Re-traumatising practices are ordinary hospital practices done thoughtlessly. Each moment below is something that happens on a good unit, on a busy day, done by a kind person. For each one, name the trauma-informed principle it puts at risk, then choose the repair. The aim is not to do less care — it is to do the same care with explanation, choice and predictability.
Eight ordinary moments
The bench
Choose a moment to begin. You will name the principle first, then pick the repair.
The six principles you have practised
SAMHSA frames trauma-informed care as four assumptions — the four Rs — delivered through six principles. Assume a trauma history may be present in anyone, and design care so it does not re-injure.
Realisehow widespread the impact of trauma is, and the paths to recovery
Recognisethe signs in patients, families, staff and yourself
Respondby building that knowledge into policy and practice
Resistre-traumatisation, actively and by design
Feedback
Change the questionInstead of asking, silently or aloud, “What is wrong with this person?” ask “What happened to this person?” Hypervigilance, a flat refusal of a procedure, a startle at a hand on the shoulder, explosive anger at being told to wait — all coherent once you know the body learned them somewhere.