Nurses are at the forefront of healthcare and play a critical role in

implementing trauma- and violence-informed care (TVIC). By adopting

this approach, nurses can help patients feel safe, respected, and
empowered during their healthcare journey. Let’s explore how nurses can
incorporate TVIC into practice.

1. Creating a Safe and Supportive Environment:

○ Ensuring Physical Safety: Nurses can ensure that the
environment feels safe and welcoming by keeping the patient’s
privacy respected, using soft lighting, and minimizing
unnecessary noise or interruptions. This can help patients feel
more comfortable and less triggered by their surroundings.

A nurse ensures the door is closed during an exam and

explains what to expect to minimize patient anxiety.

○ Empathy and Respect: Nurses can create a supportive

environment by listening actively, validating the patient's
experiences, and showing understanding. For example, a nurse
might say, "I understand this might be difficult, and I'm here to
support you at your pace."
2. Building Trust through Communication:
○ Clear Communication: Nurses should explain procedures and
interventions in a clear, non-threatening way to avoid
overwhelming or frightening the patient. Giving patients a sense
of control by asking for their consent before performing any
tasks is important, such as, "Would you like me to explain how
this procedure will go before we start?"
○ Encouraging Dialogue: Nurses can ask open-ended questions
to invite the patient to share their history or current struggles.
For example, "Is there anything you would like me to know to
 make your care more comfortable?" This shows that the nurse
cares about the patient's specific needs and fosters trust.
3. Empowerment through Control:
○ Involving the Patient in Decisions: Nurses can give patients
choices whenever possible, such as, "Would you prefer to lie on
your left side or right side for the exam?" Empowering the
patient in small decisions can help rebuild a sense of control
and autonomy.
○ Respecting Boundaries: Nurses can ask permission before
touching the patient or performing any procedure, particularly if
the patient has a history of trauma. For example, "May I take
your blood pressure now?" or "How do you feel about me taking
your vital signs?"
4. Recognizing and Acknowledging Trauma Responses:
○ Identifying Trauma Symptoms: Nurses can be trained to
recognize signs of trauma or distress (e.g., hypervigilance,
avoidance, dissociation, or emotional outbursts) and respond
appropriately. They can help the patient ground themselves or
provide reassurance, saying, "I see you're feeling overwhelmed;
would you like a moment to collect yourself?"
○ Non-Judgmental Attitude: Nurses can approach each patient
without assumptions or judgment. If a patient exhibits
challenging behaviors (e.g., anger or withdrawal), the nurse
should recognize that these may be trauma responses and not
react with frustration. Instead, they can ask, "It seems like you
might be feeling upset, would you like to talk about it?"
5. Trauma-Informed Patient Education:
○ Educating About Trauma: Nurses can provide education to
patients about the impact of trauma on health, as well as the
importance of self-care, without triggering shame or blame. For
instance, “Trauma can affect many parts of your health, and it’s
okay to ask for help or take things at your own pace.”
○ Resource Referral: Nurses can connect patients to support
resources such as therapy, support groups, or social services,
 especially if they identify that the patient is experiencing
ongoing trauma or abuse.
6. Collaboration and Support:
○ Working with Multidisciplinary Teams: Nurses can
collaborate with social workers, psychologists, and other
healthcare professionals to ensure a comprehensive,
trauma-informed care plan for patients. For instance, if a patient
shows signs of PTSD, a nurse might consult with a counselor or
refer the patient to a mental health specialist.
○ Supporting Families: Nurses can also support families of
trauma survivors by providing education on how trauma may
affect behavior and emotional responses. This can help create
a more understanding and supportive environment at home.
7. Self-Care for Nurses:
○ Managing Compassion Fatigue: Nurses should engage in
regular self-care to prevent burnout and compassion fatigue.
This includes setting boundaries, taking breaks, and seeking
support when needed. A healthy, emotionally supported nurse
is better equipped to provide trauma-informed care to patients.

By implementing these practices, nurses can make a significant difference

in the care and healing of patients who have experienced trauma or
violence. The goal is to create an environment where the patient feels safe,
supported, and empowered, which can lead to improved outcomes and a
more positive healthcare experience.