Trauma-Informed Care Podcasts: A Vital Resource for Nursing Students

The experiences of our older relatives - particularly, troubling or distressing experiences - can ripple through time and influence who we are today. In healthcare, education, and public health, the concept of trauma-informed care is gaining traction and being extensively studied. This article explores the significance of trauma-informed care, particularly for nursing students, and highlights the value of podcasts as educational resources in this field.

Introduction to Trauma-Informed Care

Trauma-informed care is an approach to practice that strives to understand how past traumas affect why our patients do (or don’t do) what is needed in order to manage their health optimally. Instead of asking, "What's wrong with you?", trauma-informed care prompts us to ask, "What happened to you?". When you look at what happened to them, we're all born this perfect child … what happened that impacted our life to where now, they're a drug addict or now they have anger management problems, or to now where they're really successful or they're really happy? We all have experiences in life that impact us.

This approach recognizes that exposure to trauma is more prevalent than one might first assume. Surveys routinely show that more than half the respondents report trauma in their past history. Traumatic experiences and the chronic stress they cause affects the HPA axis, limbic system, and neurotransmitter dysregulation. Altogether, this is a significant amount of strain on the body which can lead to physical manifestations. Additionally, trauma can affect a patient’s ability to get routine and preventive care. Many times these patients are labeled “noncompliant,” and instead of recognizing the trauma, addressing the barriers that it creates, and providing true patient-centered care, these patients often get lost in the healthcare system. The result is they often avoid seeking care or abandon treatment prematurely.

The Role of Forensic Nurses in Trauma-Informed Care

A forensic nurse is a nurse that is trained to come in and help take care of people that have experienced some type of trauma, whether it's historical or acute trauma. Most of the time, in the setting that I work, it's an acute trauma. Forensic nurses often work with community partners that include rape crisis centers, advocates, prosecutors, police, and law enforcement, and within the criminal justice system.

Forensic nurse examiners look for signs of generational trauma when working with people. Generational trauma is emotional and psychological abuse that you have experienced through life. It can be the way that your parents have parented. It's the way that cultural stories and narratives are told. There are biological factors. Generational trauma - it means it's something that was passed down from a different generation to you.

Read also: Supportive Learning Spaces

The Impact of Trauma on Health

Trauma affects your ability to take care of yourself mentally and physically. There's research that shows that, with a lot of childhood trauma, you might be experiencing more problems with eating disorders. It's not enough food, too much food, a coping mechanism. You're an emotional eater to cope with your problems, so it can lead to obesity. It might be there's a correlation with trauma and asthma and how your body reacts. When you're stressed, the release of different hormones in your body, how you cope and stuff, do you have more asthma attacks than the average person? How does this lead to hypertension? How does this lead to heart disease? There's correlations and much research out there about how trauma and how you process it affects you physically. You think about people who are really stressed and internalized. They might have ulcers. They might have high blood pressure, all of that.

Podcasts as a Learning Tool for Nursing Students

Podcasts provide a readily accessible and convenient way for nursing students to learn about trauma-informed care. They can be listened to during commutes, study breaks, or even while performing other tasks. Whether you are a beginning or an experienced nurse educator, you will get new ideas for your teaching in this podcast. Experts share teaching strategies you can use with your nursing students.

Nurse Educator Podcast

The Nurse Educator podcast offers new ideas for both beginning and experienced nurse educators. Experts share teaching strategies that can be used with nursing students.

Health Essentials Podcast

The Health Essentials Podcast features experts, such as forensic nurse examiner Michele Reali-Sorrell, who offer deeper insight into how our minds and bodies work in relation to trauma.

Beyond Nurse Residency Podcast

The Beyond Nurse Residency Podcast is an educational series where experts are interviewed on topics related to the transition of new graduate nurses into practice and beyond. In one episode, Heidi Gilroy, Director of Professional Development, Magnet, and Research at Memorial Hermann The Woodlands Medical Center, discusses trauma-informed professional development.

Read also: Nursing Education and Trauma

Straight A Nursing Podcast

The Straight A Nursing podcast discussed trauma informed care is an approach to practice that strives to understand how past traumas affect why our patients do (or don’t do) what is needed in order to manage their health optimally.

Key Principles of Trauma-Informed Care

Substance Abuse and Mental Health Services Administration (SAMHSA) has identified six key principles of a trauma-informed approach to healthcare in their resource “Guiding Principles of Trauma-Informed Care”.

Safety: Creating a safe environment, both physically and emotionally.
Trustworthiness and Transparency: Building and maintaining trust with patients.
Peer Support: Utilizing peer support and mutual self-help.
Collaboration and Mutuality: Emphasizing collaboration and shared decision-making.
Empowerment, Voice, and Choice: Empowering patients and providing them with choices.
Cultural, Historical, and Gender Issues: Addressing cultural, historical, and gender issues.

Trauma-Informed Professional Development for Nurses

Trauma-informed professional development is an integration of the assumptions and principles of the trauma-informed approach into the Nursing Professional Development (NPD) practice model. We don't have to identify who has experienced trauma. We don't have to know if they're having any symptoms. What we're doing is we're making a big picture approach to creating a healing environment.

Safety is really at the forefront of all of this. So we want to make sure our patients are safe. Our visitors are safe and now more important than ever both to to, you know, direct care practitioners as well as hospital administrators, care team well-being and safety is also hugely important. So we've already been talking a lot about psychological safety and healthcare. It's it's part of the, you know, whole high reliability organization framework to be able to speak up. If you think there's a safety issue or even just a way to make a process better.

Nurses also need physical safety, so feeling physically safe is really important to well-being. So we think a lot about like specifically workplace violence or the actual physical events that happen to nurses. But we don't talk as much about just fear. So like. To our nurses feel safe walking through the garage, getting to work. You know, after the sunsets or even driving to work, or getting on a bus or or however they they get.

Professional safety is being comfortable that you have the knowledge and resources you need to function as a licensed nurse without risking an error or risking your license.

Practical Applications of Trauma-Informed Care

Letting the patient know you are going to touch them before beginning your assessment or intervention, especially if it involves removing clothes or touching genitals or breasts.
Greet patients and families warmly and with sincerity.
Collaborate with patients on their plan of care.

Screening Tools for Trauma

One tool used for screening adults for past trauma is The Stressful Life Events Screening Questionnaire (SLE), which is a 20-question tool assessing exposure to traumatic events. Another tool is the Trauma Assessment for Adults (TAA) which is a 17-item assessment tool that asks the individual about potentially traumatic events using a yes/no format.

The New Jersey Division of Mental Health and Addiction Services suggests introducing the screening tool in a way that fosters an environment of safety and trust. “It is common for people to have experienced stressful and upsetting events. Even if those events happened to you a long time ago, those events can still affect how a person thinks and feels today. People who have experienced a traumatic event, a series of traumatic events, or certain kinds of stress over time can have different needs than people who have not. Because of this, it is helpful for us to be aware of your past experiences, and the way in which those events may still affect you. We would like you to answer the following questions on your own to see if any of these things have happened to you. These kinds of events can be frightening or distressing to almost everyone.

Addressing Hierarchical Challenges in Clinical Education

In clinical education, “teaching up” refers to instances when students tactfully share updated clinical information with preceptors who may not be up to date on recent evidence-based practices. Drs Ragan Johnson, Janelle Bludorn, and Brittany Macon-Davis describe this challenges for students and offer 2 methods of preparing students to educate their preceptors.

In the graduate nursing program, after a prebrief, students role-played scenarios, including outdated asthma guidelines, with faculty serving as preceptors. A structured debrief on giving and receiving feedback, role of power dynamics in professionalism, and psychological and patient safety with the entire class followed with opportunities for students to share various language suggestions. The PA program used a self-directed approach where learners role-played scenarios in which a PA student addressed a preceptor using outdated hypertension guidelines. Structured questions explored giving and receiving feedback and interacting with supervising physicians.

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