When I first started my nursing career, I worked on the pediatric inpatient unit. I remember feeling sad and upset when getting report on my patients who had experienced terrible trauma in their young lives. I wondered how they would make it to and through adulthood after having survived abuse, neglect, witnessing violence, or serious illness or injury.

That was over 20 years ago, and now many of these patients are showing up in the health care system carrying their pain and bad memories with them. They may be the adult we meet with a substance or alcohol use issue, chronic pain, or help-rejecting behaviors. They might be the patient whom colleagues have labeled “difficult.” Or they might be chronically late for appointments or fail to show up at all. Frequently, people with a history of trauma can be further traumatized by an interaction with an uncaring health care system and choose to avoid getting the care they need. They may be experiencing symptoms of PTSD along with their other reasons for seeking health care.

Practicing trauma-informed-care (TIC) can help address this problem. June is PTSD awareness month, and we’d like to highlight our April CE feature, “Trauma-Informed Care in Nursing Practice.” Authors Elizabeth Dowdell and Patricia Speck point out:

Trauma-informed care “recognizes that effective care requires an understanding of patients’ lived experiences and may improve patient participation, treatment adherence, and health, as well as provider well-being, through the use of strategies that increase hope by pointing patients toward their goals.”

So, while this approach to care can benefit the patient, there is also benefit for the health care worker and health care system. And because we can’t know the full story of the patient upon first seeing them, the practice needs to be applied universally.

Trauma-informed care is founded on the following core principles:

  • safety
  • trustworthiness and transparency
  • peer support
  • collaboration and mutual support
  • empowerment (voice and choice), and
  • cultural and historical sensitivity

Dowdell and Speck give a detailed explanation of the need for TIC and what it entails, and they provide a case study to demonstrate application of its steps. There is also a podcast of an interview with the authors and a table of resources for more information.

I encourage you to read the article and apply trauma-informed care where you work (if you aren’t already).

By Christine Moffa, PhD, APRN, PMHNP-BC, senior clinical editor, AJN