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Trauma is a pervasive human experience, yet trauma-informed care (TIC) is a skill that is underutilized in health care organiza?tions.Traumatic events are those associated with actual or threatened risk of serious injury, death, or sexual violence that are experienced directly, indirectly (by witnessing them), or vicariously (through the experiences of a close friend or loved one).1 Such events affect people of all ages, eth?nicities, religions, vocations, socioeconomic back?grounds, sexual orientations, and gender identities throughout the world when there is war, disaster, social upheaval, family dysfunction, adverse child?hood events, or chaos.1, 2 Responses to traumatic events vary widely, as they are influenced by a person's sociocultural history, a person's interpretation of the events, the meaning a person ascribes to the events, and the associated physical and psychological effects of the events.2, 3 Although the stress that follows traumatic events affects each person differently, it often produces last?ing emotional, mental, physical, social, or spiritual upheaval, altering the person's ability to function.2

THE ENDURING EFFECTS OF TRAUMATIC STRESS Over the past 20 years, biomedical research has shown that a wide range of chronic diseases, poor mental health outcomes, early deaths, and trans?ABSTRACT: Over the past 30 years, researchers have found that childhood trauma and its subsequent stress have a strong and cumulative effect on health in adulthood.Trauma in childhood often leads to mental health problems, skeletal fractures, and early death from conditions such as heart disease, cancer, lung disease, and liver disease.

Trauma is a pervasive human experience, yet
trauma-informed care (TIC) is a skill that
is underutilized in health care organiza￾tions. Traumatic events are those associated with
actual or threatened risk of serious injury, death,
or sexual violence that are experienced directly,
indirectly (by witnessing them), or vicariously
(through the experiences of a close friend or loved
one).1
Such events affect people of all ages, eth￾nicities, religions, vocations, socioeconomic back￾grounds, sexual orientations, and gender identities
throughout the world when there is war, disaster,
social upheaval, family dysfunction, adverse child￾hood events, or chaos.1, 2
Responses to traumatic events vary widely, as they
are influenced by a person’s sociocultural history, a
person’s interpretation of the events, the meaning a
person ascribes to the events, and the associated
physical and psychological effects of the events.2, 3
Although the stress that follows traumatic events
affects each person differently, it often produces last￾ing emotional, mental, physical, social, or spiritual
upheaval, altering the person’s ability to function.2

THE ENDURING EFFECTS OF TRAUMATIC STRESS
Over the past 20 years, biomedical research has
shown that a wide range of chronic diseases, poor
mental health outcomes, early deaths, and trans￾ABSTRACT: Over the past 30 years, researchers have found that childhood trauma and its subsequent
stress have a strong and cumulative effect on health in adulthood. Trauma in childhood often leads to
mental health problems, skeletal fractures, and early death from conditions such as heart disease, cancer,
lung disease, and liver disease. Compounding the effects of traumatic stress, health care systems often
create a population of “never-served” persons who avoid health care settings because they’ve been
subject to judgment and marginalization. Trauma-informed care (TIC) is a skill underutilized by health
care providers and organizations, yet nurse ethics and respect for human rights require us to care for all
patients equally without judgment, including those living with the stress of complex trauma. The TIC
approach respects human rights and supports nursing ethics, promoting a welcoming, inclusive envi￾ronment in health care systems and patient–provider relationships that eschews implicit and explicit
bias toward patients, regardless of presentation or personal circumstances. TIC foundational principles
guide the application of the nursing process using patient-centered care to create safety, the first princi￾ple in TIC. Here, the authors discuss the application of these core principles in nursing through a deiden￾tified case study.
Keywords: nursing care, patient-centered care, trauma, trauma-informed care
How to achieve optimal health outcomes in trauma survivors through
person-centered care.