Trauma-Informed Care: Ch 1, 2, 6, 7

• Presented September 10, content includes Chapters 1, 2, 6, and 7 from the textbook.
• A groupwork case study and NCLEX-style questions will be part of the session.

Key Terms

• Trauma-informed care promotes safety, trust, and empowerment in healthcare settings.
• Health inequities are avoidable and unjust differences in health outcomes.
• Social determinants of health are factors like income, education, and housing that affect health.
• Adverse Childhood Experiences (ACEs) are traumatic events occurring before the age of 18.
• Health literacy is the ability to understand and use health information to make informed decisions.
• Informed consent ensures patients understand and agree to medical procedures or treatments.
• Motivational interviewing is a collaborative conversation style that strengthens a person's motivation for change.
• Cultural awareness involves understanding and respecting differences in values, beliefs, and practices.
• Intimate partner violence (IPV) includes physical, sexual, or emotional abuse within a relationship.
• Transsexuality is a condition where a person's gender identity is different from their assigned sex at birth.
• The Papanicolaou test (Pap smear) screens for cervical cancer in women.
• Integrative healing combines conventional and complementary therapies to treat the whole person.

Objectives for Chapter 1

• Describe perinatal and pediatric nursing's scope in Canada today.
• Examine the historical context of Canadian healthcare.
• Identify social determinants of health impacting families and children, and explore ways to address health inequities.
• Explore trauma-informed care within Canadian healthcare.
• Detail the impact of colonialism on Indigenous people's health.
• Consider research's role in perinatal and pediatric nursing.
• Identify ways to improve interprofessional communication.
• Focus on how Sustainable Development Goals (SDGs) can improve global health.
• Explore ethical issues in modern perinatal and pediatric nursing.

Core Concepts of Reproductive Health and Perinatal Nursing

• This is a specialized area of nursing requiring specific knowledge and skills.
• Family-centered care prioritizes the needs and preferences of the patient and their family.
• Care provided in various settings, including community clinics and hospitals.
• Nurses play a vital role in ethics and informed consent, guided by the CNA Code of Ethics for Registered Nurses

Issues and Trends in Canada

• Key focus areas: the Canadian healthcare system, access to healthcare, social determinants of health, and socioeconomic status.
• Attention to health inequities within specific populations.
• Trauma and Violence Informed Care (TIC) integration will be emphasized.
• Focus on Adverse Childhood Experiences (ACEs), and the impact of culture.
• The roles of both integrative healing, alternate health practices, and high technology care are to be considered.

Vulnerable Populations and Illness

• The Homeless Hub provides resources on women, girls, and gender-diverse individuals.

Nurse Communication

• Nurses provide care that is inclusive of any gender or sexuality.
• Nurses use awareness of their own language, and ask about dietary and other health preferences.
• Generalizing clients is avoided, with the focus on individualized care.
• First impressions and trust-building with clients is essential.
• Sexual and Reproductive Rights in Canada should be considered.

Trauma

• Defined by the Government of Canada (2018) as the response to an overwhelmingly negative event including violence.

Trauma-Informed Care (TIC)

• Understand the impact of trauma and violence on people's lives.
• Establish emotionally and physically safe environments.
• Emphasize choice, collaboration, and connection.
• Employ a strengths-based approach to build patient resilience.

Being Trauma Informed

• Involves maintaining a basic understanding of trauma and adversity.
• Requires recognizing and reflecting on self-view and worldview.
• Includes planning and facilitating organizational strategies.
• Considers the workforce.

Values and Principles of Trauma-Informed Practice

• Safety: Ensuring physical and emotional security.
• Trustworthiness: Maximizing trust, using clear expectations and consistent boundaries, and transparency.
• Choice: Making individual choice and control a priority with self-determination and autonomy.
• Collaboration: Sharing power and working together.
• Empowerment: Recognizing strengths and skills for hope and possibility.
• Diversity should always be embraced.

ACEs (Adverse Childhood Experiences)

• Include abuse, neglect, and household challenges.
• Abuse can be physical, emotional, or sexual.
• Neglect includes physical and emotional.
• Household challenges include mental illness, divorce, violence, incarceration, and substance abuse.

Evolving Healthcare

• Consider health literacy in care practices.
• Consider high technology and its implications
• Access to online resources are double consideration the positive and negative.

Social Media Use

• Always consider the 6 P's; Professional, Positive, Patient/person-free, Protect self, Privacy, and Pause before you post.

Health Assessment (Chapter 6)

• Involves a full review of a patient's health status, physical and mental.

Objectives of Chapter 6

• How to provide culturally competent care during health assessments.
• Describe the process of taking a woman's history and performing a physical exam.
• Adapt the physical exam for people with special needs.
• How to screen for intimate partner violence.
• Following procedures for Papanicolaou tests.

Gathering History

• Effective communication; Verbal & Non-verbal

Cultural Considerations

• Always be aware!
• Remember, the patient is an expert on their culture & experiences.
• Consider what is culturally appropriate.

Adolescent Considerations (Ages 13-19yr)

• Increased risk with this age category exists.
• Deciding whether parents/partners should be present for discussions.
• Expected physical and cognitive development is a key consideration.

Risk for abuse

• All clients should be screened for potential abuse, all clients don't disclose.
• Consider; history, evidence of injury, & repeat admissions.
• There is a risk of intimate partner violence.

Person-Centered Care for Trans Clients

• Trans people have a gender identity incongruent with their sex assigned at birth.
• They express their gender in ways that go against social norms.
• It is an umbrella term for non-binary, transsexual, intersex, transgender, two-spirit, and genderqueer individuals.
• Trans individuals encounter structural and interpersonal stigma and are less likely to seek routine or emergency care.

Nurse's Role

• Consider language used by the client.
• Use the client's chosen name, pronouns, and identity.
• Obey PHIA, only you may know that client is trans.
• Focus care efforts on why the client is visiting or being admitted.

Trans Assessment

• Conduct assessments based on anatomy, not gender presentation.
• Trans men may require a cervix exam (Canadian Cancer Society, 2020)
• Trans women may still require a prostate exam.
• Attempt to minimize trauma associated with examinations and provide comfort.