drink, a break, getting home safely), and connect them with support services if needed.
Avoid clichés (“It was meant to be”), comparing experiences, or forcing people to talk.
Hot debriefs
A short team debrief soon after a critical event (such as a cardiac arrest) helps teams learn and support each other. A common structure: what happened, what went well, what could be improved, and how everyone is feeling. Some hospitals use brief structured formats, such as the “STOP 5” hot debrief used in parts of the NHS. Keep it supportive, not blaming. Formal psychological debriefing for everyone is not recommended as routine, but people should be offered support if they want it.
Looking after yourself
- Talk to someone you trust: a colleague, friend, family member or faith leader.
- Rest, eat, and keep some routine.
- Limit alcohol and avoid using substances to cope.
- Do things that usually help you recharge: exercise, prayer, music, time outdoors.
- Be kind to yourself: you are human.
When to seek professional help
Seek help from your GP, occupational health or a counselling service if, after about a month, you still have intense distress, flashbacks, nightmares, avoidance, low mood, or difficulty functioning at work or home; or at any time if you have thoughts of harming yourself. Post-traumatic stress disorder and depression are treatable. If you are in crisis, contact emergency services or a crisis line.
After a mistake: the “second victim”
Health workers involved in errors or adverse events often experience shame, fear and anxiety, sometimes called the “second victim” experience. A just culture that focuses on learning, not blame, protects both patients and staff. If a colleague is involved in an incident, check on them.
What employers should provide
- Access to confidential counselling and occupational health.
- Trained peer supporters and regular clinical supervision.
- Time and space for debriefs.
- Protection from violence, and support after assault.
- Fair processes after incidents.
Related: Nurse burnout · Suicide risk: how to ask · Surviving night shifts
Based on WHO Psychological First Aid: Guide for Field Workers and NICE NG116 (Post-traumatic stress disorder). General wellbeing information, not a substitute for professional help.