Trauma Nursing

~Mi Vida Loca~RN, ASN, RN · Apr 16, 2012

In our ER the ER nurses and Techs are the trauma nurses and techs. When a trauma is called we will have a Pharmacy person, Trauma Surgeon, 1RRT Nurse, Chaplin and Security, X-Ray, CP and Lab all show up. But it's the ER nurses and the ER techs that are doing everything with our ER Doc with the Surgeon.

There aren't any of us specifically set for this either. We rotate each shift and we all work in the trauma bays. When a Code is called in the hospital it's one of our ER techs, and ER docs and a RRT nurse that goes to it and if available one of our Nurses as well. If it's during a time we only have one Doc on and they are in the middle of our own emergency then our tech will go but it's the hospitalist that will need to take care of it.

Speaking of this topic, I have to say I am amazed at the amount of people that don't realize that just about everything (outside of a glidascope but that's in the bag our techs take up) that you need for a code is in the Code card. I went to a Code the other day in the ICU and a complaint was actually made against the ER staff because they are running around everywhere looking for things for this code that were all IN THE CODE CART. They didn't even have the cart in the room. It was absurd and so frustrating. They keep sending someone to go and get meds, syringes, flushes, NG tubes etc. etc. and we keep yelling out when someone says "get this" that it's IN THE CODE CART. No instead people are running around to the stock room, to the pyxsis, to other rooms and so on.

Anyway, their is my rant on that.

But I would think a Trauma nurse is the nurses that deal with the traumas. I never really looked at it as a nurse that has dealt with patients that went through a trauma. But the ones on the front lines of the trauma. So in my hospital that would be the RRT and ER nurses, but primarily the ER nurses. I suppose that could expand to the OR nurses too but we usually are getting them semi stable before they leave for surgery. I suppose everyone can have their own definition of what it entails.

FlightJunkie · May 4, 2012

In my Level 1 trauma center, the ER nurses are treating all traumas until the go to the OR, ICU, get discharged, or go to the morgue. ICU does not respond to our department and we do not take them as floats either. The only place I know of that has an exclusive Trauma RN position is Shock Trauma in Baltimore MD

rgroyer1RNBSN, BSN, RN · May 4, 2012

We have a trauma area in our er and generally the ed nurses and some sicu nurses like myself float to ed and we are generally the nurses assigned to that area, but mostly ots vetran ed and sicu nurses that take this area.

Guest 360983 · May 5, 2012

My Level 1 ER is like FlightJunkie's--the ER RN doesn't let go of the patient until they are on a different floor. The SICU nurses know their stuff, but they don't know fresh trauma (just like ER RNs don't know post op trauma) and they're plenty busy with their current patients so they don't come down. Every RN in the ER with enough experience and the appropriate training rotates into the trauma area, just like we all rotate to urgent care. The traumas are run by the ER residents and attendings. If it's bad enough we'll have the appropriate services there before the patient gets there (especially Neuro) but it is very clear that the ER doctors are always in charge.

I'd call both ER and SICU RNs at my hospital trauma nurses, as we both handle trauma, just on different sides of the OR.

We don't respond to codes on the floors--the MICU RNs are far better suited for this. We do respond to codes in the attached clinic or on hospital grounds, like the cafeteria, as those patients will end up in the ER anyways. That doesn't involve trauma, though, aside from the occasional seizure that hits their head on the way down.

Wolf at the Door, BSN · May 11, 2012

Well May is trauma awareness month :).

The trauma center, where I am brings patients to the Trauma Bay first if needed then moved to the TICU or stepdown unit.

So nobody has a TICU- trauma ICU at their facility of employment or past employment?

If you have a TICU shouldn't you have a Trauma Step Down?

Altra, BSN, RN · May 11, 2012

Yes, we have a TICU, a tele unit designated for trauma/surg patients, and non-tele trauma patients also sometimes get admitted to a med-surg or ortho unit too.

Wolf at the Door, BSN · May 13, 2012

I would like to click on and read about TICU problems, interventions, suggestions etc. I don't get where people are coming from saying their is no such thing as a trauma nurse.

hiddencatRN, BSN, RN · May 13, 2012

I would like to click on and read about TICU problems, interventions, suggestions etc. I don't get where people are coming from saying their is no such thing as a trauma nurse.

Yes, you have made it clear that you don't consider ER nurses trauma nurses.

sauconyrunner · May 13, 2012

I think the thing about Trauma is that it is a sticky thing. And Hey...I'm an Infection prevention nurse now...though I used to work in an ED and a S/T ICU.

ED nurses have a HUGE role in trauma. Hello! Trauma rolls in the door of the Emergency Department. If things are not done properly there, there is no Trauma for the OR or ICU nurses to take care of.

OR nurses also have a BIG role in trauma, though I would have to say they pretty much do cases regardless of the type of case.

Trauma/Surgery ICU Nurses also have a large role in Trauma, as they see the patient through the initial recovery.

Step Down and REHAB Nurses also have a big role in Trauma, as they are the ones that help a patient who has had major trauma recover and go on to function as well as they can after the event. Somehow I don't think we see nurses who help people recover from Trach and peg and learn to walk again at an LTAC a "trauma" nurse, but without that nurses, all the other intense work is pretty much for nothing.

I don't think that the title is one that can be exclusive, given how many people have an actual role in getting a trauma patient back to functioning. But, I can say for certain....As an Infection Preventionist...I'm SURE I am not a trauma nurse anymore.

MysticOne713 · May 14, 2012

Why does all nurses not have Trauma listed as its own specialty? There are plenty of trauma nurses. Also missing is Trauma ICU.

I agree. I think that there should be a specialty for trauma nurses who are not in the ED (ie, surgery trauma nurses like myself). :)

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Wolf at the Door, BSN · May 15, 2012

Yes, you have made it clear that you don't consider ER nurses trauma nurses.

whoa I never said that. ER nurses have a huge role in trauma. An ER nurse can easily and should be and can be called ER/Trauma nurse. That is a perfect tilted to me. I am just saying a nurse in the Trauma ICU should be called a trauma nurse. There should be a trauma section for people who work in Trauma ICU or Trauma step down. I think people are mixing up what a trauma nurse is. I know the trauma patient goes to the trauma bay first which is in the ER, that is a no brainier. ER nurses do a great job before the patient goes elsewhere. Working as a trauma nurse does not mean you deal with a fresh trauma per se. The management of the patient back to functioning occurs in places like trauma step downs. Those are trauma nurses too.