HJNO Mar/Apr 2024

Q&A 24 MAR / APR 2024 I  HEALTHCARE JOURNAL OF NEW ORLEANS   that negatively affects the patient, but being trauma-informed means watching for cues of that and then responding immediately if you notice that a patient's facial expres- sion or tone of voice after you've just said something … If they're activated, then how can you acknowledge what just happened in the moment and try to correct instead of just doubling down and escalating things. Poten- tially, a patient doesn't want to come back to this particular clinic or space or employee. Especially here at UMC where we see so much trauma, that really requires trauma- informed care for our staff who take on trauma all day every day just by doing their jobs. Secondary traumatic stress is definitely a risk of the job if employees are not feel- ing supported in their workspace or by the organization. So, really, it can help with staff burnout and staff turnover if an organiza- tion is trauma-informed. You can be trauma- informed at all levels, and it ideally starts at the very top and trickles all the way through- out every nook and cranny of an organiza- tion. That can be in training, too. It can be trauma-informed supervision of residents or med students, interns. Your team members are dealing with some of the most horrific events that can happen to a human. What is the current philosophy of engaging with victims of this type of violence? And how do the providers or the people working with them maintain their own mental health? In terms of the philosophy, I would say it's trauma-informed, reallymeeting the patient where they are and being attuned to the patient in themoment, whichmay seemobvi- ous, but in the hustle and bustle of healthcare, I don’t think being fully present happens a whole lot. Things are just moving so quickly. In order to be responsive to someone who's in front of you, you really have to be emotionally present; and that requires that providers take care of themselves, so they're not stressed and so their mental capacity allows them to be present for the people in front of themand allows them to be responsive to the patient's needs, whether that is emotional or physical. Of course, not every provider is equipped to provide emotional support, but they can provide a compassionate response that can either be helpful for a patient's emotional state or not. That requires, again, a kind of mindfulness, being present in the moment, to notice a slight shift in a patient's manner- isms or demeanor. But if you're moving so fast, you can really miss it and things can escalate quickly. On our team, we check in a lot with each other about our own bandwidth at any given time or day. Everything isn't just productiv- ity focused. We take the work very seriously, because we don't want to retraumatize indi- viduals. If I don't have the bandwidth to see a really heavy case that we just consulted on, I'm not just going to push through because I know that that could be more harmful than helpful for this family who just experienced the worst thing they've ever been through. Instead, I'm going to talk to a colleague and see where they are, if they could potentially see the patient. We have a lot of discussions about that. Also, some cases are harder for some peo- ple than others. Knowing that about yourself, knowing your own trauma history, knowing your own triggers or things that maybe you aren't as effective in working with — because we can't be everything to everyone —that's why we have a whole team, a very diverse team who, together, all have strengths that we bring to this work. We try to maximize that by communicating a lot about what the current case is and whomight be the best for that, creating a culture where it's okay to say, "Oh no, I don't have the bandwidth right now." That's not frowned upon. In fact, it's actually seen as a strength to admit that. What do you look for in a provider or staff member to be a good match for helping trauma victims? I think that we don't expect people to come in knowing the principles of trauma- informed care, but there's a natural, authentic humility that I have seen is common amongst the team members who really can get with trauma-informed care and integrate it into their practice. I think it's about people who are driven by a desire to help the community and really be of service to others. Of course, there are other things that motivate them to work, but that is a huge driving force. You kind of brought this up in the last ques- tion. The people I've seen who are effective with trauma survivors are people who, dare I say, have done some work on themselves and who are introspective and self-reflective and can recognize within themselves when they're not at their best. That's really where the work starts, maintaining wellness for you. If you don't have it, obviously it's a cliché, but how can you give it to others? You can for a certain extent, but it's time-limited. Having a practice in place to take care of yourself, but also having humility and recognizing that [while] you knowmore about a certain sub- ject like trauma psychology than the person you're talking to, the patients and the fami- lies, they know so much more than we ever could about themselves and their experi- ences. It’s having the humility to really lis- ten and believe and then be responsive and tailor your care to what they're saying. Humility, self-reflection, a good self-care routine … and having a therapist never hurts. Someone who is culturally responsive and truly recognizes that people who are not like themhave strengths and gifts to be celebrated as well is huge part of the trauma recovery process — helping people see their strengths and, no matter who they are, where they come from, or what they've been through, then building upon those strengths to help themmove forward. What is the patient footprint for this center, and how can you ensure that the center's services are accessible to citizens? The expansion and funding that we've gotten from the city covers free services for crime survivors inOrleans Parish. That could be someone who lives in Orleans or who was