Experts estimate that 70% of U.S. adults have experienced a traumatic event in their lifetime.1 While many move on from trauma without serious, lingering effects, many others develop psychological and/or behavioral health issues. If you’re a nurse, you’ve likely had more than a few patients who’ve been suffering from the effects of trauma. And you’re likely to have many more such patients in the future, even if you aren’t a psych nurse.
What should you do when you encounter a patient suffering from psychological issues related to trauma? The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) has some answers in their publication, SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach.2 Studied by Walden University Master of Science in Nursing (MSN) students in the course Psychotherapy With Individuals, SAMHSA’s trauma-informed approach to patient care provides key insights into how you, your colleagues, mental health counselors, and the healthcare system in general should approach patients who’ve suffered trauma. As excerpted from SAMHSA’s guide, here’s what Walden MSN nursing students are studying:
SAMHSA’s Trauma-Informed Approach: Key Assumptions and Principles
Trauma researchers, practitioners and survivors have recognized that the understanding of trauma and trauma-specific interventions is not sufficient to optimize outcomes for trauma survivors nor to influence how service systems conduct their business. The context in which trauma is addressed or treatments deployed contributes to the outcomes for the trauma survivors, the people receiving services, and the individuals staffing the systems. Referred to variably as “trauma-informed care” or “trauma-informed approach” this framework is regarded as essential to the context of care. SAMHSA’s concept of a trauma-informed approach is grounded in a set of four assumptions...
The Four “R’s”: Key Assumptions in a Trauma-Informed Approach
In a trauma-informed approach, all people at all levels of the organization or system have a basic realization about trauma and understand how trauma can affect families, groups, organizations, and communities as well as individuals. People’s experience and behavior are understood in the context of coping strategies designed to survive adversity and overwhelming circumstances, whether these occurred in the past (i.e., a client dealing with prior child abuse), whether they are currently manifesting (i.e., a staff member living with domestic violence in the home), or whether they are related to the emotional distress that results in hearing about the firsthand experiences of another (i.e., secondary traumatic stress experienced by a direct care professional).There is an understanding that trauma plays a role in mental and substance use disorders and should be systematically addressed in prevention, treatment, and recovery settings. Similarly, there is a realization that trauma is not confined to the behavioral health specialty service sector, but is integral to other systems (e.g., child welfare, criminal justice, primary healthcare, peer-run and community organizations) and is often a barrier to effective outcomes in those systems as well.
People in the organization or system are also able to recognize the signs of trauma. These signs may be gender, age, or setting-specific and may be manifest by individuals seeking or providing services in these settings. Trauma screening and assessment assist in the recognition of trauma, as do workforce development, employee assistance, and supervision practices.
The program, organization, or system responds by applying the principles of a trauma-informed approach to all areas of functioning. The program, organization, or system integrates an understanding that the experience of traumatic events impacts all people involved, whether directly or indirectly. Staff in every part of the organization, from the person who greets clients at the door to the executives and the governance board, have changed their language, behaviors and policies to take into consideration the experiences of trauma among children and adult users of the services and among staff providing the services. This is accomplished through staff training, a budget that supports this ongoing training, and leadership that realizes the role of trauma in the lives of their staff and the people they serve. The organization has practitioners trained in evidence-based trauma practices. Policies of the organization, such as mission statements, staff handbooks, and manuals promote a culture based on beliefs about resilience, recovery, and healing from trauma. For instance, the agency’s mission may include an intentional statement on the organization’s commitment to promote trauma recovery; agency policies demonstrate a commitment to incorporating perspectives of people served through the establishment of client advisory boards or inclusion of people who have received services on the agency’s board of directors; or agency training includes resources for mentoring supervisors on helping staff address secondary traumatic stress. The organization is committed to providing a physically and psychologically safe environment. Leadership ensures that staff work in an environment that promotes trust, fairness and transparency. The program’s, organization’s, or system’s response involves a universal precautions approach in which one expects the presence of trauma in lives of individuals being served, ensuring not to replicate it.
A trauma-informed approach seeks to resist re-traumatization of clients as well as staff. Organizations often inadvertently create stressful or toxic environments that interfere with the recovery of clients, the well-being of staff, and the fulfillment of the organizational mission. Staff who work within a trauma-informed environment are taught to recognize how organizational practices may trigger painful memories and re-traumatize clients with trauma histories. For example, they recognize that using restraints on a person who has been sexually abused or placing a child who has been neglected and abandoned in a seclusion room may be re-traumatizing and interfere with healing and recovery.
How Can You Learn More About Patient Care?
In Walden University’s MSN program, SAMHSA’s guide to using a trauma-informed approach is just one of the many materials you can study—and just one of the many ways you can improve your knowledge of nursing and your ability to provide quality patient care. In fact, through Walden’s master’s in nursing program, you can gain the skills and qualifications you need to advance your career to the level of nurse practitioner, with the option of becoming a psychiatric-mental health nurse practitioner.3
If earning an MSN degree sounds like the right path for you and your career, you may be wondering how you can make going to nursing school a reality. The good news is, Walden’s online education platform makes earning a Master of Science in Nursing more convenient than you probably think. Through Walden’s online MSN programs, you can complete your coursework from home or from anywhere else you have internet access. On top of that, earning a master’s in nursing online gives you the power to choose when in the day you attend class. This means you can schedule your master’s degree in nursing schoolwork around your nursing shifts, making it possible for you to continue working full time.
If you don’t yet have a bachelor’s degree, Walden has a solution for that, too. With Walden’s RN to MSN online program option, you can choose an MSN degree path that takes you straight from your RN to your MSN without needing to earn a bachelor’s first. Combined with all the other advantages of online learning, Walden’s MSN and RN to MSN programs offer a phenomenal opportunity to nurses looking to get ahead.
Walden University is an accredited institution offering a Master of Science in Nursing degree program online. Expand your career options and earn your degree in a convenient, flexible format that fits your busy life.
1Source: www.sidran.org/resources/for-survivors-and-loved-ones/post-traumatic-stress-disorder-fact-sheet.
2Source: https://store.samhsa.gov/shin/content//SMA14-4884/SMA14-4884.pdf.
3Career options may require additional experience, training, or other factors beyond the successful completion of this degree program.
Walden University is accredited by The Higher Learning Commission, www.hlcommission.org.