As nurses, how can we help patients with a painful past? The experience of trauma in people’s lives has a direct impact on their health behaviors, particularly an increased risk of mortality from chronic illness.
Trauma-informed care (TIC) is an approach to engage people with a history of life trauma that recognizes trauma symptoms and acknowledges the role trauma has played in their lives.
“For nurses, this translates into understanding the why behind health behaviors of our patients, withholding judgment for negative health behaviors, and helping patients heal physically, psychologically and spiritually,” writes Cathy Koetting, DNP, APRN, in her article, “Trauma-Informed Care” in Journal of Christian Nursing, Oct-Dec 2016.
Trauma-informed care seeks to change the illness paradigm from one that asks, “What’s wrong with you?” to “What has happened to you?” Studies indicate that health risk behavior and disease in childhood can be related to the span of exposure of childhood emotional, physical or sexual abuse, and household dysfunction.
In her article, Koetting outlines four essential approaches and six specific principles that define TIC, including safety, trustworthiness, peer support, and empowerment—especially through spirituality.
These concepts are evident in John 4 where Jesus provides a model of trauma-informed care for the woman he encountered at the well in Samaria:
- Jesus realized the impact of trauma on this woman’s life and reached out to her, treating her graciously.
- He recognized her trauma and gently responded, with respect and insight.
- Instead of judging and retraumatizing her, Jesus offered a relationship with God.
- Jesus gave the woman a voice as he took into account current cultural, historical, and gender issues.
- He created a safe space to interact and proved himself trustworthy.
- He empowered the Samaritan woman by being transparent and giving her knowledge that he was the Messiah.
“Nurses need to be aware of how they can integrate these ideas into practice,” Koetting urges. “The goal is to guide patients from a state of trauma to one of healing, to help patients alter their family and community environments so it is less traumatic.”
Increasing awareness of the need for TIC and conversations with colleagues can be the start of a cultural shift in the workplace. Healthcare organizations are often stressful and chaotic places in which to work, but TIC can transform the care-giving experience for nurses by remodeling their workplace culture to one that promotes holistic recovery for all.