Trauma Nursing, Gilda Cruz-Manglapus, Henry Mayo Newhall Hospital

If you’re not familiar with a trauma center, a trauma resuscitation room can look from the outside like utter chaos, but it’s actually organized chaos. Everyone knows their roles, from the lab techs and blood bank techs to the surgeons, ED physicians, nurses, ED techs, respiratory therapists, chaplains and social workers. Of course, we also often require security if a trauma case involves a suspected crime.

What characteristics do the best trauma nurses share?

Aside from clinical knowledge, trauma nurses need to be able to work in a fast-paced environment and also have a lot of compassion and judgment — these are circumstances you can’t just take at face value.

Let’s say a woman shows up badly beaten. You need to remain detached enough so that you can deal with the situation objectively. You don’t know what’s behind the woman’s circumstances, so you must withhold judgment, deal with the trauma at hand and communicate compassionately.

In 2019, there was a school shooting at Saugus High School in Santa Clarita. These types of events are very emotional for everyone, as many of us both live and work in the community — many of our ER nurses had kids who went to that school.

Those nurses needed to be able to remain present and take care of pediatric gunshot victims who could very well have been their kids or their kids’ friends. It takes a special kind of nurse to be able to do that.

How do you help staff members process difficult situations?

If a nurse needs to step away, they can talk to someone immediately. Chaplains and social workers are also there for support.

We talk openly with our staff members and offer whatever support they need. If we lose a patient — a baby o child, for instance — it can be very difficult, whether the cause is gun violence, a car accident, SIDS or something else.

Many of our nurses have worked in the facility for 20 or more years, so we know one another well. Everyone supports each other. Being able to talk openly with your leaders also helps a lot when things are tough. Our nursing director has an open-door policy and is always available.

Do you see a lot of burnout in trauma nursing?

In the last two years, burnout has been more related to COVID-19 than to trauma nursing per se. When the streets were empty back in early 2020, our census was down, since people were staying at home more, but it’s starting to escalate again.

Tell us about your community outreach activities.

One community education program we teach is called Stop the Bleed. It’s an American College of Surgeons national program where we teach bystanders to be able to assist a bleeding patient before EMS arrives.

In mass casualty events such as the Sandy Hook Elementary School shooting in 2012 and the Boston Marathon bombing in 2013, lives can be saved if there is bystander intervention like this.

We’ve focused our educational initiative on elementary, middle and high schools. A local nonprofit provided Stop the Bleed kits for middle and high school classrooms. Sadly, those kits needed to be used during the Saugus shooting.

In collaboration with the community court and the Superior Court, we have programs for teens who’ve been cited for things like reckless driving or driving while intoxicated. The court mandates that they take our classes, which teach them to be more responsible drivers. Another community program centers on fall prevention for seniors.

What is the value of the TCRN certification? Do all trauma nurses have it?

The TCRN (trauma certified registered nurse) certification is fairly new. Not all trauma nurses have the certification, and we do not require our nurses to earn it, although we encourage it. We do require that our ED nurses take the ENA Trauma Nursing Core Course (TNCC) every four years.

I earned the TCRN certification to make sure I had comprehensive knowledge. I’m not actually a bedside trauma nurse, but I take part in cases when I am able to and round with the trauma surgeons on the units. The TCRN certification helps me understand what’s happening and how our nurses are involved. Being certified, I can also serve as a role model.

We maintain a staff education program in which we teach TNCC. I’m an instructor, and we train our nurses to be instructors themselves. Our goal is to also have 100 percent of our ICU nurses complete the Trauma Care After Resuscitation (TCAR) program.

I see you’re certified as a public health nurse — tell us about that.

Part of my BSN training was geared towards public health. Trauma nursing also involves partnering with the community through initiatives such as injury prevention programs, so my BSN allowed me to fulfill the requirements to be a PHN.

Please share anything else that you love about your work.

Working at Henry Mayo allows me to highlight my greatest potential as a nurse and as a leader. The support of administration for the trauma program, the confidence that my leaders have in me, and the dedicated staff all make me want to do my best work all the time. The collaboration of our team members shows in the way we care for our community and our patients.

KEITH CARLSON, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has hosted the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.

In this Article: Career Advice, Trauma Nursing