Transitioning from Level 2 to Level 1

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Right now I work in an ED, level 2 trauma center. In the future, we plan to relocate, and I'm just wondering what the big difference is, realistically. Is there a huge difference in patients you see? Would I be prepared as a level 2 trauma nurse to move into a level 1 facility?

Has anyone made this transition? What kinds of things are different? What kinds of things are the same? What suggestions do you have as far as gaining experience?

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Specializes in ED, ICU, PACU.

Went from a level I to a level II and found that I got to do more critical stuff in the Level II, without having any traumas (severe gunshot wounds, serious accidents, traumatic amputations, etc). I believe the main differences are in having designated trauma teams and the level I must conduct trauma related research. I also think, but am not positive, that the level I must have dedicated trauma bays. The level II where I work does not have a dedicated area for critical patients, so all nurses must be ready to handle ICU and trauma-type ICU patients within their general mix of patients. The level I trauma center I had worked for limited the trauma room nurse to a maximum of 3 patients (during slow times that nurse would take the ICU patients from the general ED, leaving only the less critical ones for the general nursing staff).

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Level I facilities are required to have services available in house 24/7, such as a trauma surgeon in house, as well as an anesthesiologist in house 24/7. Specialty services also need to be available 24/7. And there has to be a neuro surgeon on call 24/7. This is what usually causes issues with some facilities to maintain the Level I status.

Patient loads can actually be heavier at a Level II depending on its location. And you still can get trauma patients received there if you are the closest facility. You should be just fine at the new facility.

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Specializes in Emergency.

I worked in Detroit at one hospital we were a level 2 only due to the fact at the OB department was at our twin hospital 6 blocks away. I can assure you one needs to be ready to care for a level one type patient even at the community band-aid station in the sticks. Our worse trauma often times walked in the front door. As Suz said there were nights our load was heavier than the level one sister hospital downtown.

Rj

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Specializes in CT ,ICU,CCU,Tele,ED,Hospice.

[ I can assure you one needs to be ready to care for a level one type patient even at the community band-aid station in the sticks. Our worse trauma often times walked in the front door. As Suz said there were nights our load was heavier than the level one sister hospital downtown.

aint that the truth i work in level 2 er and one of our worse nights a level 1 pt came in dragged by another person.he was not breathing ,barely had a pulse ,and had 3 stab wounds.after we coded him and sent him to or .found out 1 stab wound punctured his ventricle .the surgeon drained 1 liter of blood from the kids pericardium.the kid made it.thanks to us.

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Specializes in ICU/CCU/ER/CVICU.

I had the 'privilege' of working in a 14 bed hospital in the middle of Nowhere, NV. Two ER beds and NO backup. Next closest hospital was in Sparks....162 miles. Talk about stressors...... Had one heck of a doc to back me up in the ER though. Ex cruise ship doc. Would this place qualify as a Level II?

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Specializes in ED, ICU, PACU.
I had the 'privilege' of working in a 14 bed hospital in the middle of Nowhere, NV. Two ER beds and NO backup. Next closest hospital was in Sparks....162 miles. Talk about stressors...... Had one heck of a doc to back me up in the ER though. Ex cruise ship doc. Would this place qualify as a Level II?

Are you talking about Tonopah by any chance?

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Specializes in ICU/CCU/ER/CVICU.

Oh, yeah. I heard that Nye County Regional got closed or something like that. Somehow I doubt that......where would the girls go for their tests?

The wolf:chuckle

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Specializes in Peds, ER/Trauma.
I had the 'privilege' of working in a 14 bed hospital in the middle of Nowhere, NV. Two ER beds and NO backup. Next closest hospital was in Sparks....162 miles. Talk about stressors...... Had one heck of a doc to back me up in the ER though. Ex cruise ship doc. Would this place qualify as a Level II?

To be a level II trauma center, a hospital MUST have Trauma surgery, neurosurgery, ortho, & other specialties on-call at all times, able to respond within 15 minutes. They must be certified as a level II trauma center by the American College of Surgeons- I would be VERY surprised if a 2-bed ER had the resources to be certified as a level II trauma center....

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Specializes in ED, ICU, PACU.
To be a level II trauma center, a hospital MUST have Trauma surgery, neurosurgery, ortho, & other specialties on-call at all times, able to respond within 15 minutes. They must be certified as a level II trauma center by the American College of Surgeons- I would be VERY surprised if a 2-bed ER had the resources to be certified as a level II trauma center....

I kinda think the poster was making a joke about the level II.

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