By Austine Duru
Trauma can have lasting impact on its victims and those who care for them. The presence of chaplains in those situations can be integral in supporting patients, families, and staff through traumatic events. This article examines current research literature on this topic, which may hold valuable lessons for chaplains and educators.
Rambo, S., Wiinikka-Lydon, J., Okafor, J., (2020), Trauma and moral injury: A guiding framework for chaplains. This ebook introduces readers to the phenomena of trauma and moral injury. It goes into some detail about the sources of trauma and moral injury, and how these show up in individuals. The authors methodically guide chaplains to identify trauma and moral injury in their ministry and ways to effectively support and care for individuals experiencing trauma. This free ebook was recently updated to include recent COVID-19 trauma and the wounds of racial trauma that have resurfaced.
Pater, R., Visser, A., & Smeets, W., (2021), A beacon in the storm: Competencies of healthcare chaplains in the accident and emergency department. This article investigates the experiences of chaplains in the emergency department and trauma units and explores the competencies that that help chaplains become more effective in these high-paced settings. The authors interviewed chaplains and nurses across nine hospitals, and they concluded that chaplains who work primarily in the emergency and trauma spaces will need 10 primary skills. These include “psychosocial and communicative skills, knowledge of mourning processes, flexibility, sensitivity, and reflexivity. Additional competencies included sensitivity to existential concerns, practicing presence, a person-centered approach, medical knowledge, and letting go of a solution-oriented approach.” The authors also underscore the importance of self-care for those working in trauma settings.
Lewis-O’Connor, A., Warren, A., Lee, J., Levy-Carrick, N., Grossman, S., Chadwick, M., Stokes, H., & Rittenberg, E., (2019), The state of the science on trauma inquiry. The authors highlight the adverse impact of patients’ trauma and the significant role that healthcare providers play in addressing it – although they say that current inquiries about trauma are is limited. They identify principles of trauma-informed care as an important framework for effective intervention, with a focus on resilience. The authors propose best practices, including “tiered screening starting with broad trauma inquiry, proceeding to risk and safety assessment as indicated, and ending with connection to interventions.” The article is aimed at clinicians, but some of the lessons can benefit chaplains and chaplain educators. The description of the three levels of trauma (individual, interpersonal, and collective) is a reminder that trauma is pervasive and requires an interdisciplinary and multi-pronged approach. This article provides a good introduction to the concept of trauma-informed care and might be a good tool for chaplaincy training and CPE programs
Jobe, J., Gillespie, G., Schwytzer, D., (2021), A national survey of secondary traumatic stress and work productivity of emergency nurses following traumatic patient care. This research study investigates the correlation between secondary traumatic stress and productivity level of nurses in a dynamic emergency department that cares for trauma patients. Secondary traumatic stress has been described as a “normal reaction to abnormal event” (Figley, 1995). The findings suggest a positive correlation between secondary traumatic stress and lower work productivity for nurses who work in trauma patient care. The study confirms what was already common knowledge among healthcare workers, including administrators and chaplains. The authors propose several remedies, including stress reduction and management techniques, self-initiated social support, and self-care programs. This study has similar implications for chaplains who work alongside nurses in trauma patient care settings.
Gomez, S., White, B., Browning, J., & DeLisser, H., (2020), Medical students’ experience in a trauma chaplain shadowing program: A mixed method analysis. This article studies medical students who shadow chaplains working in trauma situations. The program attempts to reclaim the holistic dimension of medical education by incorporating pedagogic element of spiritual care into the curriculum (Puchalski, Blatt, Kogan, et al., 2014). The study aims to enhance the knowledge and awareness of “(i) the role of chaplains/pastoral care in patient care; (ii) strategies for engaging patients and/or families in difficult situations; and (iii) approaches for discussing issues of spirituality with patients and families.” The data, collected from 148 medical students over six years at the Perelman School of Medicine at the University of Pennsylvania, indicates that shadowing a trauma chaplain has significant benefit for medical students. This knowledge will benefit educators and/or chaplaincy programs within academic medical centers, or centers with medical residency programs.
Ashana, D., Lewis, C., & Hart, J., (2020), Dealing with “difficult” patients and families: Making a case for trauma-informed care in the intensive care unit. This article establishes that trauma often disproportionately affects low-income minority populations, who develop ways for coping with all kinds of trauma. When these learned adaptive behaviors manifest in the healthcare environment, families or patients are sometimes labelled as “difficult” by healthcare staff. This inevitably results in re-traumatization and medical trauma. The authors argue that trauma-informed care can minimize re-traumatization by seeking to recognize and understand these adaptive mechanisms in the acute care settings. This is a helpful tool for chaplains, who are often uniquely positioned to intervene in these situations to advocate for patients and families and invite dialogue to uncover prior experience of trauma.
Austine Duru, BCC, is vice president of mission with Bon Secours Mercy Health in Ohio.
