Healthy Nurse, Healthy Nation® Guest Blog: How Trauma-Informed Care is Transforming Healthcare
Published
By Sadie Elisseou, MD
Dr. Elisseou shares vital information about trauma-informed care and how nurses and their patients benefit from its use
When I first joined the Veterans Health Administration (VHA), I noticed that many of our patients showed signs of stress during their primary care appointments. Some were direct in saying, “I think I’m a little nervous being here”. Others had high blood pressure during triage or were sweaty during the physical assessment.
I observed our inspiring team of nurses provide compassionate care to our Veterans—care that was sensitive to their heroic sacrifices and their unique needs. Over time, I tried to model language and behaviors that could help our patients feel safe and empowered in clinic. One day, a trainee told me that what we were doing was “trauma-informed”. I had never heard that term before.
What is Trauma-Informed Care?
I’ve since learned that trauma-informed care (TIC) is a strategic framework for providing top-quality care to people who have lived through trauma. Trauma can be many things—physical or emotional abuse, war, natural disasters, medical illness, poverty, discrimination, school or workplace violence. As healthcare professionals, we are exposed to secondary trauma on the job, bearing witness to the pain of our patients and communities. And in today’s world, there is no shortage of conflict in our newsfeed to contribute to the stress we carry with us, at home and in the healthcare setting.
Trauma-Informed Healthcare Transformation
Fortunately, TIC offers a path forward. What started as a behavioral health model has now become a social movement, as public school systems, legal practices, and healthcare organizations are integrating trauma-informed systems change.
Research is revealing the benefits of TIC on patients’ experience and outcomes. TIC is increasingly taught in nursing schools and will impact the way healthcare systems practice. Major nursing associations are even spotlighting TIC as a strategy for safer workplaces.
The Four Rs of Trauma-Informed Care
The Substance Abuse and Mental Health Services Administration’s (SAMHSA) four Rs of a trauma-informed approach help us understand how to nurture an environment of respect and recovery for patients, families, staff, and our organizations at large.
- Realize the widespread impact of trauma. A national study showed that 89% of the U.S. population will experience at least one traumatic event in their lifetime. Trauma isn’t something that affects a subset of patients—it impacts the majority of people who both access and work within healthcare systems.
- Recognize the signs and symptoms of trauma. Among our patients, trauma can present as “no-show” appointments, agitation at the check-in counter, nonadherence to medications, and/or a host of mental and physical health conditions. For staff, trauma can disguise itself as interpersonal conflict, missed shifts, medical errors, or burnout.
- Respond by putting knowledge about trauma into practice. Specific training can help healthcare professionals apply trauma-informed principles to daily practice settings, whether for patient care, employee well-being, or nursing leadership.
- Resist re-traumatization. It is common for healthcare settings to make patients feel vulnerable or to even unknowingly call up memories of past adversities. As patients undress for an exam, prep for a closed MRI, or receive anesthesia for a colonoscopy, nurses play a crucial role in helping patients feel grounded, safe, and cared for.
By embracing TIC, we choose to honor resilience, lead with compassion, and reimagine healthcare as a place where both patients and healthcare professionals can thrive.
Sadie Elisseou, MD is a practicing physician, medical educator, and leading subject matter expert in trauma-informed care. She teaches clinical healthcare professionals how to provide top-quality care to trauma survivors and consults for companies that wish to cultivate wellbeing through stressful times.
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Blog Quality of Life
10/20/2025 1:04pm CDT
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