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The Trauma-informed NP

Many professionals have reached out to me about difficulty addressing the impromptu conversations with clients about their trauma experiences, or even discomfort asking questions about trauma during assessments. Most apprehension seems to be about how to be supportive, and address trauma in a sensitive way without going outside your comfort zone as a non-trauma professional or counselor. I want to provide three actionable tips to developing a more trauma-informed space within your patient interactions, as well as, some basic normalizing information about trauma.

Humbly stated, trauma is a shared human experience due to the prevalence and incidence of trauma throughout the world, and transgenerationally. No one is exempt from having a traumatic experience whether the experience was having a bad reaction to a medication, being sexually assaulted, or surviving a car accident. Everyone’s perception of trauma is different because of the multitude of possible traumatic experiences that can occur in one’s life. Trauma is defined as any burdensome, stressful, or adverse experience that is difficult for us to cope with whether momentarily or long term. There is a lasting impact of trauma on our emotional, physical and/or mental well-being, which alters how we see ourselves and the world around us. With this basic humanizing understanding of trauma, we can connect with our patients in a more empathetic, and non-stigmatizing way.

Tip 1
Establish a spirit of safety, comfort and non-judgement within your shared space with clients.

Reaffirm to them HIPAA and Confidentiality information pertaining to trauma and disclosure. Make sure to be transparent about the reason you are asking about their trauma history, as many people can be skeptical and private about past trauma. Prior to asking specific questions about trauma, prepare them by stating, “I am going to ask a couple questions about trauma. I know this can be difficult. Please let me know if you are uncomfortable”. Also, do your best to adhere to some of their requests about trauma triggers such as not having their back towards the door, requesting the doors opened or closed, speaking with one gender or another, etc. These basic requests can really alter their level of engagement and participation, as well as attitude. Lastly, look in their chart regarding their trauma history. Patients do not want to keep revisiting trauma history each visit. My suggestion is to simply confirm past trauma history versus asking the questions again. This is a sign of compassion that patients really appreciate.

Tip 2
Your clients want to feel humanized and cared for.

Connect with them as a human first, professional second. Validate their traumatic experiences with empathy and true listening. Show them with your body language that you care about their words by giving them good eye contact, facing them, and not multitasking. Be mindful to not cut them off, be dismissive, or ignore them. Giving them space to just talk can be so powerful. Sometimes, they just want to tell someone, and be safely vulnerable.

Tip 3
Leave the conversation on a positive, uplifting note.

Thank them for disclosing their trauma experiences as discussing trauma can be difficult. Be mindful about a client needing an appropriate referral or resource. Make sure to provide that supportive information if needed.

Family Nurse Practitioner, Clinical Instructor at Georgia State University, & Author of Out of Crazy Born Genius