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Post-Traumatic Stress Disorder
Post Traumatic Stress Disorder is an anxiety disorder characterized by reliving a psychologically traumatic situation, long after any physical danger involved has passed, through flashbacks and nightmares.
Difficult situations are part of life. We all must cope with tough circumstances, such as bereavement or conflict in our personal and professional relationships, and learn to move on. But sometimes people experience an event which is so unexpected and so shattering that it continues to have a serious effect on them, long after any physical danger involved has passed. Individuals with this kind of experience may suffer flashbacks and nightmares, in which they relive the situation that caused them intense fear and horror. They may become emotionally numb. When this condition persists for over a month, it is diagnosed as post-traumatic stress disorder.
Post-traumatic stress disorder (PTSD) is one of several conditions known as an anxiety disorder. This kind of medical disorder affects approximately 1 in 10 people. They are among the most common of mental health problems.
Children and adults can develop PTSD. The disorder can become so severe that that the individual finds it difficult to lead a normal life. Fortunately, treatments exist to help people with PTSD bring their lives back into balance.
What causes it?
PTSD is caused by a psychologically traumatic event involving actual or threatened death or serious injury to oneself or others. Such triggering events are called ‘stressors’; they may be experienced alone or while in a large group.
Violent personal assaults such as rape or mugging, car or plane accidents, military combat, industrial accidents and natural disasters are stressors which have caused people to suffer from PTSD. In some cases, seeing another person harmed or killed, or learning that a close friend or family member is in serious danger has caused the development of PTSD symptoms.
What are the signs?
The symptoms of PTSD usually begin within 3 months of the traumatic event, though they may surface many years later. The duration of PTSD and the strength of the symptoms vary. For some people, recovery may be achieved in 6 months; for others, it may take much longer.
There are three categories of symptoms. The first involves re-experiencing the event. This is the main characteristic of PTSD and it can happen in different ways. Most commonly the person has powerful, recurrent memories of the event, or recurrent nightmares or flashbacks in which they relive their distressing experience. The anniversary of the triggering event, or situations which remind them of it, can also cause extreme discomfort. Avoidance and emotional numbing are the second category of symptoms. The first occurs when people with PTSD avoid encountering scenarios which may remind them of the trauma. Emotional numbing generally begins very soon after the event. A person with PTSD may withdraw from friends and family, lose interest in activities they previously enjoyed or have difficulty feeling emotions, especially those associated with intimacy. Feelings of extreme guilt are also common.
In rare cases, a person may enter dissociative states, lasting anywhere from a few minutes to several days, during which they believe they are reliving the episode, and behave as if it is happening all over again. The third category of symptoms involves changes in sleeping patterns and increased alertness. Insomnia is common and some people with PTSD have difficulty concentrating and finishing tasks. Increased aggression can also result.
Other illnesses may accompany PTSD
People with PTSD may develop a dependence on drugs or alcohol. They may become depressed. It is not uncommon for another anxiety disorder to be present at the same time as PTSD. As well, dizziness, chest pain, gastrointestinal complaints and immune system problems may be linked to PTSD. These are often treated as self-contained illnesses; the link with PTSD will be revealed only if a patient volunteers information about a traumatic event, or if a doctor investigates a possible link with psychological trauma.
How is PTSD treated?
Medication can help with the depression and anxiety often felt by people with PTSD and assist them in establishing regular sleep patterns.
Cognitive-behavioural therapy and group therapy are generally felt to be more promising treatments for PTSD. They’re often performed by therapists experienced in a particular type of trauma, such as rape counsellors. Exposure therapy, in which the patient relives the experience under controlled conditions in order to work through the trauma, can also be beneficial.
Research into the causes of PTSD and its treatment is ongoing. Determining which treatments work best for which types of trauma is currently under investigation.
Canadian Mental Health AssociationHow might mental disorders and substance use problems affect you at work?
Depression and anxiety are leading causes of both short-term and longterm disability. Loss of productivity at work due to substance use problems has been estimated at over $24 billion a year in Canada. A mental disorder or substance use problem can make it hard to do your job properly. Some people need changes to their workplace so they can continue to work while they recover, while others need to take time off work to manage their recovery. Some of the ways a mental disorder or substance use problem affect you at work might include:
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Fatigue: If you feel tired all the time, getting to work on time can be hard. It can also make it tougher to work. Medications used to treat your disorder can also make you feel tired or less energetic.
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Thinking problems: This may make it harder to remember things, take in new information, concentrate and make decisions. You might also have a lot of negative thoughts. It’s easy to see how all of these things can affect your performance at work.
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Feeling sad or numb: It’s hard to be excited about your work if you’re depressed or in distress. You can lose interest in your work and stop caring about the quality of your work. You may not even feel like working at all.
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Judgment problems: Decision-making can be affected. You may feel more creative and more capable than usual, or have ideas that are larger than life. As a result, you might make choices that you wouldn’t normally even consider. Or you might make quick decisions without thinking of the consequences.
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Anxiety: Most people feel anxious about work at some point, especially when they’re feeling a lot of stress. But day-to-day events or situations can be overwhelming for someone living with an anxiety disorder. There are different kinds of anxiety disorders, and they can look very different from each other. Anxiety problems may occur with other mental disorders and substance use problems, too.
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Paranoia: You might feel like others are watching you or talking about you behind your back.
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Irritability: This can affect your relationships with your co-workers and your ability to work as part of a team.
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Problems relating to others: Some mental disorders make your thoughts very disorganized, or change the way you talk, act or react. This can make it hard for others to understand you.
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Feeling physically sick: Mental disorders and some medications can cause physical symptoms like stomach problems or headaches. Even if you aren’t using substances during work hours, you might still feel the effects of them at work.
Despite these possible negative effects, the news isn’t all bad. People recover from mental disorders and substance use problems. In fact, workers who are working on their recovery and workers who’ve recovered from a mental disorder or substance use problem may actually be better at taking care of themselves and managing their stress than other employees. This is because they use these same strategies to help prevent or cope with a relapse.
Municipal Pension Plan Options Video Series
Municipal Pension Plan members can now examine their pension options through an online video series. This seven-part animated series supports the existing Choosing Your Best
Pension Option booklet. These videos will assist in making the selection
of a pension option easier for Municipal Pension Plan members, by
providing another product with detailed information about the various
pension options available.
The series includes a brief introductory video that gives an overview of
the options, and more in depth videos on single life options, joint life
options and temporary annuity options.
A link to the series has been placed on the "My Pension" page navigation bar.
Government orders transfer of several Mental Health Facilities out of the Public Service
The government has today (March 28, 2013), through Order in Council, moved Forensic Psychiatric Services, Oak Bay Lodge and the Lodge at Broadmead out of the Public Service effective June 1, 2013. Forensics and Oak Bay Lodge will be moved to the Health Sector and be covered by the Health Authorities. The Lodge at Broadmead will be transferred out and become an independent employer under the B.C. Labour Relations Code.
In preparation for these events, we have today notified the government that we wish to meet with them and representatives of the new employers to discuss the terms for transferring these facilities and how our members will be dealt with in this transfer. This is a process that we have become very knowledgeable about over the years as various other portions of Mental Health Services have been transferred in the past.
Once we have the terms of the Transfer Agreement in place, we will meet with staff in each facility to discuss their options within the Transfer Agreement as well as their Article 13 rights should they choose not to transfer to the new Employer. When I say "the new Employer" I refer to the fact that they will no longer be employees of the government of British Columbia. The employer for people working at Forensics will now be PHSA; for Oak Bay Lodge the employer will be VIHA; and for the Lodge at Broadmead the employer will be Broadmead Care Society. That being said, we do not see much of an operational change at any of these worksites. On the other hand, there could be significant changes to the collective agreements, particularly for those being taken over by the Health Authorities where the Provincial Collective Agreement is in effect.
This is just a preliminary "heads up" notice to our members in these worksites. Once we begin discussions with the government we will provide further detailed information as soon as we get it.
CRPNBC ANNUAL EDUCATION DAY – Registration fee covered for UPN members
UPN continues to sponsor the registration fee for UPN members for this annual event. Registration form available HERE.
Steward's Dinner & Information Meeting
When: Wednesday, May 22, 2013
Time: 7:00 PM
Where: The Marriott Pinnacle Hotel
1128 West Hastings Street
Vancouver BC
All Stewards who wish to attend the Stewards Dinner & Information Meeting are welcome. Parking will be provided.
All Stewards attending the UPN Convention are required to attend this meeting.
PLEASE RSVP NO LATER THAN MARCH 31, 2013 to swatts@upnbc.org or call the UPN office at 604-530-9253.
Notice of 2013 UPN Convention

The Annual Convention of the Union of Psychiatric Nurses shall begin on Thursday May 23, 2013 commencing at 0900 hrs at the Marriot Pinnacle Hotel at 1128 West Hastings Street, Vancouver BC.
Hotel Details
Near Seawall stroll
This 31-story downtown hotel is a block from Vancouver's seawall promenade, 3 blocks from the shops of Robson Street, and 5 blocks from Stanley Park and Gastown.
Pool, spa tub
24-hour amenities at Vancouver Marriott Pinnacle Downtown include room service and an upscale fitness center with 52-foot pool, steam room, sauna, and spa tub. Show Case Restaurant offers casual dining.
High-speed Internet
Vancouver Marriott Pinnacle Downtown's 432 guestrooms feature panoramic views, high-speed Internet access, work desks with speakerphones and ergonomic chairs, modern decor, and marble bathrooms with separate showers.
Details of Convention and registration form are available HERE. Completed registration forms must be returned to the UPN office on or before April 22, 2013.
Need Info? Search Here
Presidents' Comment

Dan Murphy – President
Email: pres@upnbc.org
The increase in hours for the work week, as previously mentioned, has been a continuing source of anxiety for our members. 20 years ago the work week was reduced from 37.5 hours to 36 hours in part to keep nurses from being laid off. This resulted in changes to shift rotations, reduction in pay and contributions to pensionable earnings and of course a lot of anxiety from our members and nurses in general around the changes. There has not been any significant increase in staffing numbers to correlate with the increase in workload over the years, along with an inundation of paper work added to each nurse's work day. One of the principle complaints from nurses was that they are expected to complete more work and stay late to chart or complete paper work on their own time. Requests for OT to complete this work were being turned down by the managers and additional staff were not being hired to lessen the workload.
Going to the 37.5 hour work week was part of a package to improve staffing and reduce workload. We stand by our Safe Patient Care equals Safe Staffing. Along with baseline staffing numbers that we can build on we achieved enforceable commitments to hire more nurses, convert casual and OT hours into regular positions, replace community nurses for two weeks of their vacation, replace nurses on sick or LTD, and replace maternity leaves. The new rotations are not to result in layoffs with minimal impact to the member's employment and security. It helped put in place language that supports new nurses entering the workforce and those who are displaced with proper orientation and training as needed.
Those who had or have the rescheduled days off or nine day fortnight have always been at risk of losing this arrangement whether under the 36 hour week or the new 37.5 hour week. Many have already lost it or did not have it. In mental health it has always been a welcome piece as it helps RPNs recharge their batteries to manage large caseloads. Be aware, you are allowed to present a case for maintaining this but it must be centered on the consumer's needs and any negative effect losing the RSDO will have on your ability to deliver quality care, such as burnout from excessive caseloads. This is a Collective Agreement signed by both the Nurses' Bargaining Association and the Employer so it is both your responsibility and ours, as your Union Representatives, to enforce the agreement. Simply reacting with displeasure to change will not resolve our staffing, safety, and workload issues. The UPN bargains for nurses' rights and brings the mental health side of the picture to the bargaining table. We maintain that RPNs are the profession of choice for mental health.
Over the past three months I have been busy visiting sites, which I plan to continue doing. Sites such as Hillside in Kamloops, 7 Oaks on lower Vancouver Island, Maples Adolescent Treatment Center and Burnaby Youth Custody Services, along with the Forensic Psychiatric Hospital in Port Coquitlam remain on the radar for violence against our nurses and staffing issues.
In February I had the opportunity to stand before some of our MLA's at the Provincial Parliament building in Victoria and present my concerns around violence in the workplace, for those of us working in mental health, and also to profile psychiatric nursing. The presentation was well received with many questions about what we do as RPNs and specific questions about the physical and verbal assaults we face on a daily basis.
I was able to sit with Mike Farnsworth, the NDP Health Critic, on different occasions over the last six months, and talk about psychiatric nursing and the mental health picture in British Columbia.
As many of you are discovering, even as RPNs, we are not immune to the pangs of change. The most recent Health Sector Collective Agreement negotiated by the Nurses Bargaining Association (NBA), of which we are a member along with the BCNU and the HSA, has brought considerable change and challenge in its implementation.
Two areas in particular have been the changes to the prescription drug coverage and the increase in hours to the 37.5 hour work week. During bargaining, information was provided to the NBA in good faith by the Employer's bargaining team around the pharmaceuticals that would and would not be covered if we agreed to join our prescription coverage to the BC PharmaCare formulary. Unfortunately, the information provided by the Employer was not accurate and as a result several drugs that we were told would be covered are not. Some medications that required Special Authority are also not covered and this was not the deal the NBA believed it was bargaining towards.
The NBA returned to the bargaining table on March 08th, 2013 and as a result the members can use their Blue Card to obtain prescriptions as they did before February 1, 2013 and the implementation of the PharmaCare tie in would be delayed until June 1, 2013. This will provide time for the NBA and the Health Employers Association to sit and try to bring resolution to outstanding issues around our prescription drug coverage and have a clearer idea around the impending changes to come. Issues around obtaining Special Authority Certificates which are required for certain medications should be pursued by the members with their health care providers along with, if necessary, identifying suitable replacements well in advance of the June 1, 2013 PharmaCare tie in start date. If questions arise around your coverage please contact Pacific Blue Cross at 604-419-2600
. Dan Murphy,UPN President






