ER/ Trauma vs Trauma ICU

  1. If someone were interested in trauma, should they work in a Level 1 Trauma Center, or a Trauma ICU ( that receives traumas from level 1 center)? Just curious about this field of nursing.
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  2. 8 Comments

  3. by   KeeperMom
    Depends on whether you want the patient straight off the street or from the ER. Kind of depends on whether you are willing to wait the two so years it will take to be the nurse to take the "big bed" when that trauma rolls in. Most L1 ERs will have a dedicated L1 room and will only be assigned to someone on the trauma team which usually take at least a year or more to earn that spot.
    Same is really true in the ICUs I've seen. A new nurse won't get thing those super critically ill patients right off the bat. He/she will usually have to put the time in with the more minor ill patients to start.

    I've never known a SICU/STICU not be attached to a L1 center. That is part of the criteria to even be considered a L1 center anyway. Maybe I misunderstood the question.
  4. by   jprn2018
    Quote from KeeperMom
    Depends on whether you want the patient straight off the street or from the ER. Kind of depends on whether you are willing to wait the two so years it will take to be the nurse to take the "big bed" when that trauma rolls in. Most L1 ERs will have a dedicated L1 room and will only be assigned to someone on the trauma team which usually take at least a year or more to earn that spot.
    Same is really true in the ICUs I've seen. A new nurse won't get thing those super critically ill patients right off the bat. He/she will usually have to put the time in with the more minor ill patients to start.

    I've never known a SICU/STICU not be attached to a L1 center. That is part of the criteria to even be considered a L1 center anyway. Maybe I misunderstood the question.
    How long do the trauma patients usually stay in the ER? How many traumas come in each day (on average) at a Level 1 Trauma Center?
  5. by   KeeperMom
    Quote from jprn2018
    How long do the trauma patients usually stay in the ER? How many traumas come in each day (on average) at a Level 1 Trauma Center?
    Less than an hour. Goal is 20 minutes from ER to scanner, unit, or OR but that can vary based on what all needs to be done.
    We are a 800+ bed L1 hospital with six trauma rooms in the ED - one is a dedicated L1 room. We have seen up to 27 traumas to include 4 or 5 L1s in a day. I think the most L1s we had in a day was 10 or 12. I cannot remember. I've had 4 L1s in one day but one really wasn't a 1. I've had that room and never saw one single patient all day. It just varies.
  6. by   Wolf at the Door
    Former Level 1 Trauma ICU RN here. There was a separate trauma ER from the medicine ER where I worked, two totally different parts of the hospital. Trauma Bays, Trauma ER, Trauma OR, Trauma PACU, Trauma ICU & Trauma Stepdown. Burns had there own ER, OR, ICU, Stepdown.
    Summer is Trauma season so it is really busy. It depends how many trauma centers are located in your area.
  7. by   jprn2018
    Quote from Wolf at the Door
    Former Level 1 Trauma ICU RN here. There was a separate trauma ER from the medicine ER where I worked, two totally different parts of the hospital. Trauma Bays, Trauma ER, Trauma OR, Trauma PACU, Trauma ICU & Trauma Stepdown. Burns had there own ER, OR, ICU, Stepdown.
    Summer is Trauma season so it is really busy. It depends how many trauma centers are located in your area.
    Does it usually take an RN a few years to get into the trauma part of the ER? Do trauma ER nurses, or trauma icu nurses get more trauma experience?
  8. by   Wolf at the Door
    Quote from jprn2018
    Does it usually take an RN a few years to get into the trauma part of the ER? Do trauma ER nurses, or trauma icu nurses get more trauma experience?
    Yes, you should at least wait a 1.5-2 years before picking up shifts. Trauma ER is just trying to stabilizing the patient for OR. Then OR rushes the patient to ICU so that patient does not die in operating room, or the patient is actually ready to be sent to ICU.
    ICU gets more experience due to whatever was happening in trauma er (volume replacement & coding) continues on in trauma ICU and more lots more. Trauma ER stitches patients and a few other task that does not go on in trauma icu.

    I convinced allnurses to create a trauma speciality a few years back. There was a Trauma and Trauma ICU category if I remember right. I battled a few members over the need of the trauma category. I assume due to lack of traffic it failed and was removed. General specialities exist lol, oh well, I still think trauma is needed.
  9. by   Non Sequitir
    It's basically the same difference between the ER and any other floor. The ER stabilizes with the goal of 'how quickly can we get this pt to where they need to go', the floors treat with the aim to fix the problem. That's a gross oversimplification but serves this particular example well. Hospitalist/inpat docs who cover the ER can be absolutely terrible because the frame of reference for treating patients is much different. The ER needs to maintain open beds, the floors need to continue the work that the ER started.
  10. by   Wolf at the Door
    If you want to see the gore right in your face trauma er and circulate in the trauma bay. Trauma ICU we get them bandaged.

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