Trauma-informed care is not just a clinical intervention. It involves all individuals at your organization and requires a paradigm shift away from habitual, routine procedures and traditional approaches. Rather than a one-time implementation, it is an ongoing process that requires continuous learning, diligence, and communication.
Adopting a trauma-informed approach is not accomplished through any single particular technique or checklist. It requires constant attention, caring awareness, sensitivity, and possibly a cultural change at an organizational level.
A great example of TIC: As A Forensic nurse I have spent some years in the NICU and wish I had known this then. Please consider applying this to your patients that you also see no matter what the complaint or issues are.
Table 1
SAMHSA’s six key principles of a trauma-informed approach 10 adapted for a NICU setting
PrincipleApplication in the NICUa1.Safety (physical and psychological) for parents and staff• Privacy is afforded (best done in single-family rooms). • Confidentiality is maintained. • Mutual respect is demonstrated. • Providers are caring, empathic, and validate parents’ experiences.2.Trustworthiness and transparency• Communication, free of medical jargon, is frequent and regular. • Parents’ concerns and questions are respected. • Parents have access to their baby’s medical records. • Parents’ presence on rounds and during shift change is encouraged.3.Peer support• Every NICU should offer peer support to every NICU parent within 72 h of admission. • Peer support can be provided one-on-one, in a group setting, by telephone, or internet.4.Collaboration and mutuality• Parents are partners with the NICU team. • Nurses take the role of mentor and coach to parents. • Parents are involved in the care of their baby as early and as often as possible. • Family-integrated care is a promising new model. • Shared decision-making for a baby’s care plans is standard. • Nurse–physician collaboration is practiced.5.Empowerment, voice, and choice for parents and staff• Parents are provided emotional and psychosocial support to foster their resilience. • Parents are encouraged and supported in taking on their roles as parents and caregivers. • Parents’ presence on rounds and during shift change is encouraged. • Staff is supported with appropriate assignments, mentoring, and self-scheduling. 6. Cultural, historical, and gender issues• All parents are welcomed and treated equally. • Culturally effective care is provided to all.
Abbreviations: NICU, newborn intensive care unit; SAMHSA, Substance Abuse and Mental Health Services Administration. The applications were derived from the ‘Interdisciplinary Recommendations for Psychosocial Support of NICU Parents’60 and from ‘Trauma-Informed Care in the NICU.’62