In Tonier Cain’s speech, she highlights several different problems that she encountered throughout her life. Examples of three topics listed in ”Browse objectives” (n.d.) include women, children, and drug and alcohol use. As a woman, Tonier Cain has undergone extensive gender-specific abuse, having been raped numerous times, gotten pregnant, and had children who were taken away from her. She also was not well-treated as a child, with an absentee mother who did not take care of the family and forced the role of caretaker on the young Tonier. She could not attend school properly and was ostracized by the community as a result of her general unkemptness before being sent to a foster home. Lastly, she is an admitted former heavy drug user, calling herself a “crackhead” when recalling her time in the streets.
Florida has several laws and policies that are designed to address the issues related to those three topics, though there is substantial room for improvement. Of note is the state’s Women, Infants, and Children program, which provides healthy food, education, breastfeeding support, and informational assistance to its recipients at no cost (“Women, Infants, and Children (WIC),” 2021). The program helps address some of the issues that Tonier Cain has encountered, but not all of them. Several smaller initiatives are aimed at helping children with neglectful or abusive parents as well as drug users. With that said, those tasks are in large part left to other agencies, such as Child Protective Services. They manage public health issues through a variety of measures that take place on the local level and are performed by different organizations.
The Role of the Community Health Nurse
As a woman, Tonier has undergone extensive abuse by both people in the community and the people who were supposed to provide her with healthcare. She kept going from one environment to the other without learning how she may escape the cycle. The role of the community health nurse would be to provide her with education on the options she can take to recover in a safe and encouraging environment. They would also need to review the services currently provided, possibly based on Tonier’s and similar victims’ experiences, and highlight the deficiencies that needed to be corrected. They would also provide similar services concerning drug abuse and direct Tonier to facilities that offered rehabilitation. They would also track and monitor her progress over time, identifying the specific issues she had and working to find a better-tailored solution over time.
Concerning Tonier’s condition as a child, the intervention would correspondingly take place at a different time. The community health nurse would regularly visit different households, including Tonier’s, and monitor them for issues. They would identify any children who were sick at the time and provide them with treatment. They would also educate the children and their caretakers about addressing various problems that they were likely to encounter in their daily lives. In Tonier’s case, the nurse would presumably find the mother absent much of the time in a classic case of child neglect. As such, they would develop a therapeutic relationship with the parent to persuade her to care for her family. By working with her to identify her issues, they would help her mature and become a more responsible adult that would give her children the attention they needed.
Community Health Nurse Role
If the author were a community health nurse who encountered Tonier Cain’s family back when she was young, they would first conduct a thorough assessment of the situation. They would most likely find a case of child neglect, with many of the children suffering from malnutrition and a variety of other conditions. They would likely find the living conditions of the family to be inadequate in terms of both the available accommodation and the resources they had. Lastly, they would likely find that the mother had not emotionally matured enough to act as a dependable provider for the family. All of these matters would be highly problematic and would deserve immediate attention.
The author’s first recommendation would be to refer the children to appropriate healthcare services that would fully assess and treat them. Secondly, they would begin work with the mother, as outlined above, to address issues such as emotional or psychological deprivation that prevented her from extending proper care to her children. With that said, both of these interventions are subject to limitations, especially in a large family with nine children. From Tonier’s description, it appears unlikely that the broader community could be depended on for help, either. As such, as a last resort, the author would consider referring at least some of the children to foster care to relieve the burden on the family.
Guiding Principles for Trauma-Informed Care
Trauma-informed care has to take the patient’s prior history and the effects that it has had on them into account to provide treatment that helps them overcome the damage instead of exacerbating it. To that end, per “Infographic: 6 guiding principles to a trauma-informed approach” (2020), the CDC outline six guiding principles: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment voice and choice, and cultural, historical, and gender issues. All six of these factors have to be taken into consideration when caring for a patient. Through awareness and implementation of them, organizations can improve their care frameworks while individual workers become better at providing help.
The six principles are particularly vital for community health nurses because they are likely to encounter traumatized patients regularly throughout their work. Moreover, they will be doing so in a community setting, where they will not necessarily have access to a detailed medical history, even if one exists. As such, it is their task to assess the patient and help them without intensifying their trauma while starting from a position of unfamiliarity. To do so, they need to work sensitively yet effectively, earning the person’s trust and slowly encouraging them to open up. The six principles are crucial in this task and should be followed carefully for the intervention to succeed.
Community health nurses are mandated reporters by the nature of their profession, which places an additional set of responsibilities on them. Per Delong-Hamiltion and Krase (2020), in most states, when a mandated reporter has a reasonable suspicion that maltreatment is occurring or about to occur, they are obligated by law to contact the corresponding agencies immediately. Certainty is not necessary, and it is enough to infer that there is a high likelihood of the behavior taking place from one’s education and experience.
If a CHN-mandated reporter were to encounter Tonier Cain during her childhood, they would have been obligated to contact child protective services, which happened regardless. Instead, upon encountering her later on in her life and seeing the abuse she went through while in police custody, they may have had a positive effect on her life by reporting the misconduct to the authorities. The mistreatment she went through was serious enough to cause a substantial investigation of the conditions within the local police force and drive reform.
The Story’s Impact
The most significant part of Tonier’s story for a CHN is her description of how everyone would dismiss her as a hopeless drug addict. The author has learned not to dismiss anybody as beyond help, regardless of how troubled they are. This means a commitment to actively involving oneself in situations where they find issues. Children who are not properly cared for need immediate intervention, whether in terms of working with them and the parents to reform the family or through the involvement of child protective services.
Similarly, victims of sex trafficking cannot go back to their circumstances lest they become part of the same vicious cycle that Tonier Cain was in. The role of the CHN is to provide them with adequate resources and accommodations to escape the life that forced them into their current predicament. The same consideration applies to drug addicts, as addiction is often a product of social circumstances as much or more than the overuse of a particular drug. Rehabilitation services need to be made available, and the patient should be repeatedly encouraged to take advantage of them and use them as the first step toward returning to society.
Browse objectives. (n.d.). Healthy People. Web.
Delong-Hamilton, T., & Krase, K. (2020). Child welfare: Preparing social workers for practice in the field. Taylor & Francis.
Infographic: 6 guiding principles to a trauma-informed approach. (2020, September 17). Centers for Disease Control and Prevention. Web.
Women, Infants, and Children (WIC). (2021). Florida Health. Web.