Trauma Informed Care: Advocating for Children in Medical Spaces
Medical experiences can be scary, upsetting, and even traumatic for children. If their diagnosis requires them to return to the same spaces or places, and receive uncomfortable or painful treatments, that repeated trauma can build over time. The way children are treated by medical staff can make a big difference in how they feel—and how they heal.
Being trauma informed means understanding that some children (and adults) may have experienced something scary or painful in the past that can affect how they engage with the world in the present. Trauma Informed Care in medical settings focuses on making sure that every step of a child's healthcare experience is gentle, respectful, and mindful of their emotional needs.
The resources shared in this guide can help you understand what Trauma Informed Care is, why it matters, and how you as a parent can help your child feel safe and supported in medical settings.
What is Trauma Informed Care
Trauma Informed Care is a mindset that shifts the focus from “What’s wrong with you?” to “What happened to you?” Being trauma informed means recognizing that life experiences play a critical role in shaping how a person functions down to their core.
Understanding the impact of trauma. We are born with only half of our brain intact while the other half is developed over time and shaped by our experiences, including trauma.
Recognizing meaning behind behavior. Behaviors are clues that can help us understand a person’s trauma and emotional safety needs.
Responding in a trauma informed way. Trauma informed caregivers are equipped with tools that can help them connect to their patients without using shame, blame and/or punishment.
Why does this matter? Most people have experienced a form of trauma in their lives. Trauma memories are stored in the central nervous system which means that our body remembers what we experienced when we didn’t feel safe.
Not an excuse, but an understanding. Trauma experiences are NOT an excuse for bad behavior, but they can help us understand a person’s reactions and position us to help them feel safe and understood.
Advocating for Trauma Informed Care in Medical Spaces
When you schedule your child’s appointment or procedure, ask if you can speak to a nurse and explain any trauma-related needs in advance of the visit. You can be specific if you know what your child needs, or you can ask them what they recommend as medical professionals who work with children. Some possible requests or conversation topics could include.
Asking for assistance from a child life specialist to help your child before or during an appointment or procedure.
Requesting a calm and quiet room away from where other children may be yelling or crying.
Asking the care team to speak slowly and include the child in their explanation of what is going to happen.
Telling the team about things that scare your child including loud noises or being touched without warning.
Asking to bring someone with you to help you talk to the doctor and ask questions.
Requesting time to talk after the appointment or for a follow-up phone call if you or your child will need time to process information or quickly move on from an experience.
Limiting Trauma In Medical Spaces
We may not be able to entirely eliminate trauma for children undergoing medical treatment, but we can help limit the negative experiences by using the three P’s—predict, practice and plan b.
Let’s say there is an important medical appointment coming up.
Take some time with your child and try to predict what you think will happen. Imagine the drive, where you will park, and the smells, sights and sounds you will encounter. Imagine walking into the building, the elevator, the waiting room, and the exam room. Talk about what might happen in that room, and any uncomfortable exams or procedures that they may experience while they are there. Help your child prepare questions that they want their doctor or nurse to answer.
Next, practice asking those questions and/or telling the medical team what they need. Would you like them to demonstrate a procedure on your doll or stuffed animal? Would you like them to tell you about each tool they will be using or which parts of your body they will need to touch? Practice those questions and requests in advance.
Finally, have a plan b for if things get too challenging or don’t go the way you expect them. Will you ask for a moment alone to process or to take a walk around the block before you continue on to the next steps of the day? It is important to give the brain another option when the things we predict and practice don’t happen. If we don’t, our brain may find a plan b for us, and it may not be a desirable one.
Resources for Medical Parents
These resources may be helpful in limiting trauma experiences or supporting children who have experienced medical trauma.
The National Child Traumatic Stress Network has a library of tools and resources to help support individuals who have experienced trauma, including this guide with tips to help a child cope after a hospital stay.
Social stories are used to help prepare a child for a new experience. While they are most commonly used to support individuals on the autism spectrum, many children benefit from the support that a social narrative can provide. Boston Medical Center has a library of social stories for common medical procedures that you may find helpful as you prepare your child for an appointment.
The impact of medical trauma can be reduced if your family feels supported during their healthcare journey. Ronald McDonald House Charities (RMHC) are committed to serving families through essential services that remove barriers, strengthen families, and promote healing. Find your local RMHC Chapter to learn more about their programs and support services.
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Contributed by: Sarah Curry, Certified Trauma and Resilience Trainer/Specialist. Sarah has worked with critically ill children and their families since 2003 and Ronald McDonald House Charities since 2011. Her degree in communications and work with public speaking amplify her ability to create content and train others about the tough subject of trauma in critically ill children. Sarah’s work with RMHC Chapters around the world earned Cincinnati’s Ronald McDonald House the 2024 Serve More Families, Better: Core Program RMHC Global Impact Award.