Trauma can have many impacts on all of the aspects of an individual’s health. It can cause depression, nightmares of or related to the traumatic event and at its worst, an almost constant state of anxiety. The anxiety can be related to the event itself in terms of a state of fear of the event happening again or it can manifest in a more generalized state. The anxiety, depression and nightmares can make the person feel isolated as it can be difficult to find those to relate with. It can also make them feel vulnerable. Existing in a constant state of anxiety also has physiological implications. Anxiety precipitates increased cortisol levels which may lead to obesity, difficulty sleeping, hypertension, stomach ulcers and many more conditions. There can be many spiritual concerns related to trauma, such as a falling out with ones religion or a trusting in a higher power to navigate through difficult times related to trauma. 

Some long term impacts of ACES include a more chronic form of trauma that could potentially be lifelong without professional intervention or the proper social support. Adverse childhood experiences is a broad term to describe certain forms of trauma that may have happened during childhood. For instance, experiences such as not adequately being fed, verbal or physical abuse or a divorce can be major determinants of health for a patient’s future. There are studies that show a link between childhood malnutrition due to parents not being able or unwilling to feed their children and the onset of schizophrenia later in life. The verbal or physical abuse could manifest itself as nightmares or as chronic anxiety later on.

I will integrate trauma informed care principles into my practice through making it my goal to figure out how to make each individual patient feel comfortable. I’ve found it helpful when building rapport with patients to sit down with them if I have time, make small talk with them, let them know where I’m from (if I deem it safe to engage with them in this way), why I’m here, some things im interested in to hopefully spark a conversation so that they feel more comfortable. I always let the patients that I am working with, especially the vented patients that I worked with this summer know exactly what I am doing to them and why I am doing it as an attempt to decrease anxiety. I let them know that I am in the room to help them through their stay in the ICU and that I am working alongside their primary nurse as a nursing assistant. In clinical I always try to make myself available for the patient, not looking at the computer screen typing or doing something else but when they are talking I am listening. If I need to move around clothing to perform an assessment I will always ask them if they are comfortable with it and inform them as to why it is necessary. If someone requests a healthcare team member of a different sex I will  try my best to honor that request so that they can feel as comfortable as they possibly can while they are in the hospital.