Culturally Competent: The Importance of Informed Care

For many patients, the first medical professional they interact with is a nurse. From the moment they are checked in, they are in a nurse’s - and later doctor’s - care. The nurse-patient relationship is crucial to a patient’s experience. Nurses can also serve as an advocate during treatment. 

Patients come from many walks of life and have various lived experiences. Trauma Informed Care, or TIC, is “an approach, based on knowledge of the impact of trauma, aimed at ensuring environments and services are welcoming and engaging for service recipients and staff” as defined by Trauma Informed Oregon.

While this approach is typically practiced and implemented through a social work lens, there is value in adopting this approach in everyday medical settings as well. Traumas are not limited to physical injury, Merriam-Webster defines trauma as a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury.

One major trauma that patients can experience that has become increasingly prevalent is racism in healthcare settings. While this is not news to many BIPOC (black, Indigenous and people of color) folks, the increase in news coverage and stories surrounding this trauma have brought it to the forefront. 

Take Elon University’s initiative to create a more “intentional” nursing curriculum to address the racial and ethnic disparities in health care, for example. Tiffany Morris, the inaugural chair of Elon’s nursing department (debuting in Fall 2021) states: “Not only are we going to be intentional in the classroom but also in our clinical learning experience ... utilizing spaces in the community that typically may be viewed as areas where there's disparity and ... that typically have less access to healthcare.”

CHCS, Center for Healthcare Strategies, lists these 6 core principles of trauma informed care. Here are our tips to help you become more informed and cultivate an inclusive and positive relationship with your patient: 

• Safety

  • Ensure that your patient feels safe throughout their visit. Ask for consent before performing tasks such as taking blood pressure, measuring height and weight, etc. 

• Trustworthiness and Transparency

  • Establish trust with your patient by introducing yourself and asking them about their day. Practicing some empathy and care with your patients can alleviate any discomfort or nerves your patient might feel. Explain what your role is and how you are going to support them during their visit or extended stay. 

• Peer Support

  • Do you have a shared experience with your patient? Do you know someone that does? Utilize your fellow staff if needed to help your patient feel more supported. Showing support can be as simple as finding similarities or telling them a story about your own experience. 

• Collaboration

  • Do your best to ensure a seamless experience as your patient transitions to speaking with their doctor. The switch from informed care to a more systematic one can be jarring for any patient. Remember that you and your colleagues are a team and you all want what is best for the patient.

• Empowerment

  • Do not assume that your patient is or is not feeling a certain way. Ask open-ended questions and give your patient space to share their side of the story and what they are feeling. When your colleagues enter the room, reinforce the patient’s presence and allow them to speak and be a part of the discussion. 

• Humility and Responsiveness

  • Take a note of any biases that come up and address them internally. We are all human and we all have unconscious bias! It’s important to check them at the door and not allow them to inform your decision making or interaction with the patient.

By practicing more informed care as a nurse, you can provide more holistic and well-rounded care. Informed care can also increase the quality of care and patient experience. The need for more diverse, inclusive and informed nursing staff is not limited to the United States. A study from Spain states: “The nurse-patient relationship is one of the aspects that affects the patient’s autonomy. A poor or bad nurse-patient relationship decreases the quality of care and diminishes the patient’s autonomy”

What are some ways that you can practice informed care? Share this post on social media and let us know!