Nurses

Nurses caring for children in any healthcare setting will see ill or injured children (and their family members) who may be experiencing pediatric medical traumatic stress. Nurses are often the first to interact with patients and their families and the most consistent member of the healthcare team throughout their medical experience - and have a key role in providing trauma-informed pediatric care.

Recognizing the central role of nurses in addressing pediatric medical traumatic stress, CPTS has a National Nurse Advisory Committee that helps guide our work. For more information, contact CPTS.

How do nurses provide trauma-informed pediatric care?

Trauma-informed pediatric nursing care includes:

Realizing the potentially traumatic impact of illness, injury, and medical treatment experiences as well as the impact of prior trauma exposure
Recognizing reactions and behaviors that may indicate pediatric medical traumatic stress, and factors that might place some children at higher risk
Responding by taking action to reduce Distress, promote Emotional support, and address Family immediate needs (See more about the "D-E-F" framework)

Nurses in any specialty or setting can:

be aware of the prevalence of traumatic stress and its impact
implement trauma-informed practices at critical junctures across all phases of care
- use the D-E-F framework to guide care
recognize signs and symptoms of pediatric medical traumatic stress
screen for traumatic stress reactions and risk factors and make referrals for mental health care when warranted
keep developmental and cultural factors in mind
actively address inequities and health disparities that can impact care and increase traumatic stress

Nurses can serve as champions for trauma-informed practices with their peers and in their clinical leadership roles in healthcare systems. A survey of nurses providing pediatric acute trauma care found that nurses generally felt confident in providing many elements of trauma-informed care, but identified gaps in practice and need for additional training.

Tools and resources for nurses providing trauma-informed care

Find tools to help implement the D-E-F framework in your practice setting
Download free patient education handouts for pediatric patients and their parents
Find tools for screening and assessment of pediatric patients and families
TIC Provider Survey: Questionnaire to assess nurses' knowledge, opinions, confidence, and current practices related to trauma-informed pediatric care.
Observational Checklist for Pediatric Resuscitation: Checklist to help teams gauge assess their implementation of best practices in family-centered and trauma-informed care during pediatric resuscitation.
Trauma Toolbox for Primary Care
Policy statement from Emergency Nurses Association and other leading organizations on Patient- and Family-Centered Care of Children in the Emergency Department

Training and education for nurses and trauma-informed care

Take a 1 hour online course on pediatric medical traumatic stress and trauma-informed care from CPTS library of courses - earn FREE nursing CE credit
Under development: Trauma-Informed Nursing Course
- Template and materials for academic course at Schools of Nursing
- For more information contact CPTS
Find more training and education resources

Nurses and secondary traumatic stress

Like all healthcare providers, nurses may experience secondary traumatic stress reactions related to their work caring for pediatric patients. Several surveys of pediatric nurses have found that more than half experience secondary traumatic stress related to their work (see Berger and Kellogg references below).

Nurses can address secondary traumatic stress by promoting their own and their colleagues' self-care, and being champions for organizational supports for all staff.

Tools and resources for secondary traumatic stress

Download a slideset on secondary traumatic stress to share with your team
Take a 1 hour online course on secondary traumatic stress
Learn about quick tools for coping with stress related to COVID-19

Relevant readings and research on nurses and trauma-informed care

Berger, et al. (2015). Compassion fatigue in pediatric nurses. Journal of Pediatric Nursing.
Fleishman, et al. (2019). Trauma-informed nursing practice. Online Journal of Issues in Nursing (OJIN; a scholarly journal of the American Nurses Association).
Kassam-Adams, et al. (2015). Nurses' views and current practice of trauma-informed pediatric nursing care. Journal of Pediatric Nursing.
Kellogg, et al. (2018). Secondary traumatic stress in pediatric nurses. Journal of Pediatric Nursing.
Ryan-Wenger & Gardner (2012). Hospitalized children's perspectives on the quality and equity of their nursing care. Journal of Nursing Care Quality.
Wheeler & Phillips (2019). Development of trauma and resilience competencies for nursing education. Journal of the American Psychiatric Nurses Association.

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Pediatric Medical Traumatic Stress

Patient Education

Screening & Assessment

Intervention

Trauma-Informed Care

COVID-19

Resources