Time has always been a precious resource in the healthcare industry. With staffing shortages and waves of COVID and other illnesses, time seems to be at even more of a premium. When pediatricians and pediatric nurses speed through appointments, patients’ fears may increase, their cooperation may be impaired, and they may even experience more discomfort. It is critical to note that patient comfort is not a frill or superfluous; rather, it is a known factor that can help or hinder medical outcomes. Having a child life specialist on board can add extra support to both the child, child’s family, and medical team to ensure that patient trust and comfort, critical components of trauma-informed care, remain at the forefront.
What is Trauma-Informed Care?
Medically, trauma refers to severe injuries that result from an outside force – such as a car crash, fall, or burn – often requiring hospital-based treatment. Psychologically, the definition of trauma is harder to pinpoint. Just as the perception of pain is subjective (whatever the patient says it is), trauma and distress are internal states, deeply felt. They involve not only what the patient has experienced but also how they process and interpret it.
This blog discusses trauma from a psychological perspective and how routine medical procedures can either elicit traumatic memories in a patient or provide a foundation for trust and comfort.
Trauma-informed care is a patient-centered framework that aims to provide support to patients so that they feel safe during their medical procedures – even if they have not disclosed a history of trauma to the medical staff. Healthcare providers collaborate with other professionals, such as child life specialists, to offer support during the encounter with the patient to minimize fear and anxiety and to increase comfort.
Providing trauma-informed care during every appointment is vital, not optional. Patients come to health care settings with a wide range of coping skills and prior experiences. Some, but not all, may have had sufficient support to alleviate the stress of medical treatment. Others may carry traumatic memories. Most likely, the health care team will not be able to simply look at a child and determine who needs additional care, attention, or encouragement. And children typically lack the verbal skills to explain their fears and anxieties.
If teams are oblivious, or too rushed, to attend to those needing more support, patients may greatly struggle during their appointments or feel unsupported by their physician or nurse. Such negative encounters can lead to children or their parents delaying or evading preventative healthcare, including vaccinations and blood tests, in the future. The memory of how one felt can have serious consequences.
To promote a favorable patient experience, medical professionals should work with child life specialists to find simple, efficient ways to provide support and comfort. As a result, patients may leave with a sense of wellbeing, rather than disappointment, following each health visit. And this positive feeling may prompt a greater likelihood to return.
What does Trauma-Informed Care Look Like?
At its foundation, trauma-informed care is high-quality, patient-centered care rooted in safety, respect, and trust. Additionally, it focuses on helping the patient manage distress and emotions such as fear and anger. Nurses and child life specialists can work in tandem to promote trauma-informed care. For example, the nurse conducts appropriate procedures in which they have been well trained as the child life specialist utilizes their own training in child development to provide extra support needed in a potentially stressful encounter.
Needle procedures are an excellent example of how the pediatric staff and the child life specialist can work together to provide trauma-informed care. Patients who have experienced trauma report that they feel fear and anxiety about medical procedures, particularly ones involving needles and injections.
When a child is getting ready to have a needle procedure, the nurse can follow effective, routine protocol, using the patient’s name, asking for permission to touch them, and maintaining eye contact. The child life specialist also can play a vital role, providing a developmentally appropriate explanation of the procedure and why it is needed. Nurse and child life specialist can collaborate to assess the child’s pain and manage it appropriately and creatively, using breathing techniques, cold sprays, and visual distractions. They can also reassure the parents or caregivers that the needle procedure is necessary, and pain should be short-lived and minimized by pain management techniques.
After the procedure, the child life specialist can assist the child and their family manage any lingering anxieties by offering coping strategies and supporting the parents with useful advice. Ongoing assessment of the family’s needs after the appointment can connect them to social services that can provide additional support.
Benefits of Trauma-Informed Care
Patient-centered care and trauma-informed care share many benefits. Trauma-informed care helps medical professionals provide more empathetic service. Research has found a positive correlation between physician empathy, patient satisfaction, and clinical outcomes. When patients feel that their physician is being empathetic, they are more likely to trust and communicate freely. With more trust, children – as well as their caregivers – are also more likely to share relevant health information, rather than holding back. As a result, doctors are better able to provide precise diagnoses and promote adherence to their treatment plans.
With the ever-increasing demands on medical providers time, patient comfort may fall by the wayside. It is important to find efficient and effective ways that facilitate high quality care, promote patient satisfaction, and not feel like a constraint on healthcare providers’ time.
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To learn more about addressing needle anxiety for children, download our eBook here.