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#medicaltrauma is pervasive. Yesterday, I had a few tiny cysts injected with lidocaine & cauterized from my lower eyelid - a quick, minimally invasive procedure. As I was put into a 30° supine position, the medical assistant was holding my head.

The PA started to bring the needle v close to my eyeball, my heart began to race and something on me snapped. I mentally left the room, dissociating to previous states of having no control over my body in medical settings. My brain went back to being prepped for surgery in 2019.

Suddenly, I was laying on my belly, on the cold metal OR table. The anesthesiologist was setting up my epidural and sciatic nerve block for regional anesthesia. It was very uncomfortable. Partially sedated, I remember mumbling and asking them repeatedly to stop.

Someone held my legs down and restrained me so that they could finish threading the catheter into my nerve. My sedation was too light, and I eventually was put back under. Yesterday, without warning, I mentally left my dermatology office during the most minor procedure.

Instead, my brain took me back to this 67 degree orthopedic OR for a few seconds, that felt much longer. I was brought back to the real world when I was asked if I was okay because I was shaking too much to have the lidocaine safely injected so close to my eye.

I could tell that the PA was starting to get annoyed with me, and thought I was being oversensitive and overdramatic. And while I was, my hyperactive nervous system was also just responding the way it's been conditioned to over the last 9 years of my life.

Bad healthcare experiences summate, and eventually, individual horror stories of #medicalracism, #medicalabuse, having rapid response codes called, being restrained, having your dignity violated, being invalidated, and being gaslit collectively incite a trauma response.

Medical trauma is so common amongst disabled and/or chronically ill folks, and yet, I'm not sure if it's even taught in nursing, medical, PA and other health profession schools.

How can healthcare professionals apply a trauma informed lens to prevent further medical trauma?

How do providers care for patients without reactivating previous traumas? How do you bring a patient back to reality?

Some of the following are evidence based, but all are experience informed. This is how I wish was treated and practices that (would) have helped me:

1. Ask. Ask whenever possible. "Can I start X procedure?" or "Are you okay with me lifting up your shirt?" I can't explain how many times this basic practice of consent has been ignored. It doesn't make you sound unconfident.

2. Inform. Tell a patient what you're going to do, step by step (unless they explicitly ask you not to). The fear of not knowing what comes next is often larger than the actual fear of what's going to happen. I'm jumpy and especially appreciate knowing what is going where next.

3. Give choices whenever possible. Not having any sense of control always makes things tenfold scarier. I have no problems giving shots to myself because I'm in control, but as soon as someone I don't know has to do the same, I panic.

Questions to ask: "Do you have a preference on a side/which side we start with?" (When drawing blood, BP, etc)

"Tell me whenever you're ready." (Someone asked me this before a lymph node biopsy and it was so helpful)

"Would you like to do this yourself?" (tape removal, etc)

4. Validate. Telling someone that you hear their concerns/that you believe them/that you know this is scary are powerful tools. Young women with chronic illnesses are often gaslit. On multiple occasions, I've put off seeking care in fear of not being believed/taken seriously.

5. Perspective check. Even if you just came back from performing a lumbar puncture, and your current patient is stressing about a blood draw, your perspective of objective invasiveness doesn't matter. You have no idea what this person's history is with medical experiences.

After I was hospitalized for sepsis in 2014, a simple blood draw triggered panic in me for months from the amount of blown and collapsed veins I had experienced within the one week stay. If you didn't know this, you would have thought I was being an extreme weakling and wimp.

6. Honesty. I've always appreciated when someone said "this will hurt" as opposed to "it will be a bit uncomfortable" or "little pinch" and then it hurts like hell.

7. Humble yourself. Regardless of how much experience you've had, how hard you've worked, or how many patients you've seen - you most likely won't ever know what your current patient is going through or has been through.

You can consider yourself an expert on a disease, but if you haven't lived through it, you will never fully understand. You can perform 1,000,000 open heart surgeries and still not understand what it's like to have your chest cut open in two unless you've experienced it yourself.

Now that I've completely overshared, thank you for reading this if you got this far. Medical trauma is real, but it can also be prevented and approached thoughtfully, compassionately, and empathically. #MedTwitter #nursing #PatientCare #traumainformed #neisvoid #chronicillness