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to give short answers to these 2 post.
1- Trauma-Informed Care
“Trauma-informed care is an evidence-based approach to deliver healthcare in a way that recognizes and responds to the long-term health effects of the experience of trauma in patient’s lives”. (J. C. N. vol 33, p 206). I have been working for a while in the mental health care system and meeting daily with traumatized people but I’ve never realized how much impact this could have on these people’s lifelong health. Through ACE and COLEVA tools, I was informed about the wide-ranging impact that violence and abuse has on the health and well-being of all people. I was astonished to learn that each ACE score has a meaning on some kind of chronic diseases. For instance, a four categories of ACEs have a 240 percent greater risk of hepatitis, were 390 percent more likely to have COPD, and a 240 percent higher risk of a STD. (Felitti et al., 1998). I have never heard of these tools before, but I must admit that this material is very informative.
I always thought that only the mental part system was affected when someone suffering from trauma, but I didn’t know if the other systems could be affected as well. Numerous are some people, especially women victimized from Domestic Violence by their husbands or partners. The abuse can be physical, mental, and emotional. Most of these women who are living this kind of situation find themselves trapped in a violent relationship. They usually blame themselves and take the guilt because the abuser convinced them that they are the problem, and they are responsible for whatever happened. (Walker 1979; 1984). Lamentably, most of the time, children have to witness these weird behaviors. They can experience domestic violence in many ways. They may hear one parent threaten the other, observe a parent who is out of control or reckless with anger or see one parent assault the other. I interviewed a seventeen year old boy who was living in a domestic violence house with his parents and his two baby sisters. He reported living in this situation since he was four years old where he has been seeing his dad beating his mom incessantly. He continued by saying that he did the same to his sisters because he thought it was a good thing. The young boy explained that he has been in and out of jail for assaulting people, mostly females. It is very sad to hear this kind of testimony from a young boy. He had no childhood. He had difficulty in completing school because he couldn’t concentrate. He is now doing drugs in order to relieve his frustrations which cause him having suicidal ideation.
I also met with a rape survivor woman who initially suffered from PTSD, and later developed health complications due to this trauma. She recounted that she feels ashamed of herself, she can barely function, and she is been having nightmares and flashbacks. This woman is now diagnosed with CHF, chronic migraine, panic attack, and suicidal ideation. She also has relationship problem because she has no interest in sexual activity which caused her two divorces.
This is a very important subject that needs everybody’s attention and participation. I think as a nurse, I need to have a good understanding and knowledge on Trauma-informed care and using it along with the tools as a possibility to improve my practice and the outcomes for my clients, mostly those with chronic illness. The least thing a traumatized client needs is the feeling of being judged. As a nurse, it’s imperative to create a safe and comfortable environment when meeting with traumatized clients. Although in the mental health practice, a good communication skill is primordial in order to establish trust and confidence between the nurse and the client.
Felitti et al. (1998). Diagnostic Interview Schedule of the National Institute of Mental Health.
National Center for Trauma-informed Care-http://www.samshsa.gov/nctic
Trauma-informed Care: Helping Patients with a Painful pain Past. Journal of Christian Nursing, October/December 2016, Vol. 33, 4, p 206-213.
Walker, L.E. (1979). The battered woman. New York: Harper & Row.
Weber, J. R. & Kelley, J. H. (2018). Health Assessment in Nursing, 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins. CoursePoint-Online Etext & resources…
2- Trauma Informed Care
According to Merriam-Webster, trauma is an unpleasant or difficult experience that causes a disordered psychic, mental, behavioral, and emotional problem. Trauma can affect the strongest and most resilient people. There are different types of trauma; physical trauma is measurable and visible to the eye. In addition, pain can also lead to a change in a person normal level of functioning. Trauma can also happens due to stress, disease process, and emotional crisis can cause a profound impact in a person’s life. The way an individual copes with a crisis depends on that person prior experiences, support system, and resources available in the community to provide them with the necessary care and tools they might need.
Two key points that is fundamental to be ready as a health care provider is to be training and treat psychological trauma as any physical disease. Unfortunately, there is not enough training offer to health care personnel to provide patients all the support needed during a traumatic experience. In addition, patient education needs to be taught to families to learn to different coping mechanics and strategies in how to handle or live with a crisis.
According to Boles, “In trauma informed care, it is important to take time to validate a person’s coping mechanics, strengths, and support system to recognize that they are active participants in their own experience; trauma is not happening to them but around them because they have the tools to interrupt the potential cycle of trauma” (2017, p. 251).
It is fundamental to be well informed of all techniques and trauma informed evidenced treatments to adopt all necessary measurements, work as team to recognize all the non-visible or tangible symptoms of a crisis to respond in an effective and efficiently time manner.
As a nurse, I must be able to recognize, validate, and treat all the effects of any type of trauma or crisis. By doing so, I am providing holistic patient-centered care helping them create the bases for positive coping strategies to overcome any difficult situation.
In addition, implementing the nursing process, therapeutic relationship, therapeutic communication, and implementing evidence-based approach help improve patient outcomes. Recognizing that mental health condition can lead to other co morbid diseases such as obesity, diabetes, respiratory and cardiac conditions would prevent physical de-conditioning. we play a big role to identify risk factors, provide patient education, and look for all resources available to provide our patients effective nursing care.