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Medical Care and Trauma

When screening for abuse, it is important to remember that regardless of the patient’s presentation or other factors that may be at play, the person in front of you may have a long history of trauma or could be experiencing their first traumatic event. How we respond and react to a patient can make all the difference and set them on a path of empowerment or a path of silence. How the patient believes you perceive them can ultimately effect their adherence to medical treatment and could have the potential to help or harm them.

Medical care can replicate trauma and it’s important to know in what ways this occurs. So here are some thoughts to have in the forefront of your mind when working with a patient who discloses abuse or any other type of traumatic incident:

  • The power dynamics of the patient/medical provider relationship
  • Personal questions that may be embarrassing or distressing
  • Loss of privacy
  • Physical touch in intimate areas
  • Feelings of pain
  • Removal of clothing
  • Vulnerable physical position
  • Feeling a lack of control over the situation
  • Gender of healthcare provider
Being aware of these issues and the difficulty that may be involved for some patient’s when receiving medical care will greatly increase your ability to connect with your patient and provide excellent care.

Signs of Acute Trauma-Related Distress

Here are some signs to look for in a patient who may be experiencing acute trauma-related distress due to medical exams/medical care:

  • Is highly anxious, agitated, or “jumpy”
  • Appears tearful during exams, with no obvious cause
  • Physically withdraws, or becomes very quiet or “frozen”
  • Has difficulty concentrating, is very distractible, or seems disoriented
  • Minimizes symptoms that might require an intrusive exam
  • Cancels appointments or refuses needed care
  • Exhibits strong emotional reactions to relatively benign interactions (eg., crying, panic, irritability, anger)
  • Experiences flashbacks or dissociates during appointments
If you have a patient who is experiencing any of these symptoms, it’s important to stop and assess the needs of the patient at that moment. Here are some tips on how to help minimize these symptoms:
  • Ask the patient if they would like to take a break
  • Ask if they would like a safe family member or friend to be present
  • Prepare the patient ahead of time for the exam by telling them exactly what you are going to do before you do it
  • While performing exams tell the patient what you are doing step by step
  • Ask for permission to touch the patient and check in during exam to make sure they are still okay with you touching them
  • Be present and attentive

Importance of Trauma-Informed Care

Attention to underlying trauma-related issues can help:
  • Facilitate a stronger and more effective working relationship
  • Foster better patient-provider communication
  • Streamline patient-provider interactions
  • Improve patients’ adherence to and benefit from medical care
  • In other words, increasing your knowledge of trauma can improve your ability to address your patients’ precise health care needs
  • Understanding more about the impact of trauma can also help providers maintain their empathy when faced with challenging survivor reactions

Strategies for Providing Trauma-Informed Care

  • Everyone who interacts with patients should be educated about trauma
  • Regularly screen for a trauma history
  • Communicate a sensitivity to trauma-related concerns
  • Create a safe and comfortable environment
  • Thoughtfully deliver services in a trauma informed manner

Help is Here

If you have any questions or concerns about a patient or need support or assistance, please do not hesitate to contact us at 984-974-0470.