Australian community nurses’ encounters with early relational trauma: a qualitative study of lived experiences and the impact of specialist training

Abstract

Objective:We report on a qualitative study of community nurse encounters with early relational trauma in parent-infant dyads.Background: Early relational trauma involves interactional or emotional disturbance in the parentinfant dyad. Earliest possible detection is needed to mitigate negative impacts on socio-emotional development, but early relational trauma is often challenging for practitioners to detect and respond to. Study design and methods: Maternal and ChildHealth nurses in Victoria, Australia received workforce training to address this. We interviewed 20 nurses both before and after they received specialist training, to understand their lived experiences in encountering client trauma and perceived changes to their professional confidence and competence post-training. The study comprised two areas of enquiry: i) a phenomenological analysis of nurses' lived experiences in encountering possible trauma; and ii) a grounded theoretical analysis of the context of trauma encounters at baseline, and perceived change in competence at follow-up.Results: Nurses who coped well when working with trauma maintained a level of emotional distance and were able to draw on a repertoire of well-established practice skills. The specialist workforce training resulted in clear gains in nurses' confidence and capacity to identify and respond to early relational trauma.Implications: Findings highlight a need for frontline services to provide specialist training and supervision in relational trauma and to cultivate cultures of communication and support. Such programs would optimally be deployed widely, to equip professionals with enhanced knowledge and confidence to create timely change in the face of early relational trauma.

Workforce training in family therapy and systemic practices: An evaluation framework and case study

“…This work may have several implications for other training programs; for example, the value-add of consistent methods for data collection across training programs. The integration of qualitative methodologies with quantitative data collection repeated across intervals holds particular promise, as demonstrated in our recent study of nurses' experience of family-focused trauma training (Booth et al, 2022). Other training programs may draw from and build on this evaluation framework to assess training uptake patterns, trainees' prior knowledge, course satisfaction, post-training confidence and capacity, readiness, and attitudes towards adopting and using new ways of working with individuals and families.…”

‘What is it we are trying to achieve here’? Community maternal and child health nurses and clinical supervision: A qualitative descriptive study

“…Increasingly, nurses are required to identify and respond to the psychosocial vulnerabilities that impact child wellbeing, such as early trauma and family violence (Booth et al, 2022;Hooker et al, 2021).…”

“…MCH nurses work in relatively autonomous roles, often in isolation, with rural locations presenting additional challenges (Adams et al, 2021). Increasingly, nurses are required to identify and respond to the psychosocial vulnerabilities that impact child wellbeing, such as early trauma and family violence (Booth et al, 2022; Hooker et al, 2021). Among the professional development activities used by nurses, clinical supervision is considered essential for nurse support and clinical practice (ACN, 2019; Maddox et al, 2017).…”