Speciality described as “organized chaos” and “awe-inspiring.”
Trauma nursing isn’t for everyone. Confidence, technical skill and the ability to adapt in a constantly changing environment are critical attributes.
It’s hard to predict what will roll through the emergency department doors and any delay could further jeopardize the victim’s health.
“Usually the sicker the patient, the quicker things are moving,” says Michael Glenn, who worked as a trauma nurse for almost a decade before becoming a trauma quality improvement coordinator at Harborview Medical Center in Seattle.
“If you are doubting what you are doing and something gets delayed, it’s bad for the patient. It’s bad for the team that’s working on the patient,” Glenn says.
Trauma nurses frequently work with patients suffering from extreme or life-threatening injuries. Around the country, trauma centers are designated by five levels of care, depending on the resources available. Level I centers have a full range of specialists and equipment available 24 hours a day.
On the other end, Level V centers provide initial evaluation and stabilization, and if resources needed aren’t available, patients are transferred to a higher-level center.
“Trauma nursing at a Level I trauma center, because the patients are so much sicker, you have to have knowledge in really advanced procedures that we wouldn’t do here at a Level III center,” says Barb Jensen, trauma program manager at EvergreenHealth in Kirkland. “Our job here at a Level III trauma center is to stabilize.”
At Harborview, the state’s only Level I trauma center, trauma nurses work in three units: the emergency department; surgery; and intensive care. At smaller centers, trauma nurses are usually assigned to just the emergency department.
At the center of the storm
Trauma nurses play two main roles in the emergency department. At the bedside, they are hands-on with the patient, aiding the physicians with critical procedures.
“Their job is to do a systematic head-to-toe evaluation. They are going to look for injuries, start IV lines, hook patients to monitors,” Jensen says. “[They] convey this information to the doctor, and as a team they will decide how to manage this patient.”
The other role Glenn describes as “the glue that holds that team together.” These nurses document procedures being administered and coordinate overall care.
“A bad patient could have literally 12 to 15 people all around the bed doing very specialized things,” Glenn says. “The surgeon in charge is the captain of the ship. But the [coordinating] nurse is the executive officer, making sure everything the surgeon wants gets done right, by the right people at the right time.”
No special training is needed to work in trauma care, other than becoming a registered nurse which requires an associate’s or bachelor’s degree from an accredited program.
“It’s the experience you get while on the job that prepares you,” Glenn says. “Most often emergency nursing is not your first nursing job. It’s rare you would be hired as a new graduate right out of school into an emergency department. They really look for someone who has some experience.”
Many hospitals require trauma nurses to obtain additional certification, such as attending the trauma nurse core course, an intensive, two-day workshop. Advancements mean techniques in trauma care are always evolving, and continuing-education workshops can help update skills.
Keith Peterson, a trauma nurse at MultiCare Tacoma General Hospital — a Level II center — describes trauma nursing as organized chaos.
“Sometimes you have a matter of minutes to save a life,” Teterson says. “You have to be very efficient and fast, but you also have to work as one big team.”
“If it’s difficult for you to process change, you wouldn’t make a good [trauma] nurse,” Glenn says. “If you don’t mind doing things a little off the beaten path you might be a good trauma nurse.”
Finding ways to handle stress is essential for the job, Glenn says. “You have to able to manage some very emotional situations very quickly, process them and move on to the next patient.”
Jensen, who worked the night shift as a trauma nurse at Harborview for 22 years, called the job awe-inspiring.
“There is an immense satisfaction knowing you made a difference. I can’t save every life — I didn’t save every life,” Jensen says. “But I have had the gift, several times, of making someone’s passing as comfortable as I could and being there with them when they had no one else.”
National Nurses Week
When: Through May 12
2017 theme: “Nursing: The Balance of the Mind, Body and Spirit”
More info: nursingworld.org/nnw