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What is Trauma Nursing?
Trauma nurses specialize in caring for patients injured through trauma, be it accidental or intentional. Trauma nurses must be well versed in stabilizing patients and rapidly recognizing impending life threats. Patients will range in age from neonates to centenarians. Care of these patients can range from short-term in the emergency department (ED) or dedicated trauma unit to long-term in ICUs and rehabilitation units. When these patients enter the system, they don't necessarily arrive with an obvious diagnosis and can benefit from the clinical acumen of experienced trauma nurses. This specialty also requires close coordination and communication with members of the treatment team, ancillary services, and family members.
Education Requirements
Educational requirements include LPNs, ADN-prepared RNs, BSN-prepared RNs, MSN-prepared RNs, and even Nurse Practitioners (NP) and/or Clinical Nurse Specialists (CNS) in a mid-level provider role. Not all types of nurses will be present in all trauma units as hiring preferences vary by location.
Additional certifications that trauma nurses may be required to obtain or might pursue include Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), Pediatric Advanced Life Support (PALS), Trauma Nursing Core Course (TNCC), Emergency Nursing Pediatric Course (ENPC), and Advanced Burn Life Support (ABLS). Additional courses may be required by or available at other locations; this list is not all-inclusive.
BCEN Certification
Two emergency-related board certifications that Trauma RNs may have or seek to obtain are the Certified Emergency Nurse (CEN) and the Certified Pediatric Emergency Nurse (CPEN) credentials from the Board of Certification for Emergency Nursing (BCEN).
To qualify for the CEN, one must be an RN with an unrestricted license in the US or its territories, and there is no minimum practice requirement, though two years is recommended. To qualify for the CPEN, a candidate must hold a current unrestricted RN license in the United States or Canada. The certification board recommends 2 years’ experience in the specialty area however, it is not required.
A trauma-specific board certification is the BCEN's Trauma Certified Registered Nurse (TCRN) credential. To sit for the exam, one must hold a current, unrestricted RN license in the United States or its Territories. A nursing certificate that is equivalent to a US RN is also acceptable. The certification board recommends you have 2 years’ experience in your specialty area, but it is not required.
There are other certifications available through the BCEN.
AACN Certification / Eligibility
In the critical care/Trauma ICU arena, trauma nurses may have or wish to pursue the CCRN certification for critical care through the American Association of Critical-Care Nurses (AACN).
To qualify to take the CCRN exam, RNs and APRNs must have a current, unencumbered license in the United States. Exam candidates must also meet one of two clinical practice requirement options: 1) practice as an RN or APRN for 1,750 hours in direct care of acutely/critically ill patients during the previous two years, with 875 of those hours accrued in the most recent year preceding application; or 2) practice as an RN or APRN for at least five years with a minimum of 2,000 hours in direct care of acutely/critically ill patients, with 144 of those hours accrued in the most recent year preceding application.
The exam is available for three populations of care: adults, pediatrics, and neonates. Practice hours are those spent caring for a single patient population (adult, pediatric or neonatal) matching the exam for which you are applying. Applicants must include the contact information of a professional reference who can verify clinical practice.
There are several other certification levels available (not all-inclusive):
ENA Training Course
The Trauma Nursing Core Course (TNCC) training course is available from the Emergency Nurses Association (ENA) for RNs. Verification as a TNCC provider is earned upon successful completion. Participants must be a Registered Nurse with an unencumbered RN license. LPNs are eligible to attend except for the written and psychomotor evaluations. They do not receive verification and are awarded contact hours.
Work Environment
Trauma nurses often work in the hospital-based ED setting, though some facilities have dedicated trauma units that receive only trauma cases meeting certain criteria. Typically a trauma nurse can expect to have Unlicensed Assistive Personnel (UAP) in the department such as unit secretaries, registration associates, and Patient Care Technicians (PCTs). The broader interdisciplinary team also includes radiology techs, lab techs, respiratory therapists, and other specialists who participate in caring for trauma patients. The entire team, including providers, works closely to stabilize and care for patients.
Some facilities also have Trauma ICUs (TICUs). These units are typically staffed with similar assistive personnel and also include a broad interdisciplinary team with the goal of moving the patient toward recovery and eventually a step-down unit or rehabilitation facility.
Skills / Qualities
Trauma nurses should possess excellent assessment skills to identify and reverse potential life threats. Often trauma nurses are the first to see trauma patients; as such, rapid recognition and identification of issues is essential. The environment is fast-paced and constantly changing, and a trauma nurse must be able to thrive in the chaos of trauma resuscitation. As trauma resuscitation methods are constantly changing and improving through research, trauma nurses should constantly seek new evidence-based information via professional journals and online networking.
Job Outlook
Though the downturn in hiring has certainly affected nursing across the board, this is a specialty that has been relatively stable for experienced nurses. New graduate nurses may have more difficulty with direct entry into trauma nursing practice, but because emergency nursing opportunities remain available and desirable, that specialty could serve as a gateway to a trauma nursing role.
Salary (2020)
Salary will vary by education and location. Trauma nurses typically work in shifts, which results in shift differential and other benefits.
According to ZipRecruiter, the average yearly pay for an RN Trauma Nurse in the U.S. is $91,025 with ranges between $65,500 to $106,000.
According to salary.com, the average annual salary for the Trauma Nurse Practitioner in the U.S. is $94,492 with a range typically falling between $83,718 and $105,878.
About Lunah, MSN, RN
Pixie.RN: a short green-eyed redhead, very tattooed, former paramedic, ED/trauma RN, educator, infection preventionist/epidemiologist, Army veteran (66T). Avid reader, new mommy, addicted to good shoes, allnurses, and her smartphone.
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