Elizabeth B. Dowdell and Patricia M. Speck, authors of “Trauma-Informed Care in Nursing Practice”

·25 min·2 clips

Pat Speck reveals how childhood trauma shuts down oxygen to organs, leading to unexplained diseases.

This episode of The AJN Podcast features Christine Moffa interviewing article authors and nursing experts Elizabeth Dowdell and Patricia Speck. They discuss their CE article, "Trauma-Informed Care in Nursing Practice," which outlines a person-centered approach for nurses treating trauma survivors. Dowdell and Speck are forensic nursing specialists who developed the article following a policy dialogue at an American Academy of Nursing conference. Trauma-informed care is a framework originally defined by SAMHSA in 1997, built on six core principles: safety, trustworthiness, transparency, peer support, collaboration, empowerment, and cultural awareness. The Adverse Childhood Experiences study shows trauma survivors often face worse health outcomes and may avoid healthcare, becoming part of a "never served" population. Childhood trauma biologically affects neurological, immunological, and metabolic systems, often impairing memory due to oxygen deprivation in brain regions like the amygdala. The authors note a gap in applying these principles, as nurses can recite them but struggle with practical implementation in time-constrained visits like a ten-minute diabetic check-up. Their research involved surveying emergency nurses before and after a trauma-informed care seminar to measure changes in understanding. A common mistake is responding to a patient's trauma disclosure with immediate reassurance, which can interrupt the patient's necessary cognitive processing. The COVID-19 pandemic has increased institutional interest in trauma-informed care as a framework for supporting healthcare workers' wellbeing. Applying this care can reduce patient readmissions and "revolving door" scenarios, making it a financially sound practice. The approach also intersects with DEI initiatives by requiring nurses to examine implicit biases that might cause patients to feel judged. One key insight is that asking "What's going on in your life?" can be more effective than directly questioning a patient's health behaviors. Surprisingly, the optimal time to teach trauma-informed application may be early in a nursing career, as those with over ten years of experience can be resistant to change. Physical exercise is highlighted as a practical intervention to counteract the tissue damage from trauma-induced oxygen deprivation. The authors emphasize that creating safety can involve simple acts, like seeking permission before proceeding with a procedure. It may take a patient four to six safe visits before they feel comfortable disclosing deeply shameful experiences. Their research found that while some principles are easily adopted, avoiding reflexive, invalidating responses to trauma disclosures is a harder skill to master. The tone is educational and conversational, grounded in the hosts' clinical expertise and research findings. The style is practical and advocacy-oriented, focusing on actionable changes for nursing practice. This episode is ideal for nurses, nurse educators, and healthcare administrators seeking evidence-based methods to improve patient communication and outcomes. Listeners looking for a highly produced narrative or debate on medical ethics might find this straightforward clinical discussion less engaging.

As heard by us

A clear case for asking more, labeling less, and listening with care.

Christine Moffa's conversation with Elizabeth Dowdell and Pat Speck keeps trauma-informed care grounded in nursing practice. It traces the article back to an American Academy of Nursing policy dialogue, then moves into the daily work of asking better questions, making space for…

Read the full review in PlayNext →

Why you'd press play

If you want a practical, person-centered guide to trauma-informed nursing, start here.

Read the full recommendation in PlayNext →

Listen to the show on

Apple Podcasts Spotify

Play clips from this episode More from The AJN Podcast