"There are a huge array of medical dynamics that people endure, and when they leave a lasting impact, a word that we don't use widely enough is the word 'trauma.' There's an entire category of phenomena in the medical arena that are, in fact, traumatic. One way we know that these experiences are traumatic is that we know that huge portions of people who experience things like cancer do indeed develop problems like [post-traumatic stress disorder]," James C. Jackson, PsyD, research professor at Vanderbilt University Medical Center in Nashville, TN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about understanding medical trauma in oncology.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by June 26, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report increased knowledge of medical trauma and its effects on patients with cancer, caregivers, and healthcare professionals.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
• Episode 315: Processing Grief as an Oncology Nurse
• Episode 287: Tools, Techniques, and Real-World Examples for Difficult Conversations in Cancer Care
• Episode 276: Support Young Families During a Parent's Cancer Journey
• Episode 257: Redefining the Bell: The Ethics of Hope for Oncology Nurses and Patients
• Episode 103: What Oncology Nurses Need to Know to Support Caregivers
• ONS Voice articles:
• 'Between Two Kingdoms' Gives Us a Glimpse Into How Patients and Families Experience Malignancy
• AYA Cancer Survivors Experience Five Times Higher Depression Rates Than Individuals Diagnosed at Older Ages
• From Stigma to Support: Changing the Cancer Conversation
• Help Caregivers Control the Chronic Stress of Cancer Care and Manage PTSD
• Moral Injury and Trauma in Nursing
• Trauma-Informed Care Provides Person-Centered Support for Patients During Deep Distress
• When the Story Ends, Cancer Does Not Win: Reframing Death in Terminal Cancer Care
• Word Choice Matters When Caring for Patients With Cancer
• ONS course: ONS Psychosocial Dimensions of Cancer Care™
• Clinical Journal of Oncology Nursing articles:
• Psychosocial Barriers to Care: Recognizing and Responding Through a Trauma-Informed Care Approach
• Trauma-Informed Care Addressing the Mental and Emotional Needs of Patients With Cancer
• Oncology Nursing Forum articles:
• Post-Traumatic Distress and Symptom Experience in Patients With Head and Neck Cancer–Related Tracheostomy and Family Caregivers
• The Effect of Neuroticism, Fear of Progression, and Self-Efficacy on Post-Traumatic Growth in Patients With Lung Cancer Undergoing Chemotherapy
• Reclaiming Your Life From Medical Trauma by James C. Jackson

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

"Many people have a notion about what medical trauma is, but perhaps they lack a definition. I use a definition that is deliberately broad because I think it is better to be inclusive than exclusive. A medical trauma to me is a medical experience or a medical encounter that basically leaves a mark. It leaves an emotional mark, and that mark is significant enough to disrupt your daily life." TS 2:06

"When somebody develops a life-threatening illness—let's say cancer—it's not their problem only. It's very much a family problem. It affects any manner of people. There is literature that says that family members of people with life-threatening conditions often have rates of PTSD that are every bit as high as the patients do. There's also literature that says that if we can identify this issue as a family problem—a family challenge, not just an individual challenge—then very often that patient is going to do better." TS 8:23

"We just need to make space for people to feel however they feel. And we need to emphasize, I think, that in some ways, even though there's no cancer on the scan, cancer casts a long shadow in the lives of people, which is why when patients after cancer see their primary care provider, when they come back for a checkup with oncology, we need to continue this conversation of 'How is your mental health? Are you okay? How's your anxiety? How are you managing?' … We need to be really curious and kind, and we need to query people about how they're doing, even if officially they don't have cancer." TS 16:20

"Trauma-informed care has become a bit of a buzzword in our culture. But when it is engaged correctly, I think it's really important. And I think in a nutshell, what it means is that as providers, we need to recognize that some situations and circumstances are likely to be traumatic, and we need to pivot and engage people differently now that we know that. Specific features of trauma-informed care might be we're really going to value your emotional safety. We're going to emphasize that. We are going to emphasize boundaries. We are going to ask your permission instead of telling you how to do things. We are going to be really attentive to the language we use to engage you because we're aware of there might be things about your situation that are really triggering." TS 28:15

"I think one [misconception] certainly is that it is only afflicting and affecting people who are frail or weak—not very strong. That's emphatically not true. But that's a popular misconception—that if I'm strong enough, if I'm resilient enough, this experience will not be traumatic to me. It's just not true. Medical trauma doesn't just happen in emotionally weak people. Medical trauma can impact people of all sorts." TS 33:42

"The other misconception, I think, is that there is no hope for people in the throes of medical trauma. I'm not advocating 'hopium,' It's a term that was coined, I think, during the pandemic. I don't think that living with medical trauma is all rainbows and unicorns and shiny things. But the truth is, if you get the treatment that you need, you can find a way to thrive with medical trauma even as you're impacted by medical trauma. This, this 'both-and-ness' is really true. You can both be adversely affected and you can even find some beauty in your struggle. Both can be true." TS 34:13

"I wish people understood that there is a name for this phenomenon. We're naming it here today medical trauma. Not everyone who has cancer has medical trauma—not even close—but there are many people who do. And I think many of those people, they don't quite have a name for it. And when I introduce this name for it—trauma—many of them say, 'Oh, my gosh, that makes so much sense. I didn't quite understand why I was struggling so much with this. I didn't quite understand why it casts such a long shadow in my life. I didn't really understand why I was having panic attacks every time I had to get another scan at the oncology office to see if my breast cancer had returned. Now I understand. Now I understand it's because it was trauma.'" TS 35:09