As an injury prevention coordinator for a Level II trauma center, I'm working to bring trauma-informed practices to the community and have made great inroads in the area with behavioral health, but am discouraged when it comes to implementing trauma-informed practices with our inpatient clients.
Today, during multidisciplinary rounds, we discussed one of our current patients. She had been in the hospital for over a month after sustaining devastating injuries in a motor vehicle crash. She is confined to her bed and requires a return to the operating room every three days for her large wound. The patient is described as difficult and demanding with major pain issues.
Psychiatry was called yesterday to evaluate her and perhaps develop a plan to improve her compliance with the medical regime. It was only then that her psychosocial history was documented. This patient is in her very early 20s and, in her short adult life, she has experienced rape, domestic violence, the removal of her children from her home and a suicide attempt earlier in the year. She also has a history of substance abuse.
I can only imagine her ACE score and PTSD. Until yesterday this information was not even brought up to the trauma team caring for her. No one asked.
Knowing what I now know about ACEs and retraumatization, how can I influence the care this patient receives in our hospital? I see this patient going down the road of the chronic user of medical services, contributing to driving up health care costs.
What are your thoughts on this? And where do hospitals start?
We do have social services, but their resources are limited. We also have a program provided by a community partner that follows our violently injury clients admitted to the hospital and addresses their non-medical needs. I think a similar program that follows clients into the community would be appropriate for this population.
Comments (5)