Philosophy of Trauma Nursing

Main Constructs

The philosophy of trauma nursing hinges on three main constructs, which is the importance of (a) strength, resilience, and presence; (b) moral and ethical grounding; and (c) care for the self. Nurses, characteristically, possess unwavering dedication in caring for their patients. Nurses also seem to possess intricate defense mechanisms to manage the care of patients and their families, who are often in a state of crisis. These coping abilities may be inherent and/or may have been learned from years of nursing experience. In the area of hospice nursing, Lea Barbato Gaydos found that personality features and histories of these nurses may promote attributes of coping and resiliency. These features included a history of personal loss and grief before hospice nursing, endurance and hardiness in the face of significant loss, transformation through hospice nursing, and a sense of spirituality. In addition to this strength and resilience, nurses value the importance of being humanly present, which is being physically present and completely focusing on their patients' needs. The ability to be humanly present with patients and their families and soothing them through touch is a valuable facet of trauma care, especially because touch communicates caring and concern.

This human presence in the caregiving environment is a philosophical underpinning that nurses inherently understand. Jean Watson's theory of caring emphasized this sense of care and presence toward the person. One of the core values of nursing addressed in her theory was the importance of presence and support toward the person being cared for which, in turn, fosters a deeper connection between the caregiver and the care recipient. It can be difficult at times to maintain that sense of presence because of the many stressful demands of trauma nursing. Yet, nurses, like those in other caregiving disciplines, have a sense of fulfillment in caring for the traumatized. According to the trauma scholar Charles R. Figley, when care-givers are satisfied with their ability to help others, it partly results from an understanding of where the caregivers' responsibilities end and the client's responsibilities begin. Another important philosophical underpinning for those engaged in trauma nursing is being grounded in their beliefs regarding trauma, life, and death. To have strong moral grounding and accepting others' different beliefs is part of trauma nursing. In end-of-life care, some nurses develop an acceptance of death as part of a life's journey as they care for their patients during the dying process. These nurses consider it a privilege to share the journey and are compassionate and accepting of the choices made by patients and their families. In other settings where there is intense trauma, such as responding to disasters of human origin, nurses may experience shock and focus on the senselessness of the tremendous loss of life. Yet, they are typically present and very focused for their patients, their families, and the community regardless of the circumstances.

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