Nurses witness pain every day. Some pain is physical, arising from illness, injury, surgery, or chronic health conditions. Other pain is emotional, relational, and invisible. Children and youth in care often arrive carrying this invisible pain—loss, grief, abuse, neglect, family separation, exposure to violence, substance misuse within the family, disrupted attachments, cultural disconnection, and repeated experiences of rejection. While these wounds may not appear on a medical chart, they profoundly affect development, health, behaviour, and long-term well-being.

Pain management in nursing extends beyond medication and clinical intervention. The most effective nurses understand that healing occurs within relationships. Through presence, consistency, compassion, and attunement, nurses help patients regulate fear, build trust, and tolerate difficult experiences. This mirrors what children and youth in care need as they recover from developmental trauma. Just as nurses support patients through periods of illness until they can regain independence, foster caregivers provide temporary care, attachment, safety, and connection until children and youth can move toward stability, permanency, and healing.

Attachment theory teaches that healthy development occurs when caring adults are emotionally available, responsive, and consistent. When children experience abuse, neglect, abandonment, chronic instability, or repeated placement disruptions, their ability to trust relationships can become compromised. Their behaviour often reflects adaptation to pain rather than intentional opposition. Many trauma-related responses resemble symptoms nurses observe in patients experiencing distress: hypervigilance, anxiety, emotional dysregulation, sleep disturbances, difficulties with trust, and physiological stress responses.

The CARE model provides an important framework that aligns closely with nursing practice. Both professions recognize the importance of relationship-based care, trauma-informed approaches, developmental understanding, competence-building, family involvement, and ecological awareness. Nurses routinely assess not only physical symptoms but also environmental, social, cultural, and emotional factors affecting recovery. Similarly,

CARE encourages practitioners to view behaviour through a developmental and trauma-informed lens, asking not

‘What is wrong with this child?’

BUT

‘What has happened to this child?’

From a Gestalt perspective, healing occurs through awareness, authentic contact, and meaningful relationships. Human beings are wired for connection. Trauma creates interruptions in contact—disconnections from self, others, culture, community, and hope. Recovery occurs when safe relationships allow individuals to reconnect with their experiences, emotions, strengths, and sense of belonging. Nurses often become important figures in this process. A calm presence during a crisis, a validating conversation, or a respectful interaction can become a corrective emotional experience that helps restore trust.

Children and youth in care frequently require the same relational ingredients that nurses provide to patients recovering from illness: patience, consistency, empathy, predictability, and hope. Yet there is another important lesson from healthcare. Effective nursing also recognizes when support should foster independence rather than dependence. The goal is not lifelong reliance on care but restoration of functioning, autonomy, and resilience. Similarly, foster care is intended to be a healing environment where children receive the attachment, guidance, and safety necessary to regain confidence in themselves and others.

Both nursing and foster care require extraordinary resilience. Nurses repeatedly witness suffering while maintaining compassion and professionalism. Foster caregivers and child-serving professionals do the same. In both fields, resilience is not the absence of emotional impact; it is the ability to remain present despite it. The capacity to stay connected during moments of fear, anger, grief, or uncertainty creates opportunities for healing that extend far beyond any individual intervention.

Research consistently demonstrates that one caring, stable adult relationship can alter a child’s developmental trajectory. The same principle applies in healthcare. Patients often remember less about procedures and more about how they were treated. They remember who listened, who remained calm, who explained things with kindness, and who helped them feel safe. For children and youth who have experienced trauma, these relational experiences become the foundation for rebuilding trust and developing resilience.

The intersection of nursing, attachment, trauma-informed care, and foster care reminds us of a simple but powerful truth: people heal in relationships. Whether at a hospital bedside, within a foster home, or during a moment of crisis, healing begins when another person communicates,

‘You matter, you are safe, and you do not have to carry this pain alone.’

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Xanthi Keskinis M.S.W., R.S.W. (She/Her)
Clinical Service Manager for Foster Families Department, Quest Assessment, Quest Stabilization and Secure