Introduction
Depending on how the victim deals with the initial shock, both physically and emotionally, the effects of a traumatic event might vary and take varying amounts of time to surface. The effects of trauma can be felt right away, or they can be delayed for days, weeks, or even months. Post-traumatic stress disorder is a common psychiatric effect of catastrophic motor vehicle accidents (PTSD). In many cases, people develop PTSD after experiencing a traumatic event that involves death, serious injury, or harm to one’s or another’s physical well-being (PTSD).
Reluctance or refusal to drive, actively avoiding thoughts about the MVA and emotional numbing (e.g., significantly reduced or absent emotions, feeling detached from others) are all symptoms of post-traumatic stress disorder (PTSD) following a serious car accident (e.g., exaggerated startle, irritability, disturbed sleep). Some of these symptoms are what Tony is experiencing. As a counselor, I believe clients who report a serious MVA should be screened for PTSD due to the high prevalence of PTSD following such an event.
Collaborating With Others in Client Support
I would try as much as possible to seek assistance from experienced counselors. Care for trauma patients relies heavily on collaboration, which is common in nursing. We may create settings that encourage consideration, efficiency, autonomy, and respect by emphasizing teamwork. Clients and caregivers alike become equal partners in the caregiving process. As a result, the process of and consequences of their interaction become more effective and result-oriented.
Experience of Being a Paramedic
Some of the information I would require from my client would touch on his work life as a paramedic. A paramedic is the last person one wants to encounter, as their presence usually indicates an emergency. They are the ones called emergency first responders by most people (Cleary et al., 2020). Their services are needed in significant incidents like an accident, illnesses, or crises. They initiate life-saving procedures and stabilize patients before transporting them to a medical facility for further evaluation whenever necessary.
Theories and Models of Trauma Patients Counseling
Theoretical models like postcolonial, poststructural, and sociocultural theory along with Freudian psychoanalysis on trauma, serve as the foundation for commentary that analyzes depictions of severe experiences and their impact on character and remembrance. Differences in client backgrounds form the basis for the adoption of broader and more effective trauma intervention models. The sociocultural model explores the cultural and social phenomena that may have triggered or contributed to trauma and builds a treatment plan based on them (Fischer et al., 2019).
The postcolonial model views the past, present and future as connected in most traumatic incidents. It emphasizes addressing the past effects of trauma to build a basis for future resolutions, interventions, and prevention (Fischer et al., 2019). The poststructural model is based on seeking resolutions through narratives and direct engagements. In the end, the physician can identify the causes of trauma and advise accordingly.
The usefulness of Trauma-Informed Intervention Models
Most health intervention models are accepted and adopted for their benefit to patients and practitioners. The sociocultural model is effective in instilling a sense of safety in patients, especially in critical traumatic conditions. The most significant advantage and effectiveness of the poststructural model is its active ability to avoid re-traumatization (Bilton et al., 2022). The postcolonial model empowers patients, making them feel as if they are in charge of their treatment. Patients and doctors collaborate, allowing the patients to make critical decisions for themselves.
Intervention When Tony Becomes Agitated
A state of agitation is characterized by apprehension and restlessness within oneself. As a result, one can get irritable or restless depending on the environment. This is a natural reaction that may at times get out of control. High-stress levels tend to bring agitation out into the open affecting those surrounding the patient. Medical and mental health conditions can cause agitation to range from mild to extreme (Bliton et al., 2022). The initiation of treatment is often slowed by agitation, which may affect morbidity and mortality and necessitate emergency treatments. Acute agitation management focuses on three key aims: prompt behavior control, early detection and treatment of the underlying etiology, and injury prevention to the patient and workers.
If a patient is agitated, the first step is ensuring they are in a secure area. It begins with a careful inventory of the room and marking any potential weapons like chairs or food trays. Caregivers should look for possible escape routes. They should also be prepared for any potential assaults that might happen. It is best to have somebody on hand when speaking to an upset patient because the situation can quickly become dangerous, especially if the patient is physically powerful. When confronting the patients, it is best to give them at least an arm’s length of space (Williamson et al., 2019). The person interviewed may be a victim of an unwarranted physical assault. Practitioners should watch their nonverbal cues and body language as well. Clinicians should reassure their patients that they are more than just a pharmacy.
Since yelling and screaming only upsets the other patients, the initial assessment of any agitated patient should be swift and focus on minimizing disruption to the surroundings. Patient-on-patient violence is a real possibility in this scenario. The next step is for professionals to evaluate the situation and determine whether medication, seclusion, or shackles are necessary or if verbal de-escalation alone will suffice. Other techniques to use to manage agitation in John are discussed below.
Learning Patient Triggers
The question “are there any talks or situations that could bring up painful memories or emotions for you?” could be helpful in this regard. Patients may find particularly upsetting the presence of loud sounds or arguments. If one knows what sets the patient off, they can take steps to prevent unpleasant encounters. Management of agitation in patients with brain injuries begins by gaining control of the patient’s environment (Nowicki et al., 2019). In a rehabilitation context, providing the patient with a routine-based timetable is beneficial. Anxiety and violence often result from overstimulation of the patients.
How to Monitor Personal Comfort
Keeping an eye out for signs of discomfort, hunger, thirst, constipation, a full bladder, exhaustion, infections, and skin irritations is vital. Also getting the temperature just right is necessary so everyone can relax (Phyland et al., 2021). The medical staff should consider worries, misperceived threats, and difficulty expressing needs and desires. The concern should be on any signs of discomfort in the patient.
What Is Happening To Tony When He Becomes Agitated
Agitation is characterized by a wide range of uncomfortable feelings within the patient. They include restlessness, irritability, anxiety, and unease. As a result, Tony may get irritable and act aggressively depending on his stimulated emotions. As tensions rise, he may resort to name-calling and physical intimidation. Physical symptoms such as pacing, swaying, talking rapidly, fidgeting, hand wringing, or other repeated movements are common among those who suffer from anxiety.
Principles Informing My approach to Guide the Client
The Center for Preparedness and Response (CPR) at the CDC collaborates with National Center for Trauma-Informed Care (NCTIC) at the Substance Abuse and Mental Health Services Administration (SAMHSA). The two create and deliver training on the importance of trauma-informed care during public health emergencies (Levenson et al., 2021). The purpose of the training was to make first responders more conscious of the effects of trauma in the communities in which they operate. The six tenets of SAMHSA’s trauma-informed approach were taught to the attendees.
Safety
Patients should feel protected when under the care of medical personnel. Nurses are responsible for making their patients and their loved ones feel safe in every sense of the word while they are in their care. Healthcare facilities should create environments where patients and their loved ones feel secure. For instance, the proximity of others in waiting areas could re-traumatize certain people. A healthcare center’s exterior should convey a sense of calmness and security to patients (Levenson, 2020). Well-lit parking lots and walkways raise the security awareness of clients who visit at night. Security personnel trigger a sense of security and safety among all visitors.
Peer Support
Nursing staff, physicians, and other healthcare providers need a comprehensive understanding of trauma and its effects on patient care to deliver trauma-informed care. Doctors must view every patient as unique. The patients may have undergone trauma that prevents them from openly discussing their health concerns. Instead of trying to cure or heal a patient’s condition, a professional should listen to them to find out what they need. The medical professionals who have dealt with comparable cases of trauma are the best suited to addressing clients like John. A doctor who understands the effects of assault first hand may be the ideal person to treat a patient who has suffered this kind of trauma. Nurses and other medical professionals can relate to patients who have suffered trauma due to domestic abuse or battery since they have also been victims of similar acts.
Trauma Assessments Assistant
Screening for trauma-related symptoms or mental problems should prompt a follow-up examination by the agency or counselor. In the event of a positive screening, more actions are required, including an assessment to evaluate and characterize the nature of the presenting difficulties. The professionals should formulate an effective treatment strategy, and arrive at a treatment placement decision collaboratively (Pearce et al., 2018). The client may be asked to fill out a questionnaire or undergo a clinical interview with a mental health or drug abuse expert to evaluate the nature and extent of their problems. A thorough clinical evaluation will investigate the client’s life story, cultural background, psychosocial status, and available resources that may help in unearthing the client’s issues.
Assessment protocols may take more than one session to complete and should collect data from various sources. Data may be obtained from self-assessment instruments, historical and current medical records, structured clinical interviews, and supplementary data from family members, friends, and colleagues in the field of behavioral health.
Ethical and Legal Principles and Practices
Ethical principles provide one possible structure for resolving a moral conundrum. In this view, there is no one overarching concept that supersedes all others. An acceptable course of action for dealing with an ethical dilemma may be formulated (Campbell, et al., 2019). The problem’s scope and dimensions can be clarified with the help of the information gained through applying ethical principles. The principles include respect for autonomy, non-maleficence, justice, fidelity, and beneficence.
The autonomy of the client means taking into account the person’s capacity to make decisions without external influence. The counselor should accept and acknowledge the client’s right to make their own decisions. The definition of an autonomous action does not compromise the independence of any other actor. One must consider the outcome of another’s actions and how they will affect those around them. Clients who cannot appreciate the consequences of their conduct, such as minors and those with mental health issues, may have limited autonomy.
The term non-maleficence implies trying not to cause harm and originates in the field of medicine. When discussing counseling ethics, “autonomy” refers to the client, whereas “non-maleficence” centers on the counselor’s skills (Perrigault & Greco, 2022). Counselors should refrain from using techniques that could potentially hurt their clients.
Beneficence means taking into account the duty to improve the client’s situation. If the counselor cannot help, they should explain why and provide other options. The word justice means acting in a fair or honest way. It is anticipated that counselors will not treat clients differently based on their race, gender, sexual orientation, religion, disability, or other factors. Justice does not require counselors to treat all clients equally but rather to treat them fairly. The counselor-client relationship is centered around fidelity. Counselors are expected to put their Client’s needs first, even if doing so presents challenges or makes them feel uneasy (Holder et al., 2018). A counselor’s credibility rests on the client’s faith in honesty and dependability. The counselor does not need to reveal every transient idea or emotion.
Conclusion
The effects of trauma on patients may be instantaneous or delayed depending on different factors. When attending to traumatic patients, essential information is obtained from friends, family, coworkers, or the patients themselves. The most common and effective theories and models of trauma-informed care, as discussed, are poststructural, postcolonial, and sociocultural theories. The theories are adopted for their effectiveness and usefulness in delivering positive results, especially in ensuring patient empowerment and safety. Medical practitioners should learn key patient triggers and ensure control of the situation when attending to traumatic patients. Peer support and safety are key considerations for any practitioner to make when attending to patients like John. Some of the most prevalent ethical and legal issues that doctors must observe include fidelity, justice, autonomy, beneficence, and non-maleficence.
References
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