Ing Says: Everyone must learn the practice of Trauma Informed Care; it is not just theory
Trauma-Informed Care Is a Practice, Not a Slogan Flagstaff Medical Center — When the Right Staff Weren’t on Shift
This is part of an ongoing series on trauma-informed care. Read [Episode 1: I Was Wedged in a Corner Clutching a Sweater], [Episode 2: They Broke the Law and Got the De-Escalation Right], and [Episode 3: “If I Were Going to Kill Myself, I Would’ve Yesterday.”] Or start with [What Is Trauma-Informed Care?]
Trauma-informed care is not just a list of good ideas for human interaction — it is a practice. A deeply difficult practice inside systems that have historically been hierarchical, compliance-driven, and centered around dominance.
I’ve documented the times Flagstaff Medical Center got it right. This time, they got it wrong.
What Happened
After discovering what I considered to be damaging distortions in my chart — inconsistencies that looked, to me, like an attempt to discredit me during a time of extreme vulnerability — I had a painful and traumatic rupture with my therapist.
That collapse landed me, once again, in the Emergency Room at FMC, asking for help.
In the ER, I shattered into pieces. Ugly crying. Panic attack. Blood pressure dangerously high. They had to stabilize me before I could even be admitted to the behavioral health unit upstairs.
I was too raw to talk about what had happened. One staff member guessed the source of my distress, but I couldn’t speak it yet.
Once admitted upstairs, I couldn’t stop eating and sleeping — both clear signs that my system needed safety and recovery before I could do any real trauma work. Which is fine. That is what recovery looks like sometimes. You eat. You sleep. You let your nervous system remember it is not currently on fire.
The Request
On the second day, I requested ten minutes with my phone.
Not to spiral. Not to do anything that would reasonably concern anyone. I wanted to send:
- Two text messages to friends — to let them know where I was and how to reach me
- Three brief emails to legal and peer support related to my ongoing disagreement with The Guidance Center and my disability claim
I even offered to let staff read the messages. I made it clear that calling would be harder for me than writing — that written communication was how I could manage this without dysregulating further.
My request was denied.
I left AMA — Against Medical Advice.
Not because I didn’t want help. Not because I was done trying. But because I needed to feel reachable and supported outside the hospital in order to begin the real work inside it. Connection is not a luxury for people like me. It is a precondition for safety.
The Painful Irony
I was beginning to be ready to talk.
That is not a small thing. That is the thing. The moment a person in crisis moves from shut down to almost ready is exactly the moment trauma-informed care has to show up — because that window is narrow, and it closes fast when you get it wrong.
But none of the clinicians or nurses I trusted were on shift that day. I didn’t feel safe. And without safety, there is no opening.
Here is what trauma-informed care could have looked like:
Staff: “Malene, we’re worried about giving you phone access because we don’t know what’s going on yet.”
Me: “I’m starting to be ready to talk, but I don’t see anyone I usually feel safe with.”
Staff: “Would you feel comfortable talking to X person? Is there something we can do so you feel safe enough to talk?”
That would have re-established trust. It would have assumed my agency instead of assuming pathology. It would have honored the need I was clearly able to articulate — out loud, calmly, with a proposed solution already attached.
Instead, the door closed. And I walked through it.
What This Means for Trauma-Informed Care
I believe FMC is making real strides. Some of their staff are rock stars at this — I have documented that, and I mean it. Others need more experience, more training, more role-play to get there.
The staff on shift that Sunday weren’t ready.
And that matters. Because trauma-informed care is only as strong as the team you get on your worst day. Not the team you get on a Tuesday when everything is calm. The team that shows up when you are shattered and dangerously close to leaving — that team is the practice.
A sign on a wall is not a practice. A training completed eighteen months ago is not a practice. A policy in a binder is not a practice.
Practice is what you do when someone is sitting in front of you, almost ready to talk, on the worst day they’ve had in a long time.
The staff at FMC that Sunday weren’t there yet.
I hope they get there. I genuinely do. Because the alternative — more people walking out AMA because they couldn’t get ten minutes with their phone to send five messages — is not care. It is the system eating itself.
If This Mirrors Your Experience
You are not alone. What happened to you was not inevitable. It was a choice made by a provider or a facility — and choices can be documented, reported, and challenged.
File with your state’s licensing board, the Office of Civil Rights, and the Attorney General. File knowing that these bodies rarely impose meaningful consequences — because the record matters regardless.
And then come to us. Between Trust and Trauma documents what happened, names the providers and facilities responsible, and connects survivors who experienced the same pattern of harm.
One incident is enough. One person harmed is enough. We document it because it happened — not because we need a pattern to justify your pain.
“Nothing About Us Without Us.”
