How can doctors and nurses possibly add one more test, screener, or question to a 15 minute visit packed so full it's a wonder how they remember to check on everything? Doctors and nurses are pulled in so many different directions by so many different organizations, but it's for a good reason:
"We know the one place that parents go with their children is to the doctor...After birth you go as many as eight times to the primary care practitioner for well child care and immunizations. So, we have a unique opportunity to screen and support parents and to screen them to let them know they’re not alone and that we can help them.”
How can doctors and nurses possibly add more to the patient visit? And why? Would it make the care provided or the health outcome for the patient better? When implementing trauma informed care, it's important to remember two points: 1) the importance behind the need to be trauma informed and 2) the ease of incorporating trauma informed care into an already jam packed visit.
Trauma informed care means incorporating an understanding of traumatic stress into the daily care of patients and their families. This includes the inherent traumatic nature of a medical visit, as well as the trauma each individual patient and family may or may not have experienced in their lifetime. In recent years, trauma informed care has become quite the buzz word, along with adverse childhood experiences and toxic stress. And for good reason, as Elisa Nicholas, MD, MSPH, CEO of The Children's Clinic and pediatrician explains: "The cost of ignoring childhood stress and trauma can be immense for children — decreased executive function, problems in school and increased risk of alcohol and drug use. As they grow into adulthood, the problems can escalate to obesity, poverty, hypertension, heart disease, diabetes and myriad other problems."
In order to address all of these issues, you might believe incorporating trauma informed care would require a drastic overhaul to how you care for patients or numerous screeners to completed at each visit. This is simply not true. Depending on the patient's individual concerns, you may use an additional screener or two. But the most critical aspect of trauma informed care is shifting the lens through which you view your patients and families:
“It’s really opened their eyes to see if they have a patient who is not complying with their recommendations or not improving where they should be. They think about this and ask, ‘Is there something going on in your life that’s keeping you from helping yourself with your disease?’ Whether they’re not taking their medicines or they’re not testing their blood sugars. And a lot of times there’s something going on that they need help with,” says Dr. Nicholas.
It's really as simple as shifting perspective. No extra tests, screeners, or questions required for the vast majority your patients. Visit our Facebook page to share your tips and help other doctors and nurses take the first steps to implementing trauma informed care!