For some faculty and students, interest in field stems from direct experience with loved ones or community members

When Megan Ferriera’s brother was thrown from a Humvee while serving in the military, he suffered not only a head and neck injury, but also developed post-traumatic stress disorder.

Healthcare professionals were able to treat his physical injuries, but only those closest to him understood his inner turmoil.

“From the outside, he puts on a good show,” said Ferriera, who’s finishing her second year on the MGH Institute’s Psychiatric/Mental Health Nurse Practitioner track. “He’s a baseball coach. You would never know that behind closed doors, he still has sleepless nights and suffers from night terrors.”

Ferriera’s brother made progress once he found a nurse practitioner who “took the time to understand what he needed, not just in terms of being a veteran, but based on his whole life,” according to Ferriera. That patient-provider relationship inspired Ferriera to earn her Master of Science in Nursing at the IHP, where she learns about trauma-informed care — an emerging framework for acknowledging how pre-existing trauma impacts patients’ medical experiences. 

From asking if the patient feels safe at home, to indicating where they’ll place a stethoscope on the patient’s chest, IHP Nursing Instructor Kathryn Kieran recommends healthcare professionals “put their antennas up” to patients’ history of trauma.

“Just like we put on gloves every time we touch blood or bodily fluids, we should automatically assume trauma is in the background for every patient because it's so pervasive, and so many people cope with it,” Kieran said.

Coming from the Greek word for “wound,” trauma is any event or circumstance that leaves someone with physical, emotional, or life-threatening harm, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). While media outlets like Psychology Today and the New York Times publish articles questioning whether people overuse the word “trauma,” healthcare professionals like Kieran are doubling down on the idea that trauma impacts nearly everyone.

Dr. Danielle Walker, an IHP nursing instructor who treats patients with psychotic disorders such as schizophrenia and bipolar disorder, knows first-hand how trauma impacts people’s health. Growing up in Roxbury, a Boston neighborhood where more shootings occur than in most other parts of the city, Walker has “vivid memories” of hearing gunshots throughout her childhood. When Walker’s cousin died in a shooting in 2018, the Boston native decided to pursue her PhD and conduct research on how living in a violent neighborhood impacts people with psychotic disorders.

“People who are exposed to lots of violence already tend to be more at risk for psychotic disorders just because of the hecticness of their environment,” said Walker, who focused her research on Black people from Roxbury, Brockton, and other parts of Massachusetts where gun violence exceeds the statewide average. “I became very interested in how all this violence that's happening in their everyday lives — that has been happening since they were children — how is this really impacting their symptoms?” 

Walker found that while some study participants became “desensitized” to gun violence, others displayed hypervigilance, a common trauma response and symptom of PTSD that leaves people constantly alert to potential danger.

“As healthcare providers, we’re always telling our patients, ‘Oh, just go for a walk.’ A walk is free, it doesn't take anything just to get outside, but people are legitimately scared for their lives and can't go outside,” Walker said. “People want better lives, but they just have no direction on how to get out of that neighborhood.”

Walker is one of many IHP faculty members whose interest in trauma-informed care stems from direct experience with other traumatized individuals. Kieran was a history major at Brandeis University when she began fielding calls for a domestic violence hotline. Those phone calls, infrequent but emotional, influenced her decision to consider a career in healthcare.

"The vast majority of the time, the phone doesn't ring, but when it does, and you're there for someone, it's such an honor to be with people when they're having a really tough time," said Kieran, who continues to serve domestic violence survivors. "I think that's what draws a lot of us into healthcare — we want to be with people in those tough moments and help them through it."

Psych/Mental Health NP track coordinator Dr. Susan Stevens was among the group of professors who Kieran said cultivated “such a personal program” by checking in on students’ well-being, inspiring Kieran to do the same for her patients and students.

“Susan was great at teaching us ways to ground ourselves and how to think about cases so that we could deal with how sad or angry they made us,” Kieran recalled. "If you're getting too caught up in the emotion of a patient’s story and feeling it like it was happening to you or a friend or a family member, you can't be with that person — you're now in your own head."

While working for the hotline, Kieran said it was volunteers’ responsibility to take care of their mental health and move past challenging phone calls. She wants healthcare workers to know that the burden of avoiding burnout isn’t theirs to bear alone.

"People are afraid to bother others, or afraid that they'll be seen as unreliable if they talk about mental health, or specifically about starting to feel worn down," Kieran noted. "One of the most powerful things we can tell people as healthcare leaders is that we will help you. You can talk about it."

Experiencing occupational trauma is common for nurses, who often treat patients under intense, high-stakes circumstances. Kieran says that resources like the Student Assistance Program which provides free-of-charge counseling to IHP students, can help emerging healthcare workers stay on top of their mental health.

"One of the best things you can do for PTSD is get treatment early, and it prevents a lot of the symptoms down the line," she said. "If you need to talk to someone, talk to someone now. Don’t wait. It’s the best thing you can do for yourself."

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