b'| AWARENESS GUIDEferent ways. In the healthcare setting, the lack of control, assessments, and procedures can be triggering to victims or survivors. Being told what they can and cant do, not being able to eat or leave, and having people touch and look at their bodies are all ways that health-care workers can trigger the trauma response in victims without realizing it. Because of this it is imperative to try to build trust early on, to ask for permission before touching, to main-tain privacy, and to offer choices.Although it may be difficult to fathom, Estes says that when someone has made it clear that they would like to leave, the best alternative to helping them in the moment is to let them know that they can come back for help at any time.Anything that you can say or do, no mat-ter how small it may seemsomething as simple as offering them a glass of juice or wateris going to be monumental for them, she said. Youre planting a seed. If you show them kindness and support, theyre going to remember that and theyre of trying to help individuals without scaringdefined as one in which hostages develop agoing to come back to you if theyre in peril them into thinking that they will be caughtpsychological alliance with their captorsagain, and look for you, because you made with informing providers about their situa- during captivity as an emotional coping mech- them feel comfort in that moment.tions and therefore being subjected to moreanism, may also impact patients to the pointRegardless of the particular circum-abuse. All persons on staff should receivethat they refuse assistance from a healthcarestances, its most likely true that any front-this type of training in order to best care forprovider despite acknowledging that they areline provider whos involved with a human your patients, said Madison. Engaging withinvolved in an illegal ring. Some people willtrafficking patient is not going to get much local law enforcement to make sure that theynot want help, Estes said. Theyll just wantresolution. That may be difficult to process will provide appropriate services if neededto be treated and released. Stockholm syn- mentally, but Estes says a reasonable mind-when they are called to investigate a poten- drome requires intervention with someoneset is necessary for the provider. She sug-tial sex trafficking victim is also important.who has specific training so that the patientgests attempting to see all encounters as Another important tactic, Estes said, is ensur- can get to safety as quickly as possible.any hospital visit and acknowledge that the ing that any contact information that patientsCandace Miller, BSN, RN, a nurse with theoutcomes arent always known on the front receive for future contact is nondescript. AOhio State Wexner Medical Center wholines. social workers card should only state the per- launched the nonprofit organization LocalIts like anything you treat in triage; sons first name and phone number, she said.Outreach Volunteers, which serves the home- if someone comes in for chest pains, they And their voicemail should not provide anyless and victims of sex trafficking by pro- may end up having open-heart surgery, go identification, in case that a handler gets pos- viding direct outreach to meet immediatehome, and you never see them again, she session of the number. That handler is goingneeds, said that the experiences endured byexplained. Youre not always involved in to pat down any patient after they leave thethese patients can cause lifelong depressionproviding the follow up care. Due to HIPAA hospital, if not strip-search them. Someonethat affects their chances of accepting help orand other privacy laws, if a social worker fol-may actually have to try memorizing a phonehaving any positive relationships. They arelows up on a case and gets that person into number before they see their handler again, iftaught that they are not worthy, that no oneprotection, youll never know because by law they are going to get help.cares for them, she said. Their bodies andit cant be revealed where someone isthat mind are in a constant fight-or-flight, and itwould break the cover. You may not be able MENTAL HEALTH FOR THE PATIENT &takes a lot of work to train their mind to relax.to save everybody today, but if you set that PROVIDER They have been forced to watch themselvestone, eventually that person will be more Stockholm syndrome, a condition generallyand others be hurt and abused in many dif- likely to get help.nwww.elitecme.com |2020| AWARENESS GUIDE 19'