Mental Health and Wellbeing in Clinical Practice

Introduction to Communication Skills for Nurses and Midwives

Trauma is the result of distressed and disturbing events that happened in one's life by observing the events directly or indirectly, listening to the event happened to the loved ones, or coming across recurrent details of such events that affect an ability of a person to feel the full range of emotions and experiences. According to DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders), Trauma may be in the form of exposure to threatened death, serious injury, or sexual violence. The majority of people are exposed to trauma at some point in time in their life (Benjet et al., 2016). According to Hopper, Bassuk & Olivet (2010), Trauma-Informed Care (TIC) is a strengths-based framework that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasizes physical, psychological, and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and empowerment.”. It is based on the understanding that many people experienced trauma in their lives sometimes in life. Earlier health services were not considering trauma into routine processes of care which resulted in retraumatization or false interpretation of behaviors. This necessitates the use of trauma-informed approaches by health service providers. (SAMHSA,2014).In this essay how the nurse or midwife in their role can support and facilitate the six (6) guiding trauma-informed principles will be discussed and illustrated with examples from the articles.

Trauma Informed Care

In health care trauma is considered an important issue but it is less acknowledged by service delivery providers. Lack of knowledge of health service providers to differentiate between trauma survivors and those who do not experience trauma leads service recipients at increased risk of being retraumatized (Kezelman,2016). Implementation and use of TIC by service delivery persons like nurses and midwives were suggested to prevent re-traumatization by many researchers (Kezelman,2016; Reeves,2015; Seng & Taylor,2015). So the role of nurses and midwives is very important in adopting TIC.

Furthermore, TIC is regarded as the best practice in health service delivery which allows nurses and midwives to understand the trauma faced by the patients, survive method and help them to implement service methods which help in eliminating the influence of trauma recovery of the victims. To promote high-quality practice and avoiding retraumatization it is necessary to integrate and follow the principles of TIC by all the organizations. Hall, Dearie, Maguire, Charleston, & Furness, (2016) highlighted the importance of training to nurses of emergy departments and mentioned that training will enhance the knowledge and skills related to the TIC thereby reducing the risk of retraumatization. In training, it is essential to provide essential knowledge of communicating with the clients and how to identify the clients with traumatic histories and how to deal with them.

Role of Midwives or Nurses in Facilitating Six Guiding Trauma Informed Principles

A TIC comprises of 6 key principles which are generalized across different care settings. The terminology and application used may be specific to sector or care settings. These 6 key principles are patient-centric and focused on avoiding triggers which creates retraumatization.TIC believes that anyone may be the trauma survivor and every member in the health care system should understand these 6 key principles. Nurses or midwifery plays an important role in the development of trauma-informed care. The below information explains the individual principles and role of the nurses and midwifery in fulfilling the principle of TIC

Safety: The patients should feel physiologically and physically safe. Nurses should prioritize to protect the individual from any harm. Levenson (2017) mentioned the role of staff in maximizing the emotional safety of patients. If the nurses are approachable, heard and understandable patients feel good. Physical safety can be accomplished by providing locational safety, security staff, and accessibility. According to Lavenson(2017), TIC for mothers suffering from postpartum depression should ensure security and confidentiality by providing appealing physical environments.

Trustworthiness and Transparency: There should exist transparency in organizational practice and decisions which helps to build the trust of the clients and staff. If the patients mistrust the organization it will affect the treatment process. So the organization should work towards providing services that are transparent and approachable. Transparency ensures reducing ambiguity and builds trust (Lavenson,2017). Nurses should ensure that there should be proper communication flow if any change in the organizational decision concerning the patient.

Peer Support: Individual who experiences trauma should be provided with support from the organizational staff(such as nurses) and family which will enhance trust and helps in speedy recovery. Nurses or midwifery should interact with the patients and allow them to interact with similar people will help in speedy recovery. In the case of Postpartum depression, mothers reported that meeting the other mothers with the same condition or with the same history in a supportive environment helps promote recovery(Leger & Letourneau, 2015).

Collaboration and mutuality: This principle believes that recovery will happen if there is a meaningful sharing of power and decisions among staff and patients. This can be ensured by following patient-centric approaches. For the well being of the client, the organization can show their collaboration with other agencies by way of posters, brochures, and distributing referral lists and introducing to the new service providers.

Empowerment: According to these principles clients should be given a chance to raise their voice regarding the treatment processes. They should be encouraged to speak ou their inner feelings which will help in making proper decisions.This will ensure clients that their choices are honored.

 Respect for Diversity: The client's socioeconomic status, cultural backgrounds, and cultural diversity will influence their behavior. Nurses and midwifery should develop an attitude to respect the client's opinions and feelings. They should help in minimizing the negative influence of socio-economical issues on the client recovery process(Knight, 2015). Organization and service providers should understand these factors and should effectively incorporate them into the treatment process.

Implications in Implementing TIC

TIC requires service persons who are secure and healthy with good emotional management skills. The nurses and midwives should be intellectual and possess good emotional intelligence. They should be able to teach, empathetic, patient, and be a role model. It requires self-disciplined, self-controlled, and one with less abuse power(Bloom,n.d.).But in reality, the workforce in most of the organizations are under stress and populated by trauma survivors. Prevalence of the organizations giving authoritarian tratment and the organization itself facing the condition what it meant to treat(Davis,n.d.).So for correct implementation of TIC in any organization requires supportive management who are concerned about their clients and service staff. An organization should work towards improvising operational and management decisions which will help both the clients and service persons to be in a stress-free environment. It should always emphasize on providing proper training to nurses, midwives, and other service providers in implementing the 6 principles of TIC. For helping clients who are victims of trauma there is a need supporting staff who are going to with clients in their process of treatment. Supporting staff requires supporting management which is always interested in providing the policies aiming at the welfare of the people depending on that organization.

Conclusion on Communication Skills for Nurses and Midwives

Any framework which encompasses these principles should be tailored to the requirement of the client. Given the fact that anyone can experience trauma in their life. TIC is a growing need. The essay discussed that nurses and midwives play a very important role in adopting these best practices in an organization. There is a need to develop a framework that is tailored to specific cases. As health professionals nurses and midwives should be committed to client-centric practices and effort should be made to fulfill the needs and requirements of clients at all stages. The promotion of these types of values in nurses and midwives is on par with the TIC and it will ensure clients are not made to traumatized or retraumatized by the nurses and midwives. There are limited studies on nursing interventions concerning TIC (Nizum, Yoon, Legere, Poole &Lulat,2020) leading to limited knowledge related to TIC in nursing practice. So an organization should work towards guiding nurses and midwives to perform their responsibilities based on the TIC approach.

References for Communication Skills for Nurses and Midwives

Benjet C., Bromet E., Karam E. G., Kessler R. C., McLaughlin K. A., Ruscio A. M., … Koenen K. C. (2016). The epidemiology of traumatic event exposure worldwide: Results from the World Mental Health Survey Consortium. Psychological Medicine, 46(2), 327–343.

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Davis,M.(n.d.).Trauma informed care application.Retrived from Application-by-Mandy-Davis.pdf

Hall, A., McKenna, B., Dearie, V., Maguire, T., Charleston, R., & Furness, T. (2016). Educating

emergency department nurses about trauma-informed care for people presenting with

a mental health crisis: a pilot study. BMC Nursing, 15(21). doi:10.1186/s12912-016- 0141-y

Kezelman, C. (2016). Trauma-informed care and practice in nursing. Australian Nursing and

Midwifery Journal, 24(2), 28.

Knight, C. (2015). Trauma-informed social work practice: Practice considerations and challenges. Clinical Social Work Journal, 43, 25–37. doi:10.1007/s10615-014-0481-6

Levenson, J. (2017). Trauma-informed social work practice. National Association of Social

Workers, 62(2), 105–113. doi:10.1093/sw/swx001

Leger, J., & Letourneau, N. L. (2015). New mothers and postpartum depression: A narrative

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Nizum, N., Yoon, R., Legere, L.F., Poole, N., & Lulat, Z.(2020). Nursing interventions for adults following a mental health crisis: A systematic review guided by trauma-informed principles.International Journal of Mental Health Nursing. doi: 10.1111/inm.12691

Reeves, E. (2015). A synthesis of the literature on trauma-informed care. Issues in Mental

Health Nursing, 36(9), 698–709. doi:10.3109/01612840.2015.1025319

Seng, J., & Taylor, J. (Eds.). (2015). Protecting children and young people: Trauma-informed

care and the perinatal period. London, England: Dunedin Academic Press Limited.

Substance Abuse and Mental Health Services Administration. (2014). Trauma-Informed Care in Behavioural Health Services. Rockville, MD: Author.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

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