When a healthcare professional gets a better sense of what’s going on with their patients, it can be a game-changer in their lives.
Students in the School of Nursing of the Anderson University College of Health Professions are learning to better help future patients scarred by adverse childhood experiences (ACEs), environmental and/or socioeconomic factors that negatively impact health and well-being.
Dr. Cindy Cross, along with Monica Morehead and Heidi McCaulley, recently published an article in Healthecareers.com, a website of the South Carolina Nurses Association.
In the article, Cross, Morehead, and McCaulley assert that a good health outcome for a patient depends on nurses’ ability to recognize signs related to adverse health experiences (ACEs). ACEs are described as adverse experiences that occurred before age 18 and have shown to be related to chronic physical and mental health conditions and early death in adults.
ACE training is provided within the community health and mental health components of the School of Nursing curriculum to help students gain insight into recognizing patient behaviors that may be attributed to an ACE, resulting in the need for trauma-informed care (TIC).
A 1995 study by Vincent Faletti of Kaiser Permanente and Robert Anda of the Centers for Disease Control (CDC) made a connection between patients’ negative treatment outcomes and adverse experiences in their lives.
“They actually stumbled upon these adverse experiences quite by accident,” said Morehead, who is the lead instructor for community health nursing and an Adverse Childhood Experience (ACEs) master trainer for the South Carolina Children’s Trust. “What we’ve also learned in the last 10 years is that positive childhood experiences can have the reverse effect on the adverse; That tells us that we were designed by God for positivity. And when these negative things happen to us in life, my friend I have taught this course with many times says, ‘God created everything in a perfect world and gave us two parents to raise a child, but we don’t live in a perfect world anymore.’ So even though He created it for two parents, it only takes one caring adult to make a difference in the life of a child. And anyone can be that caring adult.”
McCaulley approached Morehead about incorporating ACEs into nursing students’ experience and clinicals and she agreed to do so.
“It made such an impact on those students because we teach them to provide patient centered care. We also teach them to provide trauma informed care,” McCaulley said. “We never know what someone has been through in their past from childhood up, and so we have to meet them as nurses right at that moment, right where they are, not knowing necessarily anything from before that moment and also not knowing where’ they’re headed after that moment.”
Dr. Cross commented, “There are things going on with patients that we, as the nurse, often don’t know about that affect the outcome of the patient care. By introducing the ACEs training to recognize certain cues and pointers and to ask certain questions, the nurse can determine potential underlying circumstances. For example, they came from homes where there was an abuse of some type involved because this will always precipitate our actions.”
Dr. Cross feels that integrating ACEs training into nursing students’ coursework has been an important advancement in their curriculum.
Anderson University graduate Brittany Roberts works as a psychiatric nurse in an inpatient setting and is pursuing a graduate degree to become a psychiatric mental health nurse practitioner. She feels that her ACEs training has had huge benefits in her interactions with patients.
“The ACEs training supports a holistic approach to care for oneself and others as it considers multiple domains of childhood trauma and their far-reaching effects of toxic stress, even beginning in utero,” Roberts said. “Including this deeper view of ‘who were are’ as people through a biopsychosocial approach that is offered through ACEs training encourages utilization of person-centered and trauma-informed care approaches which leads to improved patient outcomes and reduction of stigma of mental illness.”
“At the end of the day, as a nurse, you’ve got to be empathetic to your patients because we don’t all come from the same background. We want everybody to be as well as they can be, so to be as well as they can be, we as nurses must understand where they came from,” Dr. Cross said. “We already feel accomplished through our work with the students, and we’re seeing it work. They share with us how they are using it in their daily practice as a nurse.”
Roberts continued, “Even beyond academics and the bedside, I use the ACEs training daily as I navigate life offering grace to myself and others as I have learned that we are all a complex collection of experiences. I am grateful for the nursing faculty at AU, who prioritized ACEs training in the baccalaureate nursing program, and am excited about the impact the ACEs training will have on future nursing care and in our community.”
“This is a great example of our expert nursing team finding innovative ways of providing a comprehensive means of treating patients and meeting their needs both physically, mentally, emotionally and spiritually and taking our students alongside in this process,” said Anderson University College of Health Professions Dean, Dr. Don Peace. “Our nursing faculty clearly have their fingers on the pulse of what it takes to provide a great educational experience for our students.”
“To see our work in print is like that final stamp of approval—that what we are doing is important,” Cross said.