Image from: https://www.acesconnection.com/g/san-mateo-county-ca/blog/how-to-implement-trauma-informed-care-to-build-resilience-to-childhood-trauma-childtrends-org

Trauma exposure can impact psychological, physical, spiritual, environmental, and social well-being. There are many different types of trauma: traumatic grief, bullying, community violence, complex trauma, disasters, early childhood trauma, sexual abuse, terrorism & violence, medical trauma, and physical abuse. Continuous exposure to trauma can keep people in the sympathetic nervous system. It can cause continuous cortisol production, which is your “fight or flight” hormone. Elevated cortisol increases your heart rate and blood pressure, impacting the heart, brain function, nerve function, digestion, blood sugar, and overall well-being.

Traumatic events that occur during childhood are known as adverse childhood experiences (ACEs). ACEs are scores determined based on abuse, neglect, and household dysfunction. It’s shown that ACEs are common and correlated with health outcomes. People with higher ACEs score have an increased risk of traumatic brain injury, depression, suicide, pregnancy complications, STDs, diabetes, alcohol abuse, and low income.

The trauma-informed care (TIC) principles are known as the “4R’s.” The first “R” is to realize that trauma exists. I would need to approach each patient with understanding the various ways they could’ve been traumatized. The second R is to recognize how it impacts patients. The third R is to respond to signs/symptoms, such as avoidance, intrusive memories, exaggerated startle response, irritability, and interpersonal problems. The last R is to resist re-traumatization by being non-judgmental and empathetic.

In my mental health course, we discussed how trauma should be at our forefront when caring for patients—for example, taking off patient’s clothes to assess them. To prevent re-traumatization, we learned to tell the patient what we are doing before we do it. That way, the patient’s aren’t caught off guard. If they feel uncomfortable, their ability to speak up is welcome.