What is trauma-informed care? Safe or not?

[funmom]

I'm thinking about going into psych nursing. Has anyone ever heard of something called Trauma-Informed Care? Two places that I applied to mentioned this. Does this mean that staff wouldn't be able to use different holds to restrain a violent patient? What if there was a situation where a patient is out of control and trying to assault somebody, like another patient or any of the staff or struggling to escape? Would nurses get in trouble for placing a patient in a hold on the ground? I admit I don't know much about pscyh nursing and do not have any experience in this area. I just remember that I found my nursing school psych rotation to be very interesting. Would I be safe working with something like this? My husband is very worried about this and doesn't want me to get a part-time job in psych.

[Meraki]

Hi Funmom,

Trauma Informed care simply means that the care you provide is informed by an understanding of trauma and traumatic stress and how those things impact people emotionally, behaviourally, psychologically, physically and socially. Many psych patients have a trauma history. Trauma can lead to emotional and behavioural overreactivity, fight-flight-freeze and many other physicological and psychological symptoms. So trauma informed care is looking at the behaviour and presentation of the patient through a trauma lens and planning care with an understanding of trauma in mind. For example some people who have been through trauma are triggered by certain verbal or non verbal cues that can cause them to be aggressive or avoidant in an effort to protect / defend themselves. So if you saw this behaviour in the patients you would look at it as being trauma related rather than 'difficult' behaviour. Trauma informed care is a very good thing and can actually reduce the need for restraints / physical interventions as a better understanding of what is going on behind the behaviour can help staff predict adn prevent triggering or retraumatizing situations.

If you have good policies in place, a meaningful therapeutic program, sufficient staff, a good understanding of trauma, good deescalation skills, good attunement to patient needs, genuine care and concern and the time to really get to know your patients you can avoid almost all situations that would require physical intervention. I work on a very active crisis unit for patients with severe, complex and chronic mental health needs and we sometimes go months between any kind of physical hold. It takes a lot of work and supportive management and a good team to make that happen.

People get hurt when those things mentioned at the start of the second paragraph aren't in place. Lots of people who work in psych have never been hurt to the pointof being injured. Others have. To me them asking you about trauma informed care is a good sign - ask lots of questions to make sure it is a facility you would feel safe at.

Hope that helps