We Didn’t Make You Better: Orthopedic Injury and Emotional Healing

Learning that healing your body shouldn’t be all the time enough.

For much of my profession as an ICU trauma nurse and orthopedic trauma nurse, I even have focused on gaining knowledge of pathophysiology and improving the assessment skills and procedures needed to take care of trauma survivors. After ten years of practice, I felt I had entered the “expert” phase of clinical competence described by Dr. Patricia Benner IN ALL in 1982.

But I used to be completely unaware of the massive hole in my practice. A trauma survivor noticed this gap during a routine clinic visit. Mrs. H. stayed six months after breaking her ankle, which she suffered one morning in a automobile accident on her option to work. On examination, she was found to have regained full strength and range of motion, on X-rays the fracture had healed and the pain was limited to a minor ache after prolonged activity. She healed perfectly.

I told her that she was doing great in her recovery and was in a position to resume her life, including going to work. I concluded that Mrs. H’s response to this statement modified my entire perspective on patient care. “I can’t go back to work,” she said. “Since the accident, I haven’t been able to get into a car without having panic attacks.”

I used to be shocked to appreciate that I used to be unaware of what he was going through and immediately responded, “I’m so sorry. After all, we have not made you higher.

Treating the entire person.

Let my experience be a reminder of the necessity to treat the entire person, including their emotional and psychological needs. I focused solely on her ankle and neglected the remaining. Before this case was pursued, she spent six months experiencing the disturbing psychological effects of a automobile accident. From that time on, I incorporated emotional assessment into my clinical interactions. I imagine this has made me a more complete clinician. My interaction with Ms. H also led me to pursue a research program to explore the symptom experiences of trauma survivors. I owe her a deep debt.

Information for nurses on recognizing and treating emotional trauma.

Jeremy Bishop/Unsplash

For individuals who have experienced trauma, it is vital to keep in mind that although their bodies have suffered physical damage, their psyche has also experienced trauma and can have injuries that aren’t visible on a physical examination. Anxiety, depression, pain, sleep disturbances, and stress-related disorders are common amongst trauma survivors and negatively impact their long-term outcomes. Nurses across the continuum of care, from the emergency department to the outpatient clinic, are in a chief position to discover and address these invisible injuries in trauma survivors.

In this CE article “Pain and mental health symptoms after orthopedic injury”, we discuss the presentation and consequences of post-traumatic symptoms, common screening tools used to discover such symptoms, and pharmacological and non-pharmacological treatment methods.

We hope that our article will prepare and empower you to evaluate and address these symptoms in specific patient populations in order that nursing care can proceed to play a number one role in treating the entire person.

Stephen Breazeale is a postdoctoral fellow on the University of Pittsburgh in Pittsburgh, Pennsylvania.