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Trauma Informed Care in Hospital Settings - is it missing?

Sometimes life throws a curve ball and the best you can do is bunt.  It's been almost two weeks since my nearly 80 yo mother fell at home and dragged herself towards the phone, using her walking stick to knock the handset onto the floor to call 911.  Not wanting to alarm her neighbor's she asked that the ambulance drive up without their siren.  I received a call from my mom's cell phone and I was surprised to hear a mans voice - the EMT - my mom was being transported by ambulance..... at the emergency department 50 miles from my home, we learned my mom had fractured her hip.  Later, as she was being prepped for surgery, nearly 72 hrs after her fall, I was told her fractured hip was also dislocated.  I cannot fathom the pain .... 

Throughout my mom's hospital stay, surgery, and transfer to rehab - I kept looking for evidence that the healthcare system had adopted awareness of trauma informed practices / best practices for ACE survivors.  And, as the daughter of the patient, I did not experience any practices that indicated an institutional awareness of vicarious trauma - from of seeing a loved one in intense pain, confused, and completely dependent.  As a public health nurse, I witnessed too many missed opportunities to respectfully provide the patient with care that did NOT compound her traumatic, life changing experience.

A quick PubMed search indicates there is abundant research to support implementation of trauma informed practices with elderly ACES survivors and patients in general.

This ongoing, traumatic experience (post op day 11 and still the physical therapy ordered so long ago - has not begun) .... 

Are there any local, state or national hospital / healthcare systems that have implemented trauma informed care practices?  From what I've found there is a very strong business case - the return on investment in terms of fiscal benefit are known.  So I am left wondering - why haven't trauma informed practices been adopted as the standard of care in local and regional hospital settings?  




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First of all, Karen, I am so sorry for your mother and yourself.  Secondly, there are few times that people feel more vulnerable than when there is a medical emergency.  We are so dependent on the care of others, and anytime that care is not trauma-informed, it is less than quality care.  I think this is a very BIG issue.  We don't necessarily choose our medical providers because they are people that show compassion.  We choose people that are smart and like to read books and study chemistry!  However, on the side of providers, they are often expected to do a lot more than may be humanely possible and I think that adds to their distancing professionalism.  But we know, anything that reduces anxiety in patients, will help with recovery and will also help with their responses to providers.  So, yes, it is way past time we push for trauma informed care in all of our medical systems.  Hope your mom is on the mend and you are hanging in there.

Thank you for sharing this story, Karen!  A friend of mine just posed on facebook today a similar experience of feeling despondent in a hospital setting. His two year old son is a patient at the Children's Hospital in Oakland, and is undergoing very painful procedures. My friend was struggling to be a strong, supportive parent as his tiny, dear child suffered.  Shouldn't "care" include best efforts to mitigate trauma as it occurs and certainly to be sensitive to compounding trauma from the past impacting medical trauma?  Shouldn't "care" include care for the spirit and not just the body?  I hope we can advocate for changes, Karen, so your family and others can find true physical and emotional support in overcoming a health challenge.

Karen, clearly it's a good thing you are there to advocate for her. Your comments have made me rethink some of the issues I've been dealing with in terms of caring for my parents, so thank you for raising this matter. I think as many of us are or become involved in the care of our parents, we will see the system of care in a new light.  Within the healthcare system, there is far too much pressure to address the presenting problem and not acknowledge the person or underlying issue.

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