Tuesday, December 10, 2019
Trauma Informed Care Consumers and Providers
Question: Discuss about theTrauma Informed Carefor Consumers and Providers. Answer: Introduction Trauma informed care is the new approach to deliver quality care to the patients suffering with mental illness. Trauma Informed Care can be considered as an organizational structure and framework of the treatment that involves understanding, recognizing, and responding to the effects of all types of trauma. Trauma Informed Care also emphasizes physical, psychological and emotional safety for both consumers and providers, and helps survivors rebuild a sense of control and empowerment (Muskett, 2014). The people who have suffered traumatic events in their life may go through distress and anxiety. They may also be re-traumatized due to the procedure of the treatment. To save the patient from any kind of distress, Trauma informed care is used. Thus, trauma informed care is seen as the fundamental value that could be very effective for the current mental health nursing practice. This essay aims towards discuss the various pieces of literature to trace the importance of trauma informed car e in mental health settings. The essay will also discuss the relevance of the various principles of trauma informed care. Analysis of Trauma Informed Care Trauma informed care can be very effective in increasing the knowledge and skills of the nurses working in the mental healthcare settings. The nursing practice in such setting is focused on reducing the post traumatic effect and impact of trauma from the patients life and current mental health. The main focus of the Trauma Informed Care is to prevent the episodes of re-traumatizing, which could occur during the process of providing care (Brown et al, 2014). Thus, there is an increased emphasis on using the framework of the trauma informed care in the mental health setting. The focus of such framework is to understand the neurological, biological, social and psychological impacts of trauma and alleviating such effects. Trauma can lead a very harmful effect on the mental and physical health of a person. People may suffer with distress, depression, and post traumatic stress disorder or maniac attacks. Traumatized individual can also become violent and aggressive. According to Horowitz, Guyer, and Sanders (2015), trauma informed care is used to reduce the stressors that can trigger the old traumatic memories and escalate the level of violence and aggression in the mental health patients. Such behavior of the patient can increase the risk of self harm and harm to others. For such behavior restrictive interventions are applied. These restrictive interventions may include seclusion, physical restraint, or mechanical restraint and are known to exacerbate symptoms of past trauma for people with mental illness (Moran et al, 2009). However, the use of trauma informed care states to reduce the use of restrictive interventions. The nurses may have to face various issues due to vulnerability of the patients and such austere and punitive setting (Maumus and Conrad, 2016). Translating the values of such framework can also be difficult. The major theme of the trauma informed care is to reduce seclusion, physical and mechanical restraint, however in the Emergency Departments; it becomes difficult to control the patient, for which such restraints are used (Gerace et al, 2014). Seclusion and restraints are also used when mental health crisis may risk the psychological outcomes. Trauma informed care policy restricts the use of restrictive interventions, yet in Victoria such interventions are used despite of the policy that states that such episodes must be reduce in order to eliminate it completely in future (Gerace et al, 2014). Thus, framework has been provided to reduce the use of the restrictive interventions, yet it is being used in various mental healthcare setting. Such frameworks include trauma informed care, yet there is challenge to educate the nurses about it and apply suck skills and knowledge in the nursing practice in mental healthcare settings (Reeves, 2015). There is a research available for the mental health nurses providing trauma informed care to the patients. But, nurses in the Emergency departments have not been provided with multidisciplinary environment. Such nurses require specific education and knowledge before applying this framework (Stokes, 2016). Trauma informed care focuses on reducing the re-traumatizing events; this concept is explained effectively through the research study of Muskett (2014). According to his study, it is explained that applying the trauma informed care framework in Australia is mainly about reducing, whenever possible, the use of restraints and seclusion. The constant churn of the admission and readmission of the patient in the metal health settings it becomes very difficult to eliminate restraints and seclusions completely (Reeves, 2015). This means that elimination seclusion and restraint is not the only purpose of trauma informed care, but it can also be used to enhance the skills and knowledge of nurses towards other important factors. Muskett (2014) further explains that exposure to traumatic events in childhood can result in adverse effects for the mental health. This could be the compelling base for the nurses in inpatient mental health settings. Trauma informed care includes the concepts of neurological, biological, psychological and social concepts. Thus according to neurological concept or neuroscience explains that when a child goes through a trauma, the structure and functioning of the brain are changed (Horowitz, Guyer, and Sanders, 2015). The experience of the child in infancy will determine the growth and functioning of his brain in childhood. Negative experiences can disturb the development and integration of the neural pathway. This results in mood and behavior impairment in children and adverse health outcome in the adulthood (Azeem et al, 2011). Thus trauma informed care can be used to reduce the neurological impact of trauma. So trauma informed care is not just to control the symptoms and disorders, but it is about providing the sensitive and quality services to reduce re- traumatization and increasing quality of life. Principles of Trauma Informed Care The basic and most essential component of the trauma informed care is that the treatments and intervention used for the patient by the healthcare services must not inflict any kind of additional trauma for the patient that could trigger their traumatic memories and may disturb them. Different principles are included in the Trauma Informed Care framework. The first principle is the physical and emotional safety of the patients (Brown et al, 2014). This principle can help nurses to provide harmless and sensitive environment and care to the patients. It also underlines the ethical principle of autonomy. Evidence based study and tools must be use to endure safety at every step. Autonomy of the patient allows that patients should be informed about what is going on and why it is happening. Second principle is trustworthiness, which inflicts that system and services will provide the care that would be less risky for re-traumatization. This includes maintaining the professional boundaries and keep transparency with consumers. This principle reflects the administrative and organizational commitments of trauma informed care. This principle will help to change the approach of the healthcare professionals towards people with mental health issues, as it prevents any kind of treatment or intervention that may be problematic for the consumers and can hinder informed care (Hodas, 2006). Third principle is the about valuing choice. The choices of the patients about treatment must be valued, as it support autonomy and informed decision making. It helps to maintain the ethical practice of nursing. Collaboration is the next principle that values the collaboration and participation of service providers and consumers. It incorporates trauma awareness and trauma related practices. This will help the nursing professional to shift from the pathology mindset and develop flexibility in nursing practice. Fifth value principle of trauma informed care is empowerment, which promotes resilience, and understanding that every individual is competent and can heal (Roberts and Boardman, 2014). This principle use the strength focused perspective and provide hope to the patients. All these principles explain that trauma informed care is a broad framework that focuses on various aspects of nursing practice. The principles can help in enhancing the skills and knowledge of the nurses and also supports that trauma informed care is not just to eliminate seclusions and restraints, but to promote overall well-being of the patients (Anyikwa, 2016). These are the strength based principles that help to develop resilience. These principles also support autonomy of the patients and consider them as competent individuals. Conclusion Trauma informed care is the new and vital approach towards providing quality care to the patients in mental health settings. This kind of approach is considered to be very effective, as it values evidence based study and competence. The essay demonstrated the understanding of the trauma informed care through a definition. Trauma Informed care is basically focused on applying the treatments and interventions that may not inflict any further trauma. This kind of approach is based on various value principles that could be sometime confusing for the nursing professionals in understanding that how they can support these values. Essay also explained the challenges that can arise while providing trauma informed care. Some of the studies focused on reducing seclusions and restraints, but trauma informed care must be looked in a broader sense. There are other principles and tangible practices that nurse can use to improve the health outcomes in patients. Bibliography Anyikwa, V.A., 2016. Trauma-informed approach to survivors of intimate partner violence.Journal of evidence-informed social work, pp.1-8. Azeem, M.W., Aujla, A., Rammerth, M., Binsfeld, G. and Jones, R.B., 2011. Effectiveness of six core strategies based on trauma informed care in reducing seclusions and restraints at a child and adolescent psychiatric hospital.Journal of Child and Adolescent Psychiatric Nursing,24(1), pp.11-15. Brown, V.M., Strauss, J.L., LaBar, K.S., Gold, A.L., McCarthy, G. and Morey, R.A., 2014. Acute effects of trauma-focused research procedures on participant safety and distress.Psychiatry research,215(1), pp.154-158. Gerace, A., Pamungkas, D.R., Oster, C., Thomson, D. and Muir-Cochrane, E., 2014. The use of restraint in four general hospital emergency departments in Australia.Australasian Psychiatry, p.1039856214534001. Hodas, G.R., 2006. Responding to childhood trauma: The promise and practice of trauma informed care.Pennsylvania Office of Mental Health and Substance Abuse Services, pp.1-77. Horowitz, D., Guyer, M. and Sanders, K., 2015. Psychosocial approaches to violence and aggression: contextually anchored and trauma-informed interventions.CNS spectrums,20(03), pp.190-199. Maumus, M. and Conrad, K., 2016. Hospital Systems Management. InAbsolute Hospital Medicine Review(pp. 149-193). Springer International Publishing. Moran, A., Cocoman, A., Scott, P.A., Matthews, A., Staniuliene, V. and Valimaki, M., 2009. Restraint and seclusion: a distressing treatment option?.Journal of psychiatric and mental health nursing,16(7), pp.599-605. Muskett, C., 2014. Trauma?informed care in inpatient mental health settings: A review of the literature.International Journal of Mental Health Nursing,23(1), pp.51-59. Reeves, E., 2015. A synthesis of the literature on trauma-informed care.Issues in mental health nursing,36(9), pp.698-709. Roberts, G. and Boardman, J., 2014. Becoming a recovery-oriented practitioner.Advances in psychiatric treatment,20(1), pp.37-47. Stokes, Y., 2016.Exploring Nurses' Knowledge and Experiences Related to Trauma-Informed Care(Doctoral dissertation, Universit d'Ottawa/University of Ottawa).
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