Does Level of Trauma Center matter?

[NurseMedic28]

As a GN with aspirations of being a kickass ER Nurse, and hopes of one day being a Trauma nurse, it was really important to me to start out working in, or have my internship in a Level 1 Trauma Center. I thought that this would give me the exposure to the types and volumes of patients necessary both to gain experience and be marketable for future employers.

But mentors and other experienced ED RNs have been telling me that it really doesn't matter what level or size ED you start out in, and I can move up to Level 1 after, and getting the first year of experience somewhere, in any ER is the most important.

Should I expand my job search and quit being hung up on levels and trauma centers? Or does it matter to future employers?

[LadyFree28, BSN, LPN, RN]

Since you are a GN, my suggestion is to expand your search; your area may be one where beggars can't be choosers-you need to get nursing experience, then everything else falls into place.

I hope some other season nurses chime in; when I went for a Level I position, I got it the first time; I applied to Urgent Care first, then my resume was forwarded to the NM of the ED and they called me back, and here I am...

[Lunah, MSN, RN]

Kickass ER nurses, in my opinion, are versatile in all areas of the ER, not just trauma. Get your feet wet in any ER setting and go from there. You will still see traumas. :) I started in a freestanding ER and have worked in community hospitals, Level 1s and 2s, and Afghanistan. My next job is 100% trauma related, but I have a very solid background in all things ER. I value that. Good luck!

[NurseOnAMotorcycle, ASN, RN]

You are an EMT-B, and an EMT-P. Get your RN experience, and then they'll probably hire you just about anywhere you want to go because you have emergency experience. All ERs see the same kinds of pts, it's just the frequency that is different.

[NurseMedic28]

Thanks Nurses.

[CraigB-RN, MSN, RN]

It's not so much the level but the acuity and volume of patients. A level 2 community hospital can see sicker patients than a level 1 academic center.

[Maevish, ASN, RN]

It's not so much the level but the acuity and volume of patients. A level 2 community hospital can see sicker patients than a level 1 academic center.

Oh amen to that!! xo

[RUmedic]

I am in Tampa Bay area, which has Tampa General Hospital, the only one that has Level I trauma ED in all of West FLA. That being said, their ED openings have these requirements, I quote:

"Graduate of an accredited School of Nursing; licensure to practice as a Registered Nurse in the State of Florida. BSN or ASN with greater than one year experience required. Hospital experience required; Emergency Room experience required. BLS/ACLS required. PALS required for pediatric ER, TNCC preferred. (PTCB)."

Nowhere does it say a Level I trauma experience is required. In my view any ED experience would qualify.

[Bobjohnny]

You are an EMT-B, and an EMT-P. Get your RN experience, and then they'll probably hire you just about anywhere you want to go because you have emergency experience. All ERs see the same kinds of pts, it's just the frequency that is different.

It is at the community hospitals and the non-leveled facilities that you often get the patient before they even go to a trauma center. I've seen us run all 6 units of O neg that our facility keeps on hand through a single trauma patient. Obviously this is nothing in comparison to a trauma center's MTP. But, when it is all you have....

We're a non-leveled community hospital. When I interview people if they have previous EMT experience they go up the list compared to other new grads and against other nurses without ED or ICU experience.

[Lev, MSN, RN, NP]

I think volume makes a huge difference. I have not worked in a trauma center, but my community ED has higher volumes than the EDs with trauma centers. With that huge volume comes many more sick patients. Although we are not a trauma center, we stabilize and transfer patients to trauma centers and every once in a while we get a trauma arrest. I take care of critical patients every day - either mine or my colleagues.

As a new grad, I would look for experience in a high volume ER which gives you diverse experiences with adult and pediatric patients with a structured and lengthy orientation. I would look for volume and a good orientation over trauma designation.

[bgxyrnf, MSN, RN]

I've worked in a rural level none, a community level 4, an urban level 1, and a community level 2.

I can tell you that a lot of the staff from the level 1 could not make it in the level none where I was the only nurse. Don't discount experience of any type.

The fastest and most efficient way is to start in a NG program in a level 1 but there are a variety of routes.

[NurseMedic28]

Hey, thanks for the advice, bobjohnny, and that's good to know that you do give a bit of consideration to previous Paramedics. I feel like that's such a hit or miss thing, whether hiring managers care about that or even know the scope of what some medics can do or have done or the nuances of giving care in the street. I just completely revamped my linkdin and indeed profile and I'm now writing my cover letters to reflect more of a graduate nurse flavor and not really emphasizing the medic stuff anymore. I do draw on it heavily when answering behavioral interview questions, because it is where I got a good deal of exposure, but I'm thinking I'll try to get away from that too and just focus on my hospital experiences.