How PTSD Affects Medically Fragile Children

As much as 80% of critically ill and injured children can experience post-traumatic stress disorder (PTSD). As a Pediatric Home Care Nurse, it’s important to understand how PTSD affects medically fragile children to provide the best and safest care possible.

How PTSD Develops in Medically Fragile Children

Medically fragile children can develop PTSD due to repeated exposure to traumatic medical events at a young age. They often face many invasive procedures, hospitalizations, and life-threatening health events due to their condition. Because of this, kids can often deal with bad dreams, believe that everything is dangerous, and have trouble calming down or feeling happy. 

Signs of PTSD in Medically Fragile Children

PTSD in children can show up in many ways. Here are signs for nurses to look out for:

• Nightmares and sleep problems
• Lack of positive emotions
• Intense ongoing fear
• Irritability and angry outbursts 
• Acting withdrawn
• Becoming very upset when something triggers the memory of a certain event
• Avoiding things or people associated with the event
• Denying the event happened

Strategies to Help With PTSD In Medically Fragile Children

Implement Trauma-Informed Approaches 

The Distress, Emotional Support, and Family (DEF) protocol is a framework pediatric nurses can use to guide care for children with PTSD. 

• Distress: Assessing and managing the patient’s pain, asking about their fears and worries, and considering the grief and loss associated with their condition. 
• Emotional Support: Asking questions like: “Who or what does the patient need?” “Are there any barriers to the support the patient has now?” 
• Family: Assessing the parents’ or siblings’ distress, finding resources for family stressors, and addressing other needs (beyond medical).

Note: When implementing these strategies, it’s important to keep cultural sensitivity in mind as each patient can have different values, norms, and beliefs based on their race/ethnicity, gender, religion, socio-economic status, and sexual orientation.

Educate Families About PTSD

For families who might not have a clear understanding of their child’s PTSD or PTSD in general, nurses can help educate them. When a family has a better understanding, they can provide the necessary support their child needs. To help educate families about PTSD, pediatric nurses can do the following: 

• Provide educational materials like brochures and online resources about PTSD
• Offer information on support groups and other resources that families can use
• Have an open dialogue where family members can ask questions

Practice Self Care

As a nurse, you won’t be able to provide the best care for your pediatric patients if you don’t take care of yourself. When you can look after your mental and physical health by setting boundaries and seeking additional support, you can be a better support system and nurse for your patients.  

Learn more about how Thrive SPC cares for all patients, including medically fragile children who experience PTSD.