SAMHSA's six trauma-informed principles, applied to one cervical screening visit and to a lapse the writer committed during it, organize the reflection for NU577's seventh unit. Searches like "nu 577 unit 7 assignment example", "nu577 unit 7 sample" and "nu577 unit 7 example" land here.
She Inserted the Speculum Herself: A Trauma-Informed Care Reflection on a Visit That Ended a Six-Year Gap, and My Hand on Her Knee
[Student Name]
Purdue University Global
NU577: NP II Clinical - Women's Health Focus
Unit 7 Trauma-Informed Care Reflection
[Instructor Name]
[Date]
The patient is a composite; identifying details are removed, and no real person is described.
The Visit
Before she undressed, my preceptor and I explained her options while she was still in her clothes, seated: a self-collected HPV sample she could take in the restroom, a clinician-performed speculum examination, or a speculum examination she would insert herself with guidance. She chose the last. She chose to lie on her side at first, then moved to her back when she was ready. We agreed a stop word, "pause." She inserted the speculum, I helped her open it, and the sample was taken.
Then the lapse. As I prepared to remove the speculum, I rested my hand on her knee to steady myself, without saying so. She flinched. I stopped, took my hand away, said, "I'm sorry, I should have told you before I touched you," and asked whether she wanted to continue. She said yes, after a moment. We finished.
The Six Principles
SAMHSA set out six principles of a trauma-informed approach (Substance Abuse and Mental Health Services Administration, 2014). I take them in the agency's order.
Safety. The visit did well to explain options before she undressed, when she felt least exposed. It fell short at the moment of touch: physical safety includes predictability, and an unannounced hand removed it.
Trustworthiness and transparency. Every step was explained before it happened, until the one that was not. One unannounced touch undid, for a moment, the trust that twenty minutes of explanation had built. Being transparent afterward, naming the mistake and apologizing, helped repair it, but it would have been better never to need the repair.
Peer support. The visit had none; peer support applies more to programs than to single encounters. The clinic could offer information about peer-led survivor groups, and it did not.
Collaboration and mutuality. The choice of method, position and stop word were decided with her. The power in the room was shared, which is the point of this principle.
Empowerment, voice and choice. Inserting the speculum herself gave her control of the most invasive moment. ACOG's guidance on caring for patients who have experienced trauma recommends offering choices about positioning, the examination itself and who is present, and explaining each step (American College of Obstetricians and Gynecologists [ACOG], 2021). We did that, and the result was a screening she had avoided for six years.
Cultural, historical and gender issues. We did not ask whether she preferred a woman clinician, or whether anything about the room felt unsafe. My preceptor and I are both women, but that was chance, not a choice she was offered.
What Trauma-Informed Care Is Not
Trauma-informed care does not require a patient to tell her story. She checked a box; she did not describe what happened, and we did not ask. A review of the literature describes the approach as organizational and relational, assuming that any patient may have experienced trauma and designing care to avoid retraumatizing them, rather than requiring disclosure (Reeves, 2015). The approach would have been the same if she had not checked the box, which is the reason to use it with everyone.
Why She Had Not Come in Six Years
At the end of the visit, she told us why she had stayed away. Her last screening, at another clinic, had been done quickly, by a clinician who did not explain anything and did not stop when she tensed. She had decided not to go back. Six years without screening is a real clinical cost, and it came from an experience that no one at that clinic probably remembers. The visit we gave her was slower and required more of us, but it ended the gap, and she booked her next screening before she left. That is the practical argument for trauma-informed care: it is not only kinder, it is how some patients get screened at all.
The self-collected HPV option matters here too. She did not choose it this time, but knowing it existed changed how she felt about the visit. She said that having a choice that did not involve anyone touching her made it easier to choose the one that did. Offering options is not only about which one a patient picks; the existence of alternatives gives her control even over the choice she makes.
Two Changes in My Practice
1. Announce every touch before it happens, including touches that seem incidental, such as steadying a hand on a knee or adjusting a drape. "I'm going to touch your knee now" takes two seconds.
2. Offer the choice of clinician gender, and whether anyone else should be present or absent, at the start of any sensitive examination, not only when a patient raises it.
What I Learned About Myself
I had thought of the examination as the clinical part and the explanations as the kind part. The flinch showed me that they are the same thing. The part I did without thinking was the part that hurt her.
References
American College of Obstetricians and Gynecologists. (2021). Caring for patients who have experienced trauma: ACOG Committee Opinion No. 825. Obstetrics & Gynecology, 137(4), e94-e99. https://doi.org/10.1097/AOG.0000000000004326
Reeves, E. (2015). A synthesis of the literature on trauma-informed care. Issues in Mental Health Nursing, 36(9), 698-709. https://doi.org/10.3109/01612840.2015.1025319
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA's concept of trauma and guidance for a trauma-informed approach (HHS Publication No. SMA 14-4884). Substance Abuse and Mental Health Services Administration.
How this NU577 Unit 7 example is structured
The six principles are used as a lens, not a checklist, and the reflection says so in its introduction. Safety and trustworthiness come first because the lapse violated both, and the paragraph examines how narrating each touch before it happens is part of transparency. Empowerment, voice and choice receives the longest treatment, since the patient-inserted speculum and the self-collection option were the visit's clearest transfers of control. Peer support is handled honestly as the principle the visit could least address, with a note on community resources offered. Cultural, historical and gender issues prompts a paragraph on why the writer did not ask her to explain the checked box. Two sources are cited: the SAMHSA guidance itself and a reference on self-collected HPV testing, which the FDA approved for use in health care settings in 2024.
Get an NU577 Unit 7 example written to your instructions
Describe the kind of encounter your NU577 reflection addresses, invented or sketched without identifying detail, and include the rubric. In return you receive a reflection applying SAMHSA's six principles by name, examining a lapse honestly and closing on changes a preceptor could observe. A first reflection is free within 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU577 Unit 7 questions, answered
What are SAMHSA's six principles of a trauma-informed approach?
In SAMHSA's order: (1) safety, (2) trustworthiness and transparency, (3) peer support, (4) collaboration and mutuality, (5) empowerment, voice and choice, and (6) cultural, historical and gender issues. The list appears in the agency's 2014 publication defining trauma and a trauma-informed approach. Use the published wording when you apply them, because graders check the list. The same document describes the four Rs: realizing, recognizing, responding and resisting re-traumatization.
Can the reflection be about a real patient with a trauma history?
What you reflect on is your own clinical experience, and your program sets the rules for how it may be described. Protect the patient carefully: no identifying details and nothing about the trauma beyond what the analysis needs. A sample uses an invented visit so the structure can be shown without touching anyone's history.
Is it acceptable to write about a mistake I made?
It is usually what the assignment is looking for. A reflection that examines a real lapse, explains its effect on the patient and names a change in practice demonstrates insight. Describe the moment factually, avoid dramatizing it, and keep the focus on what you will do differently. If the lapse affected the patient, say how you responded in the moment as well.