Any psychiatric / mental nurses out there? Looking for suggestions people could make regarding how nurses in inpatient settings could improve their daily practice according to principles of trauma informed care. Stuff from places like SAMHSA provides lots of very general stuff but everyday?
Research provides the following ideas
- suicide risk assessment -- much higher in those with ACEs (Dube 2001) but how well is it assessed? by asking -- Dore, Mills et al (Australia) 2012 --A part of which might be finding out more about the experiences of abuse / trauma (Read's "funnel technique") following
- Asking "What happened?" instead of "What's wrong? (diagnostically)
- Sleep? so-called "exaggerated startle responses" when awoken (hate the expression -- not exaggerated, but increased, but ...)
- Validation of person / feelings vs DBT (Linehan, 2002), brings up ...
- Previous therapy? Quality of therapeutic relationship
- Experience of emotion dysregulation (I used to call them "the dreads" -- feelings of dread arising for "no apparent reason"
- Experience of dissociation, "nightmares", flashbacks & how dealt with
People will appreciate that these things apply transdiagnostically rather than necessarily for any particular diagnosis -- I'm sure there must be heaps, just haven't seen it in one article so far
Have people come across the English SAFEWARDS model and are you able to critically comment on it? While initial reviews (by its developer Bowers) have been positive, others have criticised these for lack of rigour.
Or the SPEC (safe practice, effective communication) model? -- oriented towards more TIC / reducing seclusion/restraint
You might notice that these things differ -- the former -- life trauma; the latter (SAFEWARDS, SPEC) -- iatrogenic trauma -- are hospitals doing enough to reduce the effects of life trauma, even if they're reducing the trauma they themselves cause?