How Do We Move Forward With Trauma-Informed Care?

Operator syndrome: Nursing care and considerations for military Special Operators

ABSTRACT

Operator syndrome is a common and predictable constellation of interrelated medical and psychiatric conditions and social and functional impairments experienced by special operations forces. Nurses in all settings should be aware of this emerging trend among veterans they encounter in practice so they may identify and intervene using evidence-based approaches and effect a positive outcome.

Text messaging support to enhance nurses' well-being and connectedness

ABSTRACT

Nurses face numerous stressors due to increasing patient acuity, challenging staffing ratios, and trauma from the COVID-19 pandemic, among many other factors. To help improve nurses' daily self-care, nurses need diverse tools and interventions, such as peer support through text messaging (TM). This article evaluates the benefits of TM and strategies to use TM in providing effective peer support among nurses.

Trauma Informed Care for Nursing Action Bachelor of Science in Nursing Course

BACKGROUND

Nurses commonly experience psychological trauma with high risk for a host of mental health concerns such as suicide, depression, anxiety, and substance use disorders, as well as high rates of burnout and moral injury. Despite rigorous academic preparation, baccalaureate nursing education curricula lack content on the widespread effects of trauma.

METHOD

Using a trauma informed care (TIC) model, an innovative course called Trauma Informed Care for Nursing Action (TIC4NA) was created.

RESULTS

This course allows students to safely explore the profession of nursing to transform their learning about trauma related to patient care, the nursing community, and society.

CONCLUSION

TIC curriculum delivery offers supportive strategies to mitigate negative outcomes during nursing school. This content could have positive effects on nurse and nursing student retention as well as mitigating a barrage of negative outcomes for individual nurses and the nursing profession. [J Nurs Educ. 2024;63(4):233-240.].

Impact of Trauma-Informed Care Training on Attitudes Among Emergency Department Personnel, Staff Advocates, and Nursing Students

BACKGROUND

Health care providers may risk retraumatizing patients and intensifying patient distress unless they practice trauma-informed care. As the first line of defense in assisting trauma survivors' physical and emotional recovery, health care providers must use a strengths-based framework that promotes resilience and expands on the trauma survivor's existing resources.

OBJECTIVE

This study aimed to compare the effect of trauma-informed care training on the attitudes of emergency department personnel, staff advocates, and nursing students toward trauma-informed care.

METHODS

This study used a pretest-posttest design. Assessment of attitudes toward trauma-informed care was done before and after trauma-informed care training. Data collection occurred from February 2021 through August 2021. Participants included three cohorts of emergency department staff, advocates for trauma survivors, and nursing students. Attitudes toward trauma-informed care were measured using the Attitudes Related to Trauma-Informed Care (ARTIC) Scale.

RESULTS

A total of 433 participants were studied, including 88 emergency department staff, 123 staff advocates, and 222 nursing students. All three cohorts significantly increased ARTIC Scale scores posttraining (p < .001). At preintervention, all three cohorts significantly differed from each other on ARTIC Scale scores (p < .01). In contrast, postintervention, ARTIC Scale scores did not significantly differ between nursing students and advocates (p = .99). Nursing students showed a significant increase in scores from pre- to postintervention compared with either advocates or emergency department staff.

CONCLUSION

The results strongly suggest that health care providers can improve attitudes toward trauma-informed care after completing training on the principles and application of trauma-informed care.

American Academy of Nursing Expert Panel Consensus Statement on leveraging equity in policy to improve recognition and treatment of mental health, substance use disorders, and nurse suicide

Rates of nurse mental health and substance use disorders are high. Heightened by the COVID-19 pandemic, nurses are challenged to care for patients in ways that often jeopardize their own health and increase risks for their families. These trends exacerbate the epidemic of suicide in nursing underscored by several professional organization clarion calls to nurses' risk. Principles of health equity and trauma-informed care dictate urgent action. The purpose of this paper is to establish consensus among clinical and policy leaders from Expert Panels of the American Academy of Nursing about actions to address risks to mental health and factors contributing to nurse suicide. Recommendations for mitigating barriers drew from the CDC's 2022 Suicide Prevention Resource for Action strategies to guide the nursing community to inform policy, education, research, and clinical practice with the goals of greater health promotion, risk reduction, and sustainment of nurses' health and well-being are provided.

Implementing a novel self-care clock strategy as part of a trauma awareness intervention in a university setting

PURPOSE

This study compared post- and preintervention trauma-informed care attitudes, explored relationships among outcomes, and identified self-care behavior changes participants are willing to make.

DESIGN AND METHODS

A quasi-experimental study with content analysis was conducted with 96 adults that took part in a Trauma Awareness Intervention including a novel self-care clock.

CONCLUSIONS

Participants' trauma-informed care attitudes improved (p ≤ 0.05) compared to baseline and were positively related to their post-intervention compassion scores (p < 0.05). Qualitative analyses revealed self-awareness, self-care, empathy, applying a trauma lens, changing the narrative, and student-centeredness as the main themes in participants' responses.

PRACTICAL IMPLICATIONS

This university-based initiative had a positive impact on attitudes toward trauma and should be explored in other settings, as there is an unmet need for trauma-informed care strategies at the community level.

Perspectives on Racism in Health Care Among Black Veterans With Chronic Kidney Disease

Importance

The burden of chronic kidney disease (CKD) and end-stage kidney disease falls disproportionately on Black individuals in the US, with Black veterans experiencing substantial consequences, and only a portion of the disparities in health conditions and health care can be explained by nonbiological factors. Among Black individuals, racism is likely one of those factors, suggesting the need to examine the consequences of racism and the resulting social structures that establish and perpetuate these racial disparities.

Objective

To investigate the health care experiences of Black veterans with CKD and identify and explore the racial discrimination encountered by this vulnerable population.

Design, Setting, and Participants

This qualitative study used semistructured interview guides to investigate the health care experiences of 36 Black veterans with CKD who received care at the Corporal Michael Crescenz Veterans Affairs Medical Center in Philadelphia, Pennsylvania, from October 2018 to September 2019. Interview transcripts were analyzed using applied thematic analysis.

Results

Among 36 Black veterans with CKD who characterized racism in the context of their care at a Veterans Affairs medical center, the mean (SD) age was 66.0 (7.8) years; 35 participants (97.2%) were male, 1 participant (2.8%) was female, and 19 participants (52.8%) were married. The mean (SD) duration of military service was 8.0 (7.0) years. Overall, 15 participants (41.7%) were not dependent on dialysis, and hypertension was the most common comorbidity (9 participants [25.0%]). Veterans described the ways in which racism produced emotional and physical stress, including psychological symptoms (eg, anger and hurt) and physiological symptoms (eg, headaches). Veterans described a strong sense of distrust in the health care system coupled with a need to be hypervigilant during clinical encounters. When encountering racism, veterans described bottling up their feelings, which sometimes led to maladaptive behavior (eg, substance use). Veterans also described individual and collective positive strategies (eg, faith) for coping with the stress of racism.

Conclusions and Relevance

In this study, Black veterans with CKD experienced racism in the clinical setting that produced physical and emotional stress and a strong sense of distrust in the health care system. These findings highlight an important opportunity for education and training of health care professionals in the implementation of trauma-informed approaches to care as a means of addressing race-based stress and trauma.