03 Nov

Healthcare providers want to do good for our patients. However, the nature of our work and our field does mean that at times, our patients may be hurt from our actions -- either actions made to help the patient heal (such as when we give certain medications, or insert a urinary catheter); or actions made unintentionally, such as when we inadvertantly deliver a look or make a comment that the patient or client might find offensive.

The term "Iatrogenic" means "something that was generated from a medical/healthcare encounter".  For example, an infection that one might pick up from contaminated equipment while admitted in a hospital can be called an iatrogenic infection. We can therefore call any emotional or psychological trauma that we might inflict on patients,  "Iatrogenic Trauma" (Cheng 2016).  The goal, then, of having a trauma-informed organization is really to reduce iatrogenic trauma --either that which  might occur to patients/clients; or that occuring to healthcare workers due to interactions with co-workers, patients/clients, family, administrators, managers, the healthcare system or government regulations.

Understanding the neurobiology behind trauma can help us develop a framework for reducing iatrogenic trauma.  Such frameworks will differ from the commonly taught "Principals of Trauma Informed Practice" in some key points (see the blog concerning "choice") when applied to healthcare, because in healthcare,  patients are often not safe from potential serious physical harm.  The Triple S Goals, however,  is a framework that keeps both the neurobiology of trauma and the circumstances of healthcare in mind. Read more about how to apply it in "The Handbook of Trauma Informed Practice Essentials -- a Study Guide" (In Print, due out in 2020).

Erika Cheng, MD CCFP FCFP