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
