Mental Health and Wellbeing in Clinical Practice

Introduction to Trauma-Informed Nursing Practice

The Trauma-informed care is the method that uses the strength framework which is important to improve the knowledge and acknowledgement of the survivor or providers faced trauma to improve the mental health. Nurses play an important role in helping the patient to improve their mental health by utilizing the different principle (Purkey et al., 2018). The different principle those are important to deliver the right care to the Trauma-informed care which includes safety, trustworthiness, choice, collaboration, empowerment and respect for diversity. These principles are important to improve the quality of the care to address the mental issue of the patient that will improve the wellbeing (Sweeney et al., 2018). The essay is going to discuss the role of nurse or midwifery in supporting or facilitating the six guiding trauma-informed principles to improve care.

Trauma-Informed Principles

Nurses are the major care providers and the first line of the contact of the patient thus they play an important role in improving the safety in the trauma-informed care in the mental health setting. Nurses in the trauma-informed care department are expected to improve their clinical practise that is important to deliver safe care by improving the health care services delivery method. The patient in the mental health setting requires special attention due to the behavioural issue that leads to irrelevant behaviour which can be harmful to the others (Hall et al., 2016). The different aspect that requires effective nurse role in improving safety in the trauma-informed care includes reviewing the incident of seclusion, structured briefing of the incident, improving sexual safety at workplace and close supervision of the workforce activities. Some other major role that is played by the nurses to improve the safety of the work includes evaluation of consumer safety plan, constructive peer feedback, improving understanding concerning trauma effect and planning for safety workshops (Isobel & Edwards, 2016). The findings are supported by Fleishman et al. (2019) by adding that patient privacy is also one of the major aspects that are covered in the safety role of the nurse in trauma-informed care. The nurses play a major role to maintain the safety of the care environment that includes privacy and confidentiality of the patient-related information. The cultural safe care is also important for the patient faced trauma to improve their comfort and participation in the care.

The trust between the patient and the health care professional is very important to increase the perspective of the care by better addressing of the patient issue. Nurses in trauma-informed care play a play role in Trustworthiness with the patient to improve the quality of care. The major role of the nurses in the traumatic-informed care is to decrease the chances of misinterpretations of the actions, understand the professional boundary, seek permission from the patient before any action and explaining care procedure to the patient. The trustworthiness is important to help the patient to freely express and provide them with a supportive environment to improve the health status (Williamson & Kautz, 2018). The trustworthiness is important in the nurse-patient relationship to help the patient to discuss the traumatic experiences which are important to improve the care. The nurses play an important role in helping the patient to trust them by right communication skills, professional proficiency and clinical practise style to improve the perspective of the care. Therapeutic communication is important to improve the rapport with the patient that is built over the trust of the patient that led to a better patient health outcome. The nurses should improve the interaction with the client that helps the patient to discuss the health issue and preferences related to the care (Reeves, 2015). 

The nurses also play an important role in improving the ability of the patient for choices related to the care facility. The patient should prefer the care or the health care service he/she want to avail by improving the choices of the care facility for the patient. The nurses play a major role to maintain the patient autonomy that is important to understand and implement the patient preferences in the care. The trauma-informed care requires increasing participation of the nurses in upholding the patient ability to decide the care and delivery method that is most comfortable for them concerning their mental health state. The implication of the care services provided by the nurses should be following the patient preferences so that early recovery can be done (Hornor et al., 2019). The nurse involves increasing the consumer ability to make choices can justify their professional role at the greater extent that helps to improve job satisfaction. Nurses are expected to help the patient to understand their right and responsibility concerning the care so that they can understand and improve their decision-making ability related to the care facilities. The better understanding of the patient concerning the care helps the patient to accurately judge the different strategies to prefer the right care strategies to improve care (Cleary & Hungerford, 2015). 

Collaboration in the care is very important to improve patient participation in the care by the key role of the nurses. The nurses are in direct contact with the patient during the care process and thus it increases their credibility to improve the collaborative care of the patient to deliver the person-centred care. The patient in trauma-informed care has experienced serious distress situation that leads to deteriorated mental health thus nurses are expected to decrease the distress that will improve patient autonomy concerning the care. The nurses in trauma-informed care have increased responsibility to use extra stress to assist the patient to decrease the stressful situation (Reeves, 2015). The collaboration with the patient is important to improve the person-centred approach of the care that will improve the patient health outcome. Nurses are expected to coordinate with the patient to understand and improve the participation of the patient in the care that helps to personalize the care which directly improves patient satisfaction. The nurses are key plays in the person-centric care which is important to provide the holistic care to the patient which lead to the physical, mental and emotional wellbeing of the patient. Nurses are expected to be directly connected to the patient during the care so that patient can participate in the care by freely discussing a different aspect of the care. The collaboration helps the nurses to improve the quality of the care that is important to treat the patient faced trauma that disturbed the mental wellbeing of the patient (Knight, 2018). 

Patient empowerment is important to increase their self-efficacy to deal with the minor fluctuation in the health which increases their power to control their health status. The Nurses play an important role in the empowerment of the patient by engaging in different activities that are important to improve the individual skills concerning health management strategies. Nurses play an important role in the skills-building of the patient which helps them to understand and implement this in future practice to improve self-management capability (Isobel & Edwards, 2016). ). The supportive environment developed by the nurses is important to assist the patient in increasing their learning concerning the care strategies. The nurses help the patient to understand their capability and requirement of the different strategies to balance out the thing that are important to improve the individual ability to control deteriorated health (Machtinger et al., 2018).

The increasing diversity in the health care sector also increases the responsibility of the nurses to improve the cultural competency in the care. The increase in cultural competency in the care helps the nurses to improve the care perspective by considering the cultural aspect of the patient to improve patient comfort. The incorporation of the cultural aspect in the care helps the patient to improve the participation and incorporation of the different cultural belief in the care. Nurses are expected to improve the cultural competent skills that help them to understand and consider the different cultural values which are important to incorporate in the care to decrease negative experience due to the trauma (Baird & Alaggia, 2019). The cultural competency in the care helps the nurses to respect and acknowledge the different cultural practise that is important to help the person in reducing the negative effect occurred due to the trauma. The nurses are major players to improve the cultural competency in the clinical practice by incorporating cultural competent communication skills and clinical practise to increase patient comfort. The nurses also play a major role in improving the working pattern of the organization by incorporation of the cultural competent workforce to improve the diversity in the care (Hughes et al., 2016).

The essay can be concluded by adding that nurses play an important role in the care of the patient faced trauma and the help to improve the individual ability to improve their health status. The different principle that is included in the trauma-informed care includes safety, trustworthiness, choice, collaboration, empowerment, and respect for diversity that are important to assist the patient in the care faced trauma. The nurses are important players in trauma-informed care as they are directly responsible to help the patient in the care and simultaneously empower them to improve their skill to deal with the minor fluctuation of the health status. The six principles that are framed to improve the trauma-informed care have a major role of the nurses in improving individual clinical practise and organizational working pattern to increase patient participation in the decisions making process related to the care strategies. The major role in the care of the nurse’s increase their credibility to improve the quality and safety of the care by following the principle associated with trauma-informed care. 

References for Trauma-Informed Nursing Practice

Baird, S. & Alaggia, R. (2019). Trauma-informed groups: Recommendations for group work practice. Clinical Social Work Journal, 1-10. https://doi.org/10.1007/s10615-019-00739-7.

Cleary, M. & Hungerford, C. (2015). Trauma-informed care and the research literature: How can the mental health nurse take the lead to support women who have survived sexual assault? Issues in Mental Health Nursing, 36(5), 370–378. https://doi.org/10.3109/01612840.2015.1009661 

Fleishman, J., Kamsky, H. & Sundborg, S., (2019). Trauma-informed nursing practice. OJIN: The Online Journal of Issues in Nursing, 24(2). https://doi.org/10.3912/OJIN.Vol24No02Man03

Hall, A., McKenna, B., Dearie, V., Maguire, T., Charleston, R. & Furness, T. (2016). Educating emergency department nurses about trauma informed care for people presenting with mental health crisis: A pilot study. BMC Nursing, 15(21), 1-8. https://doi.org/10.1186/s12912-016-0141-y 

Hornor, G., Davis, C., Sherfield, J. & Wilkinson, K. (2019). Trauma-informed care: Essential elements for pediatric health care. Journal of Pediatric Health Care, 33(2), 214–221. https://doi.org/10.1016/j.pedhc.2018.09.009 

Hughes, V., Delva, S., Nkimbeng, M., Spaulding, E., Turkson-Ocran, R.-A., Cudjoe, J. & Han, H.-R. (2019). Not missing the opportunity: Strategies to promote cultural humility among future nursing faculty. Journal of Professional Nursing, 1-6. https://doi.org/10.1016/j.profnurs.2019.06.005 

Isobel, S. & Edwards, C. (2016). Using trauma informed care as a nursing model of care in an acute inpatient mental health unit: A practice development process. International Journal of Mental Health Nursing, 26(1), 88–94. https://doi.org/10.1111/inm.12236 

Isobel, S. & Edwards, C. (2016). Using trauma informed care as a nursing model of care in an acute inpatient mental health unit: A practice development process. International Journal of Mental Health Nursing, 26(1), 88–94. https://doi.org/10.1111/inm.12236 

Knight, C. (2018). Trauma informed practice and care: Implications for field instruction. Clinical Social Work Journal. 79-89. https://doi.org/10.1007/s10615-018-0661-x 

Machtinger, E. L., Davis, K. B., Kimberg, L. S., Khanna, N., Cuca, Y. P., Dawson-Rose, C. & McCaw, B. (2018). From treatment to healing: Inquiry and response to recent and past trauma in adult health care. Women’s Health Issues,29(2), 97–102. https://doi.org/10.1016/j.whi.2018.11.003 

Purkey, E., Patel, R. & Phillips, S. P. (2018). Trauma-informed care: Better care for everyone. Canadian Family Physician Medecin de famille Canadien64(3), 170–172.

Reeves, E. (2015). A synthesis of the literature on trauma-informed care. Issues in Mental Health Nursing, 36(9), 698–709. https://doi.org/10.3109/01612840.2015.1025319 

Sweeney, A., Filson, B., Kennedy, A., Collinson, L. & Gillard, S. (2018). A paradigm shift: Relationships in trauma-informed mental health services. BJPsych Advances24(5), 319–333. https://doi.org/10.1192/bja.2018.29

Williamson, L. & Kautz, D. D. (2018). Trauma-informed care is the best clinical practice in rehabilitation nursing. Rehabilitation Nursing, 43(2), 73–80. https://doi.org/10.1002/rnj.311

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