What Nurses Should Know About Racial Trauma and Its Impact on Patients

Racial trauma often is an under-recognized threat to patients’ health and well-being.

Jamila Holcomb, PhD, LMFT, a faculty member at Florida State University and a Relias contributor, explains what nurses need to know about racial trauma in this interview.

Holcomb teaches courses on parenting, adolescent development, and public policy related to children and families. She also is a licensed marriage and family therapist specializing in individual, family, and trauma counseling.

Q: What is racial trauma and trauma-informed care?

A: Racial trauma is the physical, emotional, and psychological pain associated with experiencing or witnessing racism. The act of witnessing is key. Pain can come from watching someone being victimized as a result of racism. Trauma-informed care describes care guided by the evidence surrounding racial trauma.

Q: What’s an example of racial trauma?

A: Repeatedly hearing media reports on the death of George Floyd can be experienced as a vicarious kind of trauma. The symptoms are similar to post-traumatic stress disorder. People may have increased heart rate, nightmares, and may feel on edge. Nurses might see their patients experiencing more depression symptoms, distrust, or feelings of being unsafe. It can make us more distracted, easily irritable, and disrupt our sleep.

With racism, because it happens so frequently, racial trauma can pile on and create more long-term mental health concerns and long-term physical concerns such as cardiovascular disease and hypertension.

Q: Whom does it affect?

A: Racial trauma can affect all people of color. It can affect white individuals. If you are the victim or you watch someone who looks like you be victimized, that’s going to impact you differently than if you are white. A white person might feel guilt or shame as a result of someone from their community enacting harm on someone else.

Q: How does it affect treatment or outcomes?

A: Because of racism and discrimination, we know that providers will often give less quality care to people of color. Research says Black individuals are less likely to receive medical treatment when they’re in need. They are also less likely to receive pain medication or are given less pain medication based on biases. These are implicit biases that are going to impact the nursing profession and quality of care. Also, nurses who are not aware of racial trauma might minimize or dismiss a patients’ symptoms as not real or as being exaggerated.

We do see racism linked to outcomes in terms of high death rates. For instance, Black moms are dying at a higher rate than any other race in the months before and after giving birth.

Q: Are there additional questions nurses should be asking?

A: On standard intake medical forms, when asking people their history, I do think it’s important to include their experiences with racism and discrimination as a way to open the door to talk about that. They can indicate any symptoms that might be happening because of racism. Then, nurses can follow up with support and treatment options. Providers feel awkward talking …read more

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