00:05
What is trauma informed care?
And why is it necessary for
us to even talk about it?
Well, trauma informed care is care
that gives us a complete picture
and considers a person's
entire life situation.
00:19
And it's healing focus.
00:21
So the whole beginning of care is
around that healing orientation
and health outcomes.
00:28
And also considering
the whole person.
00:30
When we don't consider
someone's entire life picture
where we can do is cause
harm up to an including death
and also trigger people
through retraumatization
unintentionally, when we haphazardly
approach care of a person.
00:45
And oftentimes we do that because
we think about what is
the person here for today.
00:51
We're not thinking about all the
things that created the situations
that we deal with, with a person
each time they show up.
00:58
And also considering when we
talk about trauma informed care,
that you may not get
that whole picture
the first day you meet the person,
but we want to consider it
with each subsequent visit.
01:09
So with trauma
informed interactions,
we definitely want
to approach it always
from a focus on respect.
01:16
Respect for human life and dignity,
which is one of those
humanitarian principles.
01:22
With the core principles
of trauma-informed care,
it begins with safety.
01:26
And when we think about safety,
we're thinking about
physical safety,
as well as psychological safety.
01:32
How do we create
psychological safety?
Where we're obviously
we can't control
what someone thinks and feels,
but the way we act can promote
that psychological safety.
01:42
And we do that with
empowering patients
embodying everything
about them being a human.
01:49
A human life, the
dignity, the respect,
respect for whatever that trauma is
to that patient and their response.
01:56
Trust worthiness and transparency
is another one of those principles.
02:00
We definitely want to make
sure we include people
in everything being transparent
about everything we're going to do,
making decisions with the goal of
building and maintaining trust.
02:11
And how do we do that?
Number one, embracing people.
02:15
and every part of those people
without judgment.
02:18
Peer support is a big one.
02:20
When we think about trauma informed
care in the workplace environment.
02:23
What does it look like
in terms of that?
So if someone is
burned out on something,
maybe taking care of a
particular type of patient
at one point in time,
and they get burned out
a patient that may require
a little more effort and care.
02:36
So how do we look at that and
support our colleagues in that?
And then what does
peer support look like
in terms of a patient situation?
So if a person has been
through some type of trauma,
we want to make sure
that the patient is aware
of some resources.
02:51
And I use the word patient loosely,
because in some situations,
if a person's not sick,
they may still need us to provide
some type of resources for them
in terms of peer support
groups with people
who have experienced some
of the same types of trauma.
03:06
And I do also want to
point out that trauma
occurs at different levels.
03:11
Oftentimes,
we think about really, really
severe and serious
traumatic situations.
03:17
But when we think back
to micro aggressions
are different things
people experience
in terms of bias,
and in terms of stigma,
exposure to those situations can
also create trauma over time.
03:28
So we want to think
of trauma broadly.
03:31
Then thinking about the next
principle of collaboration.
03:35
We as healthcare providers have to
be aware of the power differentials,
even if we think we're being
very humble with people.
03:42
There is a power differential
by way of your title
and by way of your
role and position
in terms of the healthcare sphere.
03:49
So making sure that we
acknowledge that with ourselves
and include patients
in decision making,
because shared decision
making also helps
what will lead to another one
of those principles.
04:01
But with empowering patients,
to feel some type of
control over their bodies,
and also over their health care.
04:09
Empowerment. So there is some
controversy around that word,
because who are we
to empower somebody.
04:14
But we do inadvertently
empower people
by just respecting number one,
which is like at minimum
what we should do.
04:21
And also including people
in those decisions,
because even though something says
we have to approach care
in a certain way.
04:29
We have to individualize
it to each patient.
04:31
So whether a textbook tells us
things have to be done
a certain way
to cure a certain disease or to
improve health of an individual,
we have to respect what the
person wants in terms of
how they want their
treatment plans to look at.
04:47
It may not include all
the things that we think
should be a part of that
and there may be reasons for that.
04:53
So that's why it's very important to
build those trusting relationships.
04:57
And we have to recognize
a patient's strengths,
and also say something to it.
05:02
Affirmation is one of those
big things when we talk about
micro aggressions and
micro affirmations.
05:08
We want to do the same things
in terms of a patient's health.
05:11
We want to meet them where they are.
05:13
Believe in resilience and
their ability to heal.
05:16
And people don't have
to heal at our pace.
05:18
They can heal at their own pace.
05:20
And they can also approach
their care at their own pace.
05:23
So just because they don't want
to do something we prescribe
or recommend today,
we want to give them time
while educating and explaining
because that trauma
may be informing.
05:33
How they approach and
accept what we offer.
05:36
And then the next principle is
humility and responsiveness.
05:40
And just acknowledging
and recognizing
the historical trauma
that may be associated
with biases and stereotypes
that a person may have experienced.
05:50
So just if we keep it in mind,
and it may be something that
is superficial to you, but not to
the person who has experienced it.
05:58
So it's unique to everyone.
06:01
And again, just keeping in mind that
we may think about sexual trauma.
06:05
We may think about
intimate partner violence,
we may think about people who
have served in the military
and all the big things or
people who have experienced
any type of trauma.
06:14
One of the most
recent ones was COVID.
06:17
And the burnout of health care
providers working during that period
when the pandemic
was at its height.
06:24
So, in addition to those things,
there may be some other lower level
trauma experiences
that are heightened
by some of the bigger
traumatic experiences.
06:35
All of the more significant
and emotionally intense.
06:39
And again,
it's what it is to that person.
06:41
Just creating this base of
psychological and physical safety
will help people be more apt
to have conversations with you
about some of their experiences.
06:52
And also making it a
non-judgmental space
and more of a helping space.
And you do have to say that.
06:59
One of the examples I can give,
and it is not necessarily
related to trauma,
but when I worked in
the STD environment,
just given a preface to before
we start asking those questions
of why you want to ask?
That you're asking questions to
help people not to harm people.
07:17
So they will be
more likely to share
those things with you
if you tell them
why you're asking those questions.
07:25
So especially sensitive things,
when you're going to do
a physical exam.
07:30
If you're going to touch a person
in a certain way, or whatever it is,
and you don't know that
they may have been exposed
to some type of sexual trauma.
07:37
The example I gave about asking
questions about sexual history,
those things are very personal.
They are can be very sensitive.
07:46
We don't know things like
even just religious background
or cultural background
that will influence
how people interact with
you about those questions.
07:55
So, building rapport,
showing respect,
given those explanations
is extremely important
before you just start asking
people those types of questions.
08:05
Allow patients to
bring a trusted friend
or family member into the room
with you if they seem nervous.
08:11
And this goes back to
that cultural intelligence.
08:13
You do have to be so aware
and not sometimes rules
can be bent or broken,
especially if our goal is to provide
comprehensive, and holistic,
and sensitive care,
patient sensitive care,
and culturally sensitive care.
08:32
So some of the benefits of using
trauma informed care principles
is that is just good for everyone.
08:39
It encourages people to have
full engagement in their care.
08:43
It promotes that trust and improves
the long term care relationships
as well as outcomes.
08:49
And relationships with you as an
individual health care provider,
regardless of your role,
and also relationships
with the healthcare system,
regardless of the organization.
08:59
But we know there's often
mistrust in the system.
09:03
But if we show people that we
really care and are committed
to every aspect of who
they are as human beings,
then we're more likely to
decrease some of the disparities.
09:12
And then in terms of workplace.
09:14
It reduces burnout when we
show that we really care
and that we do want to
support our colleagues
as well as patients in
terms of any type of trauma.
09:25
And we don't want to
trivialize or minimize
anything that anybody
has been through
just because it may seem trivial
to us or we can't relate.
09:33
We still need to be
there and provide
the resources that people need.