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Scott Webb: Most of us have experienced some form of trauma in our lives. And on some level, the trauma that we've suffered has informed the rest of our lives. And joining me today to explain how Franciscan health is providing trauma informed care, meaning that those providing our care are sensitive to the traumatic events that we've suffered is Stacey Quick. She's the Franciscan Community Health Improvement Coordinator. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stacey, it's great to have you on. And we were just kind of speaking here a little bit about trauma informed care. And what is that exactly and what does that mean to folks? So let's start there. How does trauma impact a person's health?

Stacey Quick: Trauma impacts a person's health across a lifespan when early trauma happens, which is called adverse childhood experiences. And those are things as in physical abuse, emotional abused, Physical neglect, any sort of household dysfunction, whether it's mental illness, substance abuse, a parental figure treated violently. It increases a person's risk for many health disparities, such as chronic illnesses, diabetes, heart disease. There's so many different things that happen with that. And it's been proven how do ACEs affect like society as a whole? It decreases a person's life expectancy by 20 years. If they have a score, there's a scoring with that of six or higher.

Scott Webb: That's really interesting. And from the perspective of providers or Franciscan Health. And we think about trauma informed care. Is that really what it sounds like it is, which is really just being sensitive to the fact that people have suffered traumas and we need to consider them when we're providing care? Maybe you can take us through that.

Stacey Quick: Yes, there's so many different moving parts to trauma informed care. And typically what happens even in my own learning experiences, trauma, isn't just the trauma that we know of. For example, we usually think domestic violence, substance abuse. We don't really think about trauma being anything from poverty, discrimination, homelessness, like cyber bullying, these all these different components of trauma. So the first step is just understanding what is trauma, what are the different types of trauma? And it's easy to think, even in my experience.

I think trauma is something that happens to someone physically like a surgical procedure you can see the trauma on the body. You can see and measure how successful they are with healing. But the trauma that we're talking about is internal. Where it's, loss of a loved one and natural disasters, how is it changing a person's life and resetting their perspective or changing what's happening around them for them to thrive and be healthy? So that's really first is kind of what is trauma, what are the different types of trauma and expanding our kind of brain on.

It's not just the trauma that we know affects the person. What are the other things going on in a person's life or a child's life that is traumatic for them? And is it a single incident? Is it something that's chronic and kind of repeated or is it complex where there's different types of trauma going on at the same time? And those all have different health outcomes and different impacts on a person's life.

Scott Webb: Yeah, I see what you mean. And it makes me wonder when a friend or a family member, a loved one, or even, you know, providers like yourself providing care to folks. How do we listen but sort of not absorb that person's trauma? We're trying to help them, but if we absorb too much of their trauma, it might begin to sort of weigh us down and we can't help them the way we'd like to. How do we do that?

Stacey Quick: Absolutely. The term for that is vicarious trauma, where when you're listening to a person and you're kind of processing with them, In order to do that with compassion, we have to have emotion with them. That's how we open the conversation for them to share with us what I have learned and what a lot of providers have come back and said, this is how we address Vic car trauma, or take care of ourselves, or what we call self care, is how we measure our success. I know that sounds strange to like, well, what do you mean success? We're talking about how do I talk to a person.

It's, you're there for them. You're opening up. You're having that compassion, but humans we're fixers. We want to be able to be there for them and say, this is your next step. I wanna help you. I don't want you to be in pain. But our perspective is just the fact that we're being there and we're listening and we're there for them. And we're having that compassion. But the next step in our brain is the logical, well, how do I fix this? And we start to identify our success or how the person's outcome or how well we did on what happens next in their life. And that's out of our control.

So how do we kind of listen to them and not absorb it is reflecting back what they're saying, having open ended questions, like tell me more about, or talk to me about, or from your point of view, to really help them understand and get perspective of how they're feeling, but then not absorbing all of that. And then afterwards thinking I did my part, I came up, I had compassion, I helped walk them through that. I gave them a resource or I helped them identify what their next step was that they knew they were able to do or had the capacity to do. But I know that the whatever happens is out of my control and I'm gonna let that go. Does that make sense?

Scott Webb: It does. Yeah. And I was thinking, listening to you there. I was thinking sounds very much like being a parent, right. We listen, we try to provide, you know, emotional, possibly physical while we're listening, but in the end we have to allow these folks or our kids, to live their lives and do what feels right to them next. Is that right?

Stacey Quick: Yes. Absolutely. And in the beginning, we were talking about the different types of trauma we can't prevent all trauma. We can't prevent poverty, we can't prevent job loss, or we can't control the economy. I wish I could control the weather so that when we have parties our outside the weather is exactly what I want to be, but we can't control natural disasters. So along with helping a person, a child adult identify how they're feeling about it and sitting with them in that moment, we can also think about how do we build resiliency in them or capacity, so that the next time something traumatic happens, they know how to respond to it in a way that helps them move through it faster. Or helps them to understand it better so they can process their emotions in a different way.

Scott Webb: When we think about resiliency and you mentioned it there, specifically about trauma and trauma informed care. Take us through that. What does that mean? What does resiliency look like?

Stacey Quick: Yes. And there's so many different, definitions of what resiliency is, and it's easy to get intimidated by the word resilience, because it seems like it's so complex and we want our children. We want our friends and family and people that we serve to not go through the things that they're going through. Again, with the fixing mentality, we want them to understand and be able to cope with things going on when traumatic things happen. But resiliency there's different, what we call protective factors to kind of help build resiliency.

And I know all of that sounds really complex, but it's really simple because a lot of evidence has been collected over the years from the CDC and different research and different medical facilities and agents. And it comes down to this, for resiliency, there's a couple of different things that across the board, doesn't matter if it's a child, if it's an adult, if it's a community, it's these two things. Social emotional learning with identifying emotions, how to process them, how to have a healthy, nonviolent way to deal with them and problem solve.

So when they have a conflict or something comes up, how do they process emotions? What are the good coping skills that we can have? And then also community support or connectiveness, and that's simply having a person care about you to have that compassion. Like again, when you interact with them and you're sharing and you're having that moment with them where they're telling you, this is what I've been through, this is what's going on. Those two things is how we build resiliency across the board.

Scott Webb: Yeah, and I think it's so important. And you mentioned there just having that community based support, right. And of course, over the last couple of years, we've all learned to zoom and sort of embrace that. So people have been meeting online, but now people are meeting in person again, and there is so much help and support out there. Really trauma informed care, like we're talking about today and. Wondering, when you think about how to practice resiliency, if that's something you can do, put this really into practice.

Do you have an example, folks that you've worked with patients you've worked with, can you gimme an example, of a time when you really feel like you were able to help them be resilient and maybe not make the same mistakes twice, or how to overcome one of those obstacles? Can you give us like a, sort of a real world example?

Stacey Quick: Oh, absolutely. So I've done a lot of research and been in the field of eating disorders and a lot of resources are scarce. So this is one of those examples where for homelessness, for food insecurity, there are a lot of resources, but this particular case that I am aware of, it's about the person needing resources and needing that connectiveness. But not receiving it, but then receiving it. So for an example, a person had gone to the ER six or seven times across the span of two months. And it was for the same type of thing where they had some clinical issues with their eating disorder and were just, low potassium. They weren't eating.

And the people who were interacting with this person didn't have resources and didn't have the time to really delve in and support them in the way that they needed. And what had happened was there was, some training in education that was done and there was one nurse practitioner that interacted with this patient. And the only thing they did was sit down with them and provide five or 10 minutes to ask them. What's really going on? What's behind, the clinical manifestations? Okay. We know you've got this, some eating disorder, you've got some low potassium, you've got all these other things.

Tell me more about how you feel what's going on on the inside? And from that moment that provided that supportive feeling connected to someone. Most of the time, a person who's in that crisis or in that trauma, there's isolation involved. So for this case, the resiliency part of building that in a real world example was making sure that person wasn't isolated, they do have someone in their life that cares about them. That doesn't have any other motive other than just being there. Does that make sense?

Scott Webb: It does. Yeah. And I think it's such a human thing, and I think as I wrap up here with you today, Have you found,, that providing the type of care that we're discussing here today, that trauma informed care, have you found that it was more challenging? And now that we're sort of coming out the other side of COVID, do you sort of welcome now really being able to meet with people in person and really help them in person and really make those connections?

Stacey Quick: Absolutely. It has definitely been challenging where normally those positive connective people that can provide the support were now undergoing their own traumatic experience, because it was a pandemic across everybody. It didn't discriminate on whether you had a low, a score or what your resiliency ability was, but now that we're coming back to in person, I really think it has changed where service providers have to be meeting their own emotion first. And that has taught us as we're learning what it really feels like to be connected, we can give empathy instead of sympathy.

And what that entails is sympathy is being able to say, I know what sadness feels like. I know what it's like to feel pain. Empathy now comes from, I know what it's like to feel isolated and to feel stuck and to be scared and to have all of these things going on and feel like no one was there for you. When you can identify that, because we've all been through it now. We know what it's like to feel isolated and alone, and to feel helpless and scared because we didn't know what was gonna happen. And we're able to really connect with the people around us.

And now that we're back to in person, we've got all of the closeness of we're humans. We wanna be around people. We are not meant to be alone, so we can really connect with them and really sit in those emotions and process for them and just really be there for them and for ourselves. So it's good for us as providers, but it's also good for those we serve. Cause we can serve them now with a compass or like that lens of compassion and what that really means to be with someone when they're going through that crisis or that trauma.

Scott Webb: That's perfect. We've all had this collective trauma of coronavirus and COVID 19. So thinking about folks really coming together, providers looking out for themselves. Right. So that they're physically and mentally well, and then being able to provide that trauma informed care for the community members who need them, it just brought a big smile to my face. So, Stacey, this was great. Thank you so much. You stay well.

Stacey Quick: Thank you.

Scott Webb: And to learn more about trauma informed care and building resilience, visit Franciscanhealth.org. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.