Paper Example on Trauma as Public Health Issue

Introduction

Trauma exposure has become prevalent in societies globally. Population-based data from many nations have shown that the majority of adults will possibly encounter a traumatic event in their life. It has also been evidenced that exposure to trauma is pervasive in children and adolescents globally. A significant amount of children are exposed to trauma due to various crises such as natural disasters, conflicts, and other emergencies. The impact of trauma exposure on public health is significant for individuals and communities alike. Catastrophic occurrences such as terrorist attacks and man-made and natural disasters can be irreversible and devastating impacts on the society. The negatives impacts do not only concern the one who is injured or lost their life, there is also the destruction of property and infrastructure (Magruder et al., 2017). When traumas happen during childhood or adolescent stages, there is disruption of many elements of development in various aspects such as emotional, social and even cognitive aspect. The outcome is adverse mental health and educational complications. Trauma treatment attracts ethical and leadership challenges as examined in this paper. This paper discusses ethical and leadership challenges associated with this issue.

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Ethical Challenges

Ethics can be described as the application of moral principles that have been largely regarded as the accepted conduct. Despite there being a different interpretation of universal ethical principles because of cultural variations, a common trend is adopted across a majority of cultures. These ethical principles include justice, non-maleficence beneficence, and dignity of a person (Hardcastle 2010). In most cases, laws have provided written guides for the behavior of society and thereby setting adhered moral principles. It is, however, important to note that not all laws are ethical and the breach of outlined ethics does not consider illegal. It, therefore, means that the mitigation of an ethical breach does not always lead to legal prosecution. However, a health care professional may be disciplined by the organization they work for the breath of their ethical principles. The objective of trauma treatment is optimal management, and this necessitates a rapid decision making in addition to procedural skills (Hardcastle 2010). In most cases, the administration of these skills is done without a patient's informed consent due to the condition of the patient.

Most traumatic patients are received at the emergency centers in which case the patient rarely makes decisions concerning the services offered. There are no prior medical conditions and lacks a previous patient-health care provider relationship which makes rapport creation hard. The patient is not in familiar surroundings and in other cases not in a health care facility of their choice (Nica et al., 2017). Sometimes, the client is unable to provide their treatment history which may require the use of personal proactive devices by the nurses. This can have an adverse effect on the experience of the patient.

The severity of the injury may be too bad to appoint the care of the patient is futile which can result in disagreements with the family of the patient concerning more treatment. In some cases the ability of the patient to provide informed consent leaving the clinical team to operate on the basis of the best interest principle (Hardcastle 2010). This means that healthcare practitioners are forced to rely on proxy consent or substituted judgment. This increases the possibility of vicarious liability and in most cases, the practitioner is in an ethical dilemma.

Leadership Challenges

Trauma is one of the leading causes of deaths in hospitals alongside the long-lasting implications on the patients. This means that this public health issue cannot be understated and therefore require the necessary attention. Research has shown that the provision of correct initial treatment can help avoid deaths or serious health complications. The trauma team has the responsibility of providing this initial treatment. However, the trauma team has often cited non-technical skills as the challenges they faced in the provision of care and these include cooperation, communication, and leadership. A study completed in Norway established that leadership was the main influencer of team function (Hjortdahl et al., 2009). During the study, the participants pointed to a lack of leadership in case of a dysfunctional teamwork.

A good leader needs to have a situation awareness which means the ability to gather information, understand the information and project and anticipate possible states. It also their responsibility to make decisions without leaving any room for misunderstanding concerning the message conveyed. A team leader needs to be able to manage tasks and intervene if necessary. In the study, participants pointed out the issue of a leader has the ability to bring calmness and confidence.

The Implication for the Patient Outcomes and Safety

Provision of care for trauma patients is characterized by how it is time and resource extensive. Fragmentation of the provision of care for trauma patients is possible due to the complex nature of care needs and their families. This complex nature of care and need for multiple healthcare practitioners can result to inefficiencies, suboptimal care, effort duplication and missed injuries. There is also a lack of adequate planning, coordination, and communication which result in fragmented, uncertain reduced patient satisfaction. Additionally, this marks increased trauma patient complications (Curtis et al., 2006). There is lengthy hospital stay and increased cost limit allocation of resources and effective use of the available resources. In other cases, the patients are often satisfied by the various care professionals but point out that the general episode of care is not properly managed or coordinated. Ultimately, this adversely impacts on patient outcome and safety.

To address this issue, there has been the development of the concept of case management. Many trauma centers in the United States have implemented case management which has resulted in increased efficiency. This has introduced a trauma case manager whose responsibility is to negotiate, arrange and coordinate services in the provision of care to trauma patients resulting to improvement in the quality of care thereby improving patient outcomes and safety. Additionally, this has helped in the conservation of hospital resources.

Stakeholder Analysis

Stakeholders are the people or organizations that are of special interest in a certain program. In public health, stakeholders are categorized into three groups ("Program Performance", 2012). These include:

Stakeholders involved in program operations: These include the organization's management, staff, and funding organizations.

Stakeholders served by the program: These include patients, community members, and advocacy groups among others.

Stakeholders who evaluate the programs: These include those individuals in a position to make decisions concerning the operations and service of a program such as funding organizations, the public or taxpayers, and coalition member.

In trauma case, the primary stakeholders include:

• Trauma patients
• Trauma services
• Clinicians caring for the trauma patients
• The Ministry of Health
• Retrieval services ("Program Performance", 2012).

Leadership Style Address to the Situation

The coordination of nurses, doctors and ancillary staff for the provision of care to patient demands teamwork and leadership. This is quite necessary in emergency settings such as trauma cases where practitioners from various specialties work together to care for the trauma patient (Barach & Weinger, n.d). According to Advanced Trauma Life Supper (ATLS) specifications, the essence of leadership has been reinforced by the emphasis that for a team to function effectively, one individual in that team must assume the leadership role (Ford 2016). Leadership styles used in trauma centers are categorized into directive leadership and empowering leadership. Directive leadership is the typical military chain of command which the commanding officer gives instructions to subordinates. Such type of leadership style is utilized when the operation to be performed is simple, straightforward, and the leader is the only person with the necessary expertise (Barach & Weinger, n.d).

In this case, I will employ empowering leadership, in which there will be a delegation of responsibilities, allowing other members of the team to make decisions. My focus will be on the other dynamics of leadership such as team communication and coordination. The complexity of the task necessitates the need for members of the team to share responsibilities. This means the management of communication and information is correctively done and there is increased adaptability for the achievement of goals. As the leader, I will ensure all members understand my expectation and vision for the team through effective communication. I will ensure the team members promote diversity and inclusion so that differences between various members are accepted. The team members will be diverse to promote organization culture.

Leadership Strategy for dealing with the Challenge

Leadership has been perceived as a critical element in trauma management. As an empowering leader, I will ensure that I promote team communication and the decision-making process will be shared. This shows that I am ready to promote inputs from the team members. The team members will be able to communicate effectively and support each to realize the set goals. This will promote the quality of care for the trauma patients.

The expectations will be positive outcomes across various facts of the trauma care environment which include quality of care, trauma team satisfaction, and general improved work environment. Another outcome will be the realization of personal and team goals (Elwell & Elikofer, 2015).

Conclusion

Trauma has emerged as a public health all over the world. There is an increased occurrence of natural disasters, terrorist attacks, and man-made disasters. This means there is an increased occurrence of traumatic cases. The provision of care for trauma patients attracts ethical issues because in most cases the patient is unable to participate in informed consent. Additionally, there are leadership challenges since the provision of care requires management and coordination of different care providers. In trauma management, there are two main leadership styles and they include directive and empowering leadership style. They are utilized in different settings with the varying scope of work. The utilization of empowering leadership style promotes the participation of the trauma team in decision making and management of information. This is essential since all members feel a part of the team. Ultimately, the use of this leadership has been found to promote positive outcomes for the patients and the healthcare providers. This means that the trauma patients receive quality care and healthcare specialists are satisfied in their roles.

References

Barach, P., & Weinger, M. Trauma Team Performance. Retrieved from https://pdfs.semanticscholar.org/6462/5173e69f924b7da2a342980ffe6d770873bd.pdf

Curtis, K., Mitchell, R., McCarthy, A., Wilson, K., Van, C., & Kennedy, B. et al. (2017). Development of the major trauma case review tool. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 25(1). doi: 10.1186/s13049-017-0353-5

Elwell, S., & Elikofer, A. (2015). Defining Leadership in a Changing Time. Journal of Trauma Nursing, 22(6), 312-314. doi: 10.1097/jtn.0000000000000165

Ford, K., Menchine, M., Burner, E., Arora,...