Interdisciplinary Discharge Planning in Pediatric Patients with Spinal Cord Injury Secondary to Firearm Violence

Purpose: To describe the physical and psychosocial barriers to discharge planning for pediatric victims of firearm violence resulting in spinal cord injury following acute inpatient rehabilitation in an urban setting. This poster will highlight the roles of each interdisciplinary team member in discharge planning, identify opportunities for collaboration, combating compassion fatigue, and vicarious trauma experienced by healthcare professionals.

Description: Approximately 5,800 children in the United States are treated for gunshot wounds (GSW) each year.4 Firearm violence is currently the second most common overall cause of injury in children in the United States.4 These pediatric patients present with an increased burden of care, especially those with medically complex injuries.
Pediatric victims of firearm violence may face unique challenges for discharge planning following spinal cord injury; these may include physical, emotional, psychological, behavioral, and psychosocial barriers to discharge. In our urban setting, patients discharging home following gun violence may continue to experience poverty, racism, food insecurity, violence, cultural expectations, decreased access to education, distrust in medical establishment, lack of accessible housing, and challenges with law enforcement.
For many medical professionals, entry level training has not prepared them to navigate these barriers to discharge planning. It is paramount for the health care professional working in an urban setting with victims of firearm violence to work with team members to support one another
Opportunities for team collaboration with this patient population may include home assessments for accessibility, legal challenges, and child custodial placements. Each of these team members provide assistance to the patient and family to guide them towards a successful discharge, yet support one another through the emotional challenges experienced in working closely with pediatric victims.
Healthcare professionals working with children following firearm violence are susceptible to experiencing compassion fatigue. Symptoms of compassion fatigue can include bottled up emotions, isolation from others, feeling physically or emotionally tired, sadness, and difficulty concentrating. It is important that healthcare workers identify compassion fatigue so that they can utilize techniques to combat burnout in order to best care for their patients and themselves.

Summary of Use: When healthcare professionals have a greater understanding of the challenges surrounding discharge planning in pediatric victims of firearm violence, they may improve the likelihood of a successful discharge for the patient.

Importance to Members: Due to the high rate of pediatric victims of firearm violence, it is important for pediatric physical therapists to have an understanding of the challenging physical, emotional, psychological, and behavioral aspects of this population. Identify the personal impact on yourself, be aware of compassion fatigue in colleagues, and learn ways to combat compassion fatigue. Understanding the unique barriers to discharge may improve discharge outcomes in the future.