Clinical scenario: Primary care, family health team

Mina works as a nurse in a family health team. She is assigned to administer the HPV vaccine to a 17-year-old female patient. When administering the vaccine, Mina notices several cuts on the patient’s hands, some of which are deep and appear to be fresh injuries. When asked, the patient states that she “fell into a rose bush.” There is no mention in the patient’s chart about a trauma history or any report of prior cutting behaviour. Mina is meeting this patient for the first time and is not likely to be part of her regular care. What should Mina do next?

Mina can build a trauma-informed care practice by using the bold-faced strategies on this list. The non-bolded options should be avoided, as they will not be helpful.

  • Accept what the patient told her and leave it at that
  • Document her observations in the patient’s chart, making note of the nature and number of injuries and the patient’s response
  • Pretend she didn’t see anything, someone else will find out anyway
  • Meet with the nurse practitioner associated with the patient’s team and verbally report her observations: i.e., report her concern that the injuries may indicate cutting behaviour, and document the conversation in the patient’s chart
  • Challenge the patient and tell her she has to “tell the truth”