How health care providers are learning to help patients undergoing a traumaKatherine Phillips | College of Nursing Jul 10, 2018
“I have been volunteering for Operation Smile, and we perform hundreds of cleft lip and palate surgeries, burn grafting, and syndactyly repairs throughout one busy week to transform the lives of many. I love being taken out of my comfort zone as a nurse and needing to rely on basic assessment skills, not having tech devices at my fingertips, and having to communicate nursing needs to people who speak different languages,” said CU Nursing student Jaime Pollard.
Jaime Pollard enjoys giving her time internationally to rural communities, helping to provide services to populations with limited access to health care.
Working remotely in rural settings, health care providers must rely on their knowledge and skills when working with patients, especially in trauma situations. However, making medical decisions during stressful situations has created new training in psychological first aid.
At CU Nursing, students are given the opportunity to take coursework in psychological first aid through Grand Support International, a program which is used to teach nursing students how to work with patients and families who have experienced trauma.
Psychological first aid is the practice of characterizing the response to trauma. Trauma affects our brain and physical health, leading to impaired function and judgment. When experiencing trauma, we can be overwhelmed, and emotionally, we become helpless.
However, psychological first aid addresses five basic principles that focus on these stress responses: safety, calming, self-efficacy, connection, and hope. By controlling these five principles and teaching families, patients, and health care providers how to use psychological first aid, it can help to improve the experience when receiving and giving care.
Teaching these key skills
Rural communities often have limited access to resources. Utilizing psychological first aid in these remote settings can be helpful when treating patients who have experienced trauma. However, this can be challenging especially when patients are too traumatized to focus on getting the help they need.
Taught by Laura McGladrey, FNP, PMHNP, RN, FAWM, a senior instructor teaching in the undergraduate and graduate programs, as well as at Grand Support International, students learn how to assess a patient’s psychological condition when providing treatment. Her background in emergency medicine, humanitarian aid, and wilderness medicine has been used to train nurses in rural health, as well as trauma care in the field.
When under intense stress, the body responds emotionally, creating a “fight or flight response” that causes one to forget how to think logically. By using these techniques in traumatic situations, providers can help patients feel safe.
“Trauma creates psychological scars that form stress injuries that can have long-term psychological effects on the patient and the rescuer. It is important to make the person being rescued feel safe, secured, reassured, and able to start the physical and emotional healing process immediately,” explained Pollard.
As health care providers, it is particularly important to use psychological first aid to communicate and educate patients in traumatic situations. Teaching providers about these techniques, why psychological first aid is important in trauma situations, and how understanding and implementing these principles in the field can help bring better care to patients. However, it is rare that students and health professionals receive this training prior to going out into the field.
“We honestly don’t do a great job at training nurses to assess for stress injury in patients and/or families or in themselves,” said Pollard.
The First 5 minutes
When utilizing these skills in practice, it is important to consider the family and the patients. Although health care providers are taught how to treat patients, helping families feel like they have the power to be involved in care is essential to promoting psychological first aid in the health care setting.
In a concept called “the First 5 Minutes,” the plan of care is summarized by nurses so families and patients have a greater understanding of the care they are about to receive. It is important to implement this kind of concept for nurses so they can more efficiently care for their patients.
“When patients and caregivers know when meds are due, when imaging or operations are scheduled, what their goals for ambulation or intake are, they are less likely to use their call lights to ask those sorts of questions. This is important for nursing workflow so that nurses can spend more quality and uninterrupted time in the patient’s room,” said Pollard.
Additionally, this practice can also be used to establish self-efficacy between patients and providers, which increases communication and knowledge about care.
“With that information, patients and caregivers are more likely to be autonomous in care and feel fulfilled when goals are met which creates a positive attitude and moves patients forward,” added Pollard.
In the clinical setting, using these techniques are useful when working with patient’s families to make them feel like they are part of care and to prevent them from feeling scared or overwhelmed from their experience in the hospital.
“Psychological first aid equips us to assess whether families and patients are able to think logically, accept and process information that is being told to them,” added Pollard.
Implementing this method of communication between patients, families and providers increases communication and decreases the likelihood of miscommunication.
“Our number one negative comment in patient and family satisfaction scores is that families receive inconsistent messaging, or don’t feel communicated with. Spending 5 minutes at the beginning of the shift to get on the same page helps alleviate that problem and helps them feel heard. Patient and family satisfaction scores are always part of our hospital pillar goals,” said Pollard.
Applying these skills
Using these skills, Pollard hopes to work in rural medicine as well as a first responder with training in wilderness medicine.
“Wilderness medicine is founded in consistent, basic, complete assessments in trauma situations and forces me to rely on my nursing knowledge to make medical decisions in the remote context,” said Pollard.
Whether working in a rural setting or in a clinical setting, psychological first aid is used to care for patients by allowing them to feel safe, connected, and in control of their care, which helps improve patient care.