The Prevalence and Impact of Trauma and Why Trauma-informed Care is Needed in Nursing Education

Chapter one explores the reasons why student nurses need to be educated in trauma-informed care. Trauma-informed care endeavours to help people who have experienced trauma and targets change at the organizational and clinical level with the aim of improving client/patient outcomes. Various forms of adversity that exist are presented, and we are informed that trauma is not merely a childhood occurrence but may occur at any point across the lifespan. Stereotypical biases and racial stigma experienced by the following special populations are explored, those with differing sexual orientation or gender identity, older adults, refugees and immigrants, people of colour, and Indigenous people. The role that bias and implicit bias play in structural trauma aimed at specific populations is explained. An overview is given of the following specific trauma-related responses, trauma triggers, acute stress disorder, post-traumatic stress disorder, secondary traumatic stress, vicarious traumatization, and compassion fatigue. The Four Core Assumptions of Trauma-informed Care as recommended by the Substance Abuse and Mental Health Services Administration (SAMHSA are explored, because they are foundational for providing traumaresponsive care, and consist of realizing, recognizing, responding, and resisting retraumatization. Healthcare professionals are strongly encouraged to practice in a trauma-responsive and trauma-sensitive manner. Incorporating trauma-informed approaches into the Nursing School curriculum is recommended for the following reasons. Adversity is prevalent in society, and high number of people who access health services have experienced trauma. Student nurses are not currently learning these skills in a comprehensive way in all schools. Student nurses may have a history of trauma, and they are exposed to adverse and stressful events in clinical training. Two Narrative Case Studies are presented. The first shares the story of a Counsellor who developed compassion fatigue, and the second one reveals the complexity of the trigger response. The following learning activities are suggested: connecting with the goodness in life; changing prejudices and stigma; and participating in a trauma-sensitive practice challenge. A self-care strategy that promotes self-compassion is included at the end of the chapter.

Keywords: Adverse childhood experiences (ACEs), Acute stress response, Bias, Caring, Caring pedagogy, Colonization, Compassion, Compassion satisfaction, Compassion fatigue, Empathy, Ethic of care, Gender identity, Historical trauma, Indigenous people, Implicit bias, Intergenerational trauma, Interpersonal violence (IPV), LGBTQ2S, Narratives, Phenomenology, Post-migration trauma, People of color, Posttraumatic stress disorder (PTSD), Psychological trauma, Residential schools, Racial microaggression, Racial trauma, Resilience, Structural trauma, Systemic racism, Sexual orientation, Secondary traumatic stress (STS), Traumatic stress response, Traumaresponsiveness, Trauma-sensitivity, Trauma, Trauma-informed care, Trauma triggers, Vicarious traumatization, Violent trauma.