Soraya is an occupational therapist in an acute care hospital. Along with her other clinical responsibilities, she provides splinting services to in-patient units in the hospital. Today, she has received a referral to make a forearm splint for a 32-year-old male who has had surgical repair for compartment syndrome on his left forearm. While reviewing the chart, Soraya discovers that the patient developed compartment syndrome because he passed out after a bout of heavy drinking and was lying on his left arm all night. His medical history includes substance use (alcohol and marijuana), depression, and anxiety. Nursing notes indicate that the patient is reported as being “aggressive during dressing changes” and “non-compliant with nursing and wound care post-op.”
The following table list strategies, informed by TIC practice tips, that Soraya can use to help her build a trauma-informed interaction with this patient.
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Drag the appropriate strategy to its matching practice tip for trauma-informed care.
- Soraya has read about the prevalence of trauma and is aware of the long-term health impacts of trauma
- Soraya reflects on the bias that healthcare providers may have towards people who use substances and how this can impact interactions between providers and patients, including use of labelling language
- Soraya resolves to interact with the patient in a respectful and compassionate manner
- “Many people have had traumatic experiences in their life — situations in which they felt their safety and lives were threatened. I ask all my patients about their trauma histories because we know trauma has a big impact of their health. You don’t have to answer the question if you don’t want to, but is there anything I should know about your history that will help us to work together in a way that makes you feel safe?”
- “I noticed that dressing changes have been difficult for you. Can you tell me more about this? It will help me to make the splinting process more comfortable for you”
- “Thank you for telling me that you are having a lot of pain and are worried about taking care of your incision and splint after discharge. I know there are a lot of instructions to follow and it can feel confusing”
- “I want to make sure that you have the help you need to heal well from your surgery after you are discharged from the hospital. The surgeon will be making a referral to our outpatient wound clinic. Would it be okay if I make a referral for a home care social worker for you? They can help you to access transportation and other services while you are recovering from your surgery.”
Be aware of the prevalence of trauma and its impacts
Recognize that some health practices can be traumatizing
Provide a safe environment
Routine query about trauma history
Recognize when someone is being triggered
Respond to disclosures
Risk assessment and referral