{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"Episode 426: Tools to Support Patients and Nurses Through Medical Trauma in Oncology","description":" \u201cWhen people with PTSD [post-traumatic stress disorder] get quite avoidant\u2014and that can be expressed in so many different ways\u2014the implications can be really profound. I think an important invitation to oncologists and oncology nurses and primary care providers who care for people battling cancer is let\u2019s explore what's underneath these avoidant behaviors. Is it a very practical thing? Or is it that underneath this avoidant behavior is really profound fear?\u201d James C. Jackson, PsyD, research professor at Vanderbilt University Medical Center in Nashville, TN, told Lenise Taylor, MN, RN, AOCNS\u00ae, TCTCN\u2122, oncology clinical specialist at ONS, during a conversation about addressing medical trauma in oncology. Music Credit: \u201cFireflies and Stardust\u201d by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by July 31, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center\u2019s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to medical trauma in oncology care. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast\u2122 episodes: Episode 421: Medical Trauma in Oncology Episode 287: Tools, Techniques, and Real-World Examples for Difficult Conversations in Cancer Care Episode 264: Stop the Stressors and Improve Your Mental Health as a Nurse ONS Voice articles: Help Caregivers Control the Chronic Stress of Cancer Care and Manage PTSD [post-traumatic stress disorder] Past Trauma Lowers Hope, QOL, and Coping Ability During Cancer Managing Cancer-Related PTSD Starts With Acknowledgement Moral Injury and Trauma in Nursing Trauma-Informed Care Provides Person-Centered Support for Patients During Deep Distress Clinical Journal of Oncology Nursing articles: How Can a Trauma-Informed Care Approach Be Applied to Patients With Gynecologic Cancer? Psychosocial Barriers to Care: Recognizing and Responding Through a Trauma-Informed Care Approach Oncology Nursing Forum articles: Post-Traumatic Distress and Symptom Experience in Patients With Head and Neck Cancer\u2013Related Tracheostomy and Family Caregivers The Effect of Neuroticism, Fear of Progression, and Self-Efficacy on Post-Traumatic Growth in Patients With Lung Cancer Undergoing Chemotherapy The Relationship Between Colorectal Cancer Survivors\u2019 Positive Psychology, Symptom Characteristics, and Prior Trauma During Acute Cancer Survivorship ONS course: Psychosocial Dimensions of Cancer Care\u2122 ONS Huddle Card: Coping Screening tools Clinician-Administered PTSD Scale for DSM-5 [Diagnostic and Statistical Manual of Mental Disorders, 5th edition] (CAPS-5) Hospital Anxiety and Depression Scale Primary Care PTSD Screen for DSM-5 PTSD Checklist for DSM-5 Trauma Screening Questionnaire International Society for Traumatic Stress Studies: Free Resources PESI Reclaiming Your Life From Medical Trauma by James C. Jackson To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode \u201cFor many people who have been traumatized, if they can avoid it, they will. They may not avoid the annual evaluation that is so hugely consequential\u2014they might not avoid that. But they may well avoid a routine visit for a checkup to their oncologist. They very well may avoid a visit with a psychologist who is wanting them to talk about hard things. They may avoid visiting a friend in the hospital because it reminds them of really upsetting things. So, this issue of adherence and compliance is a really big problem.\u201d TS 3:19 \u201cScreening tools for things like PTSD can be very useful. They\u2019re quite practical, and they\u2019re appropriate to use. I really like something called the Post-Traumatic Stress Disorder Checklist. ... Using it is going to be very straightforward. You\u2019re going to want to map it onto a 30-day window, and you\u2019re going to employ it with patients. It\u2019s a 20-item self-report. It assesses 20 DSM-5 symptoms of PTSD. It\u2019s not diagnostic, but if people score in this range of 30, 31, 33, we typically are going to believe that that is very suggestive of significant PTSD.\u201d TS 9:17 \u201cOne of the things we should be doing all the time is modeling and attempting to normalize this idea of being open about mental health difficulties. When I say modeling, this is a complicated issue. ... I\u2019m very open talking about my own battles with mental health. And in some ways, that invites my patients to do the same. I don\u2019t recommend necessarily that a nurse says, \u2018Oh, by the way, I have PTSD. I\u2019m going to tell you about mine. I want you to tell me about yours.\u2019 That\u2019s a boundary issue. But I think it does behoove us as clinicians to create a culture as much as we\u2019re able, where we can talk about mental health difficulties in a matter-of-fact way, acknowledging that mental health is health. These tools, to me, go a long way in that direction.\u201d TS 13:41 \u201cThe survivorship process is ongoing. I think a nurse can assist a patient in so many ways longitudinally over time. ... One of those ways is to continue checking on mental health outcomes in patients. Continuing to check on mental health outcomes, continuing to explore them, and continuing to invite patients to talk about things that other people might not be asking about. It\u2019s easy for family members to assume, \u2018Hey, you know, you\u2019re cancer free now. You look fine, so you must be fine.\u2019 It\u2019s very possible that the patients we\u2019re talking about are not fine. They\u2019re far from fine. For that oncology nurse at a follow-up clinic or in an oncology setting to talk about this, continuing to affirm that it would be okay for patients to struggle, continuing to put this issue on a front burner\u2014I think that\u2019s really important.\u201d TS 21:17 \u201cI\u2019m aware of nurse-led support groups where nurses can talk very freely about their own challenges, in a safe space. ... Working to build cultures in the context of the intensive care unit, let\u2019s say, where we have a lot of patients with cancer that prioritize well-being nurse driven programs. ...  The bottom line is if there is a warning light that is blinking, nurses need to attend to that. And in attending to it, they\u2019re going to be more present for their patient. They\u2019re going to be better able to support their patient. They\u2019re going to be better able to support each other. And I think often, in the culture of nursing and psychology, too, people just put their head down, their shoulder down, and they just plow through in ways that are really counter to their mental health.\u201d TS 29:56 \u201cThe truth is medical trauma can be well-managed. It\u2019s not simple. It\u2019s not always intuitive. There are all sorts of caveats with regard to this, but the truth is people with medical trauma can live really rich and meaningful lives. ... So, the default setting, I think, should be not one of pessimism. It should be that people with medical trauma can and do get better. If you are a patient with medical trauma and you are in my purview, until proven differently, I\u2019m going to assume that you can get better too.\u201d TS 36:28 ","author_name":"The ONS Podcast","author_url":"http:\/\/onsvoice.libsyn.com\/website","html":"