Lecture 6 - Trauma-Informed CareMcGill Model of Nursing Family Resilience Flashcards
What is trauma
- Single or repeated what
- Overwhelms what?
- sources of trauma EEDSS
- 3 characteristics of trauma UUN
- Single experience or repeated experiences
- Overwhelms one’s ability to cope
Experience of abuse Experience of assault Death or injury of others Severe injury/disability to self Sudden job loss
1) Unexpected, 2) Unprepared, 3) Nothing could stop it from happening
What is trauma informed care
Viewed as?
Instead of?
Involves recognizing
- Widespread what
- Knowledge of what?
Principles of TIC Practice? 4 TECS
Providing care in a manner that is welcoming and appropriate to the needs of those affected by trauma (Harris & Fallot, 2001)
Viewed as affected by an “injury” rather than being “Sick”
Instead of “What is wrong with you?,” shift to “What has happened to you”
- Widespread impact of trauma
- Knowledge of signs and symptoms of trauma in self and others (e.g., patients, colleagues)
- Trauma Awareness (above)
- Emphasis on safety and trustworthiness
- Creating opportunity for choice, collaboration and connection
- Strengths-based and skill-building
After the ABCs, Consider DEF
What is DEF and describe them
AAC WB AGA
Distress
- Assess and manage physical/emotional pain
- Ask about fears and worries
- Consider grief and loss
Emotional Support
- Who and what does the patient need now?
- Barriers to mobilizing existing supports
Family
- Assess distress among all family members (e.g., parents, children, siblings)
- Gauge family stressors and resources
- Address other needs (beyond medical)
McGill Model of Nursing
Developed by Dr. Moyra Allen in 1970s
-What report and implementation of what
What is special about this model?
- Nursing has a what
- Main goal of nursing is what
- Shifts from a what to what
Serves as a what
Provides a what
-Lalonde report in 1974 (New Perspectives on the Health of Canadians), and the implementation of universal health insurance and public funding which created an increased demand for services
- Nursing has a unique & complementary role
- Main goal of nursing: form a partnership with person/family
- Shifts from a deficit/problem oriented approach to a strength-based
Serves as a compliment to the CFAM- CFIM Model because it has the same theoretical perspectives
It provides a practical framework for how nurses can work with Family Strengths, Potentials and Resources
perspective
McGill Model of Nursing
Deficit perspective
- Focused on what
- Whose the expert
- Nursing plan Based on what
Strength based perspective
- Focused on
- Who is the collaborator with who
- Focus on what who does
- Nursing plan based in?
- Focused on what was wrong, missing or abnormal
- Clinicians as expert
- Nursing plan based on lacks/failures r/t the problem
- Focused on what families know/can do
- Clinician as collaborator (partnership with family)
- Focus on strengths in/around the individual, family, community
- Nursing plan based on strengths/potential of client/s in a situation
Problems with a “problem or deficit orientation”
- Labels family as what
- Gives off what 3
Do families need out help because we know what to do
Labels family, Needing help from a Professional
Stigma
Hopelessness, learned helplessness
Alienation from the nurse
(NO! we need to empower them and not take over! So they don’t sink without us)
Four types of strengths
- Strengths are what to the family system
- What are the four types TACQ
- Strengths enable families to CCD
Strengths are Internal to the family system:
- Traits (e.g., optimism, resilience) (mindset/approach to life)
- Assets (e.g., finances) (valuables, time)
- Capabilities, Skills or -Competencies developed (e.g., problem-solving skills)
- Qualities - more transient in nature than a trait or asset (e.g., motivation) (depends on circumstance)
Strengths enable families to:
cope, change, and develop
Potentials & Resources
Potentials include?
Resources include?
Potentials include precursors/assets that could be developed into a strength.
Resources include assets external to the family system.
Interest (joining parenting group) [Potential]
Access to library [Resources] (eco map)
Strategies for working with Strengths: (remember these are internal to the family)
The nurse can assist to?
4?
IPDC
Identify Strengths
Provide Feedback
Develop Strengths
Call Forth Strengths
Identify strengths
-Use what questions to assess what?
Help them what
Use open-ended, exploratory-type questions to assess:
- Perceptions of concerns
- What is important to them?
- What they are trying to do
about it to accomplish?
Helping them identify
“What it is that they are good
at doing?”
- Providing Feedback:
- Needs to be what
- Using what interventions
- If genuine and authentic it does what
Need to be explicit, specific and descriptive
Commendations – sharing observations about the strength (“mirroring strengths”)
If genuine and authentic
- boosts sense of competence and confidence
- creates context for change
- Developing Strengths:
- The overall goal is
What are the 3 approaches to do this?
- Transfer what
- What reframing
- Developing
The overall goal is to facilitate coping and development
3 approaches to do this:
- Transfer strength from one experience to another
- Cognitive reframing – helping to consider a different perspective
- Developing knowledge or competency
- Calling Forth Strengths:
- At every stage what?
- The goal is what
- How? What do I say? 7
At every stage the nurse must consider how potentials and strengths could be used to achieve goals and solve problems.
The goal is improved care planning and increasing family capacity!
I really appreciate..... I have noticed.... I was struck by how you.... I see you were able to utilize... You must be proud..... I remember you saying you handled this ....., that is a great coping mechanism you can use ....
Strategies for working with Resources: (remember these are external to the family)
The nurse can assist to: 3
- Identify what
- Mobilize what
- Regulate what
The nurse can assist to:
- Identify resources
- Mobilize and use resources
- Regulate resources
- Identify resources:
- Explore what?
- Ask them to express 4
- What and what of network and connections
Explore with use of ecomap
Ask them to express (e.g.,)
- What do you spend time doing?
- Who do you spend time with
- Who do you rely on?
- Who causes you stress?
Quality and quantity of network and connections
- Mobilizing and Using Resources
- Help what
- Together what
- List/Identify what
- Determine what
- Help families identify where there is a need
- Together decide the type – “the specific fit”
- List/identify what actual resources exist
- Determine together who best to make the contact (sometimes shared or nurse acts as coach, but the more active the family > greater self confidence grows in their abilities) [The best fit]
- Regulating Resources
- Problem what
- Help what
Problem-solve together how to minimize problems and maximize benefits
Help to manage the input – may decide together to look for alternatives
What is Resilience?
- The ability to what
- Resilience what
- The ability what
- Not all individuals what
- Are you born with it?
“The ability to withstand and rebound from disruptive life challenges”
Resilience contributes to positive adaptation within the context of significant adversity
The ability to “Struggle well “ and surmount obstacles
Not all individuals have the same outcomes following traumatic events
Key Protective Factors (EXAM)
Individual Protective Factors: (Within us, developed over time)
- Internal what
- Emotional what
- What system
- Self what
- Effective what
- E and T
- H
- T
- G
Individual Protective Factors: (within us, developed over time)
- Internal locus of control (power to change your situation)
- Emotional regulation (children need to learn)
- Belief system
- Self-efficacy (ability to have confidence to reach goals)
- Effective coping skills
- Education and Training
- Health (perceptions of health, even in the face of illness)
- Temperament (Can be a buffer to the effects of unhealthy things)
- Gender (Do you self identify as male or female) (females don’t do dumb shit)
Key Protective Factors (EXAM)
Family Protective Factors:
- What structure
- What partner
- Family what
- What interaction
- What environment
- What support
- Family of what
- What income
- What housing
- Family structure (Nuclear family, blended family, size)
- Intimate partner relationship stability
- Family cohesion (how they bond)
- Supportive parent- child interaction
- Stimulating environment
- Social support (important)
- Family of origin influences (examples families set)
- Stable and adequate income
- Adequate housing
Key Protective Factors (EXAM)
Community Protective Factors:
- Involvement in what
- What acceptance
- What mentors
- What neighborhoods
- Access to what schools and care
- Access to what healthcare
- Involvement in the community (large support network
- Peer acceptance
- Supportive mentors
- Safe neighborhoods
- Access to quality schools, child care
- Access to quality healthcare
