NURS310 Lecture Notes - Lecture 4: Brainstorming, Clinical Pathway, Otitis Media
22 Jun 2018
School
Department
Course
Professor
•Trauma
•Trauma
•76% of Canadian adults experience trauma in lifetime
•Enquire about trauma as part of routine practice
•Women find it acceptable to be asked about domestic abuse
•Many do not disclose domestic abuse unless asked
•Asking paved the way for openness, trust and future disclosure
•Women in later stages of an abusive relationship find repeated enquiry
particularly appropriate
•Trauma Informed Practice
Outline
Notice Signs of Trauma
Asking about Trauma
Histories of Violence and Trauma
Responding to Disclosures
Making Referrals
Documentation
•Domestic Violence Pathway
Physical Indicators
•Bruising
•Burns
•Lacerations
•Facial injuries
•Back pain
Injuries Inconsistent with explanation
•Genital injuries
•Stab wound
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Emotional/Psychological Indicators
Anxiety
•Panic attacks
•Choking sensation
•Palpitations
•Chest pain
•Non-specific abdominal pain
•Reluctance/delay in seeking treatment
Depression
•Insomnia
•Crying spells
•Loss of Appetite
•Memory Loss
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•Interview the patient on their own
Check medical record for previous presentation/history
Be supportive, ask direct questions
1) In my experience individuals often get these types of injuries when someone hits them
in some way. Did someone hit you?
2) It seems your injuries could have been caused by someone hurting or abusing you? Did
someone hurt you?
3) We know that abuse an violence affect many people and this directly affects their
health, I wonder if you have ever experienced any violence or abuse?
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•Responding to Disclosures
What’s most important is the therapist’s authenticity and sincerity.
•"Thank you for trusting me enough to share such a personal and difficult story”
•“I appreciate the courage it took to share that with me.”
•“I want you to know that what happened wasn’t your fault. You did whatever you had
to do to survive.”
•Responding to Disclosures
•“I am so sorry that you were hurt/mistreated/harmed.”
•“You deserve support. You deserve a witness for your pain. You deserve to learn
strategies that can help you to heal.”
•“You are not alone. You don’t have to be alone in your healing.”
•“You’ve just taken the first step. It would be my privilege to help you take the next one.”
•Determine Evidence
No evidence
Continue Care as per normal procedure
Violence/Abuse Confirmed
Enquire about children
Follow procedure for addressing violent/abusive experience
Violence/Abuse Suspected (may be denied)
Enquire about children
Follow procedure for addressing violent experience
•Where violence/abuse is suspected
Health care workers have a mandatory responsibility to ask about child safety:
1) Do you have children? If so have they been hurt or witnessed violence?
2) Who is/are your children with now? Where are they? How old are they?
3) Are you worried about your child/children’s safety?
•Next Steps
1) Revisit confidentiality
2) Validate what has been shared
“I can see that it took a lot of courage for you to share this with me today and you are
exhausted. I will take your lead in terms of taking a break for now, perhaps finishing another
day, or continuing with our conversation.”
•Next Steps
find more resources at oneclass.com
find more resources at oneclass.com
