Is Trauma Nursing Right For You?

Trauma Nurse

Becoming a Trauma Nurse

Trauma Nursing, also called Emergency Nursing, is a critical specialization within the nursing field. Trauma nurses undergo specialized training and education to develop the skills necessary to assess, intervene, and stabilize patients in life-threatening situations and conditions.

These valuable skill sets are applicable in many different urgent and critical care settings. It is an increasingly popular specialization as the work is challenging, dynamic, rewarding, and has good growth potential professionally. However, it requires an exceedingly demanding role with significant responsibilities and requirements.


Becoming a trauma nurse requires additional education and certification. Most trauma nurses are registered nurses or nurse practitioners that have experience working in emergency or critical care practice and have further continuing education credits. The Board of Certification for Emergency Nursing (BCEN) recommends 2 years of experience in the emergency department; however, the 2 years is not a requirement.

Registered nurses, who wish to specialize in trauma nursing, must receive at least the Certified Emergency Nurse (CEN) designation. This certification is awarded by the Board of Certification for Emergency Nursing and requires passing a 3-hour long computerized exam on emergency nursing.

Nurse practitioners, on the other hand, receive their designation through postgraduate studies and added clinical hours within the specialization. Trauma nurses interested in further specializing can achieve certifications within specific sub-specialties including pediatric emergency nursing, critical care nursing, and flight nursing.

Trauma nurses can also pursue additional professional qualifications in areas including Advanced Cardiac Life Support, Advanced Trauma Life Support, and more. All of these certifications and qualifications must regularly be renewed through retesting or completing continuing education courses or programs.


Necessary Skills

Trauma Nursing is a very rigorous field with significant medical, physical, and psychological demands. Emergency nurses must have a broad range of skills as they care for patients with all types of life-threatening conditions.

They do everything from triage assessment, which is prioritization of patient care depending on the urgency or immediacy of the condition; resuscitation of critical patients; and stabilizing patients with the administration of medication or other treatment modalities.

Working in trauma requires strong, flexible, and adaptable personality skills to cope with high-pressure medical situations. They must work well under extreme pressure remaining calm and observant even in chaotic crisis situations while also being prompt in thinking and reacting quickly.

Effective communication is critical for trauma nurses. They must work together efficiently with doctors and other members of the healthcare team while interacting compassionately and therapeutically with distraught families.

Trauma nurses must also have the ability to cope well with stress and have the stamina to withstand the fast-paced nature and grueling long hours of the work in addition to the extreme severity of problems encountered, which can physically and mentally drain the care providers.


Trauma nurses are exposed to a wide variety of work settings. Emergency rooms and critical care units are the most common areas for trauma nurses.

In emergency rooms and urgent care centers, trauma nurses are responsible for assessing, referring, and stabilizing patients before diagnosis.

Trauma nurses in critical care units see a slightly different work flow as they address sudden crises faced by the most critically ill patients after diagnosis.

Emergency nurses may also choose to work in mobile transport care, military or government organizations, or other facilities that require emergency medical services. Trauma nurses may also pursue alternative careers other than actual medical care, such as becoming administrators, educators, and researchers.

Roles and Responsibilities

During trauma situations, emergency nurses are the first line of defense. Trauma nurses deal with patients with critical, and mostly potentially fatal conditions that don’t yet have specific clinical diagnoses.

They must conduct a quick, systematic, extensive, and accurate assessment of the patient’s condition to implement interventions for the patient’s particular problem(s) thereby preventing injury, complications, and death. This evaluation includes, but is not limited to:

  • Physical exams
  • Recognizing and identifying the signs and symptoms of a life-threatening problem
  • Having a sound clinical judgment in applying the proper treatment plan or monitoring system necessary to stabilize their condition

This process requires quick thinking and problem solving to determine the best course of action for the patient. After the patient is stable, trauma nurses will facilitate further procedures or medical interventions and aid the primary care provider in diagnosing the patient or rendering further treatment.

Trauma nurses must then effectively communicate all pertinent information to the rest of the healthcare team and the patient’s family members or significant others.


Learn more about the important roles trauma nurses play during different types of emergency medical situations:

Written by  and last updated Apr 19, 2017

FDA Bans Use of Powdered Gloves

Noncompliance Cited at Joint Commission Standard

The US Food and Drug Administration (FDA) recently published a final rule banning the use of powdered gloves.* As stated in the citation summary, “The Food and Drug Administration (FDA or Agency) has determined that Powdered Surgeon’s Gloves, Powdered Patient Examination Gloves, and Absorbable Powder for Lubricating a Surgeon’s Glove present an unreasonable and substantial risk of illness or injury and that the risk cannot be corrected or eliminated by labeling or a change in labeling. Consequently, FDA is banning these devices. This rule is effective on January 18, 2017.”

Further clarification in the final rule indicates that “the ban applies to all powdered surgeon’s gloves and powdered patient examination gloves without reference to the type of material from which they are made. Additionally, the identification of non-powdered surgeon’s gloves and non-powdered patient examination gloves is also being revised to remove reference to material.”

As a result of this FDA ban, The Joint Commission now evaluates organizations to assure that required implementation of non-powdered glove use occurs as part of the routine survey evaluation. Effective January 18, 2017, for all accreditation programs, instances of noncompliance are being cited at Leadership (LD) Standard LD 04.01.01, Element of Performance (EP) 2: The [organization] provides care, treatment, and services in accordance with licensure requirements, laws, and rules and regulations.”

The final rule also provides guidance on the proper disposal of remaining stock of powdered gloves, recommending that “unused supplies at hospitals, outpatient centers, clinics, medical and dental offices, other service delivery points (nursing homes, etc.), and in the possession of end users, will need to be disposed of according to established procedures of the local community’s waste management system.” While it is important for organizations to address and manage the disposal process, The Joint Commission will not evaluate the organization’s disposal process of any remaining stock because this is outside the scope of the Joint Commission survey.

Questions may be submitted via the form at:

* US Food and Drug Administration (FDA). Banned Devices; Powdered Surgeon’s Gloves, Powdered Patient Examination Gloves, and Absorbable Powder for Lubricating a Surgeon’s Glove. Accessed Feb 9, 2016.


Preventing violent and criminal events in a healthcare setting

Anyone in a health care facility can become a victim of violence. Since January 2010, The Joint Commission has received 185 reports of violent criminal events from its accredited organizations. Of these, 102 were patient-on-patient violence (61 rapes, 22 homicides and 18 physical assaults). Six of the physical assaults were patient-on-staff violence. Half of the 185 reports were committed by and/or on behavioral health/psychiatric patients, or in a behavioral health setting.

The majority of homicides and physical assaults involved beating, punching or kicking, or strangulation or asphyxiation. Of the injuries sustained, the most common were head injury, head trauma, or eye injury. Of the 28 reports of physical assault, six resulted in the death of the victim and six resulted in permanent loss of function.

Safety Actions to Consider:

While risk factors for violence vary depending on the facility and the patient population, the following general prevention strategies may be considered, especially if your organization’s patient population includes behavioral health or psychiatric patients.

Identify risks and plan to reduce those risks:

  • ♦  Form a multidisciplinary committee (such as the environment of care or safety committee) that includes direct-care staff and union representatives (if available) to identify risk factors in specific work scenarios and to develop risk reduction strategies.
  • ♦  Conduct a risk assessment of the organization, including geographic location and service area, as violent offenders may travel to your site seeking services.
  • ♦  Conduct an assessment of risks associated with the patient population. Periodically reassess for those risks and any new risks.
  • ◊ In non-acute care settings, determine admission and exclusionary criteria for patients who have a history of violence and who pose a risk to existing patients and staff.
  • ♦  Survey employees to determine how safe they feel while working, and how prepared they are for handling violent situations.
  • ♦  Maintain an ongoing dialogue with local law enforcement regarding risk factors in the community (for example, gangs), and the local crime rate. Although the facility may be located in a low crime area, patients and their families may be from other areas.
  • ♦  Implement a comprehensive violence prevention program and periodically evaluate the program.
  • ♦  Implement a plan to address identified risks and update the plan as new information is presented. For example:
  • Hospitals may consider having the security lead on each shift meet with the charge nurse on each open unit to dialogue regarding emerging issues, or may instruct EMTs to take rival gang victims to separate hospitals (if clinically appropriate).
  • Behavioral health care programs may consider having a daily shift meeting to alert the team about risk factors related to newly admitted patients or new risk factors in the existing patient population.
  • Community and home-based programs may consider changing the locations for providing service when there are risks present in the area in which a patient’s home is located.

Environmental design

  • ♦  Develop emergency signaling, alarms, and monitoring systems.
  • ♦  Install security cameras and panic buttons.
  • ♦  Improve lighting in hallways, rooms, clinical offices and parking areas.
  • ♦  Provide security escorts to the parking lots at night.
  • ♦  Design the triage area and other public areas to minimize the risk of assault.
  • ♦Some strategies may include: 
    Provide staff restrooms and emergency exits.
    Install enclosed nurses’ stations.
    Install deep service counters in, or enclose, reception areas.
    Arrange furniture so that staff can easily access the closest exit.
    Minimize the presence of objects that could be used as weapons.
    Make waiting areas comfortable and accommodating.
  • ♦  Restrict the movement of the public by using card-controlled

Administrative Controls

  • ♦  Design staffing patterns to prevent personnel from working alone and to minimize patient waiting time.
  • ♦  Develop a system for alerting security personnel and other staff when violence is threatened.
  • ♦  Flag charts of patients who have exhibited prior violent behavior.
  • ♦  Establish a “zero tolerance” expectation for threatening and violent behavior and communicate how this behavior will be addressed up to and including discharge or transfer from care.
  • ♦  Consider establishing a police check-in station or substation.


  • ♦  Work with local law enforcement to provide employees with crime prevention training.
  • ♦  Train staff to recognize and manage assaults, resolve conflicts, and maintain hazard awareness. Training should address how to manage crises with potentially volatile patients and visitors, especially those under the influence of drugs or alcohol, or those who have a history of violence or certain psychotic diagnoses.
  • ♦  Provide staff with tips on how to be alert and cautious when interacting with patients and visitors.
  • ♦  Familiarize staff with policies, procedures and materials on violence prevention.

Safety Culture

  • ♦  Provide a culture where employees are comfortable reporting events to management, security and law enforcement.

Plan for post-event activities

  • ♦  Provide an environment that promotes open communication.
  • ♦  Develop written procedures for reporting and responding to violence.
  • ♦  Offer and encourage counseling whenever a worker is threatened or assaulted.


Source: The Joint Commission’s Workplace Violence Prevention Resources Portal

Legal disclaimer: This material is meant as an information piece only; it is not a standard or a Sentinel Event Alert. The intent of Quick Safety is to raise awareness and to be helpful to Joint Commission-accredited organizations. The information in this publication is derived from actual events that occur in health care.

©The Joint Commission, Division of Health Care Improvement

History of Joint Commission Pain Standards, Lessons to Address Opioid Epidemic Detailed in JAMA ‘Viewpoint’

The Journal of the American Medical Association (JAMA) has published a Viewpoint editorial “The History of the Joint Commission’s Pain Standards: Lessons for Today’s Efforts to Address the Prescription Opioid Epidemic” by David W. Baker, MD, MPH, executive vice president, Division of Healthcare Quality Evaluation, The Joint Commission.   The Feb. 23 editorial summarizes lessons to be learned since 2000, when The Joint Commission introduced standards for organizations to improve care for patients with pain, amid national efforts to address underassessment and under-treatment of such patients.

“Our sincere hope is this analysis of lessons learned over the last 16 years will help our country’s efforts to address the prescription opioid crisis,” Baker says. “Our goal at The Joint Commission is to try to prevent the pendulum of medical practice from swinging back too far toward the poor pain control of the past. It’s imperative we find a way to balance effective pain management for patients with the need to safely and judiciously prescribe opioids and protect the health of the general population.”

The Joint Commission continues to address pain management for patients. In 2016, based on extensive assessment of public health, health care organization and patients’ needs, The Joint Commission, with expert input from a Technical Advisory Panel of national pain experts, began drafting revisions to its pain management standards for accredited hospitals. The proposed standards were posted at The Joint Commission website for public comment Jan. 9 through Feb. 20, and will be finalized based on analysis of the information gathered during the comment period.

More information on pain management including the draft pain management standards is available on The Joint Commission’s website.



Pumpkin Health Benefits (And Ways to Prepare It)

Photo of small pumpkins with wood bucket

With pumpkin growing contests, pumpkin carvings, pumpkin pie, and pumpkin spice everything, it’s no wonder pumpkin is so popular. Not only is it fun, seasonal and yummy, it is also very nutritious!  Pumpkin has few calories and is rich in Vitamin A and other vital antioxidants. Some even consider pumpkin a super food.

Health Benefits of Pumpkin

  1. 1. Keeps your vision healthy. A single cup of pumpkin contains about 197% of your daily vitamin An intake. Vitamin A plays an important role in keeping your vision healthy by protecting the surface of your eye. Vitamin A can also help decrease your risk of macular degeneration keeps your skin healthy and promotes bone health.
  2. 2. Helps you sleep. Pumpkin contains an amino acid called tryptophan. This is the same amino acid found in Turkey so it will help induce sleepiness.
  3. 3. May lower blood pressure. One study found that individuals on a high-fiber diet experienced a drop in blood pressure and pulse pressure. So in addition to helping your cholesterol levels (see next!), the pumpkin will also help keep your blood pressure levels in check.
  4. 4. Keeps your heart healthy. All the fiber that is found in pumpkin can also help keep your heart healthy. Fiber can reduce both “bad” cholesterol (LDL) and overall cholesterol. Scientists believe this is because it binds with cholesterol particles and then removes them from the body through the digestive system before it’s absorbed.
  5. 5. Pumpkin keeps you full. Including pumpkin in your diet may help you lose weight. Pumpkin contains fiber which also helps promote fullness and staves off hunger.
  6. 6. Mood booster. Pumpkin contains tryptophan, which is an amino acid that helps the body produces Serotonin. Serotonin is a neurotransmitter that is responsible for influencing things like mood, sleep, and even memory. Also known as the “feel good” chemical, when you have more serotonin, it’s likely that your mood will improve!
  7. 7. Antioxidants in abundance. Remember how much Vitamin A pumpkin has? It’s a powerful antioxidant that some research says it helps fend off cancer. Beta carotene, which converts to vitamin A, helps protect our cells and boosts immune system function.

How to Prepare Fresh Pumpkin

Photo of pumpkin puree in a bowl

  1. Choose smaller pumpkins! Smaller pumpkins are more flavorful and work better in recipes than the large ones that we typically use for carving.
  2. Choose your method. Will you use the baking method, boiling method, or microwave method? This article from has excellent instructions on all three!
  3. Basic Prep: Cut the pumpkin in half, discard the stem, and remove seeds and pulp.

Baking Method:

Place the two halves face down in a baking dish and cover with foil.  Bake at 375 F for 1 ½ hours, or until tender. Once the pumpkin has cooled, scoop out the flesh and purée.

Boiling Method:

Peel the pumpkin and cut it into chunks. Place the chunks in a saucepan, cover with water and bring to a boil. Cook until tender, cool, and mash or purée in a food processor.

Microwave Method:

Microwave on high for seven minutes per pound. Turn pieces every few minutes so that they cook evenly. Purée or mash


Registry Network Receives the 2015 Shiftwise Service Award

Registry Network, Inc. has received ShiftWise’s award for Highest Fill Rates – Nursing  in the region we serve.

Supplier Spotlight: Registry Network, Inc.

Company Location: Carlsbad, CAregistry network

Type of Staffing: Per Diem and Travel for Nursing and Allied

Name: Eric Frehe

Job Title: Chief of Operations

The 2015 ShiftWise Service Award Recipient

The Service Award recognizes partners who have exhibited a talent for consistently filling openings for their clients at the highest level.

SW: First off, congrats on winning the 2015 ShiftWise Service Award! What were the leading factors that lead to such a high fill rate percentage?

Registry: Thank you for the award, we truly appreciate it. We pride ourselves on our efforts to recruit and hire top talent. This makes it possible to have a large number of clinical staff ready to submit at a moment’s notice.

Another leading factor is our ability to stay on top of our staff’s professional credentials and other requirements of our clients. Our staffing coordinators know which clinical staff are readily available without question and can be matched to orders quickly. Finally, a key factor is the loyalty of our long-term clinical staff. They know RNI is committed to providing them rewarding assignments at respected healthcare facilities, with good pay and support. Their ongoing availability is key to our fill ratio.

SW: What was your staffing experience like prior to ShiftWise?

Registry: We have used an automated staffing, credentialing, and payroll system called Staffmed, now Stafferlink, since 2003.   This simplified and automated our staffing protocols, getting us ready for the era of the MSP and VMS. One of the biggest changes since we started using ShiftWise would be the number of phone calls and faxes that used to consume us. We have used a dozen or more varieties of MSP’s and VMS’s over the last several years. In our opinion, ShiftWise is the best by far for ease of use, functionality, and reliability.

SW: How has ShiftWise helped to streamline your staffing process?

Registry: ShiftWise can be used by any staffing agency anywhere, anytime, as long as their device can get on IE. All necessary information is in one place. The simple design and user interface has made training easy for all.

SW: In the last year your company has booked over 80,000 hours to almost 7,000 orders! How did RegistrY Network, Inc. successfully book so many orders?

Registry: The efficiency of ShiftWise has undoubtedly helped us to be more effective in staffing our clients. This serves to augment our 34 years of experience in the healthcare staffing industry, our long familiarity with the communities we serve, and our commitment to recruiting and retaining highly competent healthcare professionals.


SW: Are the candidates that are filling your shifts getting positive reviews?

Registry: Yes! Their positive reviews and our ability to see the number of prior visits per unit definitely keeps our clinical staff booked. Since our goal is to hire only highly qualified candidates, we have seen our clients hire over 30 of our clinical staff in the past year. Frankly, this isn’t the most favored outcome for a staffing company, but it would be hard to find a more positive review of our staff!

SW: What is you favorite feature within the ShiftWise application?

Registry: I have to say Staff Time Tacker is my favorite feature. No more paper sign in sheets! Our staffing coordinators generally say ‘Orders’, since that is where all of the fun in staffing happens. Payroll stays in ‘Timeslips’ but wishes it was a little faster. Credentialing hangs out in ‘Staff’ and Billing in ‘Accounting’.

I guess we all have our favorite piece in the application.

SW: As 2015 comes to end what’s your plan of action to continue filling such a high percentage of open shifts for 2016?

Registry: The plan is to keep doing what we’ve been doing for the past 34 years! We have had little turnover with our administrative staff and we work happily and effectively as a team.

SW: What would you say to a supplier who is considering using ShiftWise?

Registry: We highly recommend any supplier not already working with ShiftWise to reach out to them and get started. ShiftWise is fair and respectful to suppliers and gives small and mid-sized companies expanded opportunities. Registry Network always recommends ShiftWise to any facility that is considering using a VMS for the first time or changing from their current one.

Respiratory Protection Basics

Who needs respiratory protection? Everyone should be familiar with the basic issues regarding respiratory protection.  However, there are many more issues that need to be addressed as part of a comprehensive Respiratory Protection Program (RPP).  If you are responsible for managing or administering your company’s RPP the following are some questions you will need to be able to answer:

  • Do you require respirators in your workplace?
  • Who needs a respirator to keep safe at work?
  • Are your employees trained on how to use, care, and maintain respirators?
  • Have employees been cleared to wear respirators by a medical professional?
  • Are there different types of respirators?
  • Which type is right for your valuable staff?

What are the types of airborne hazards? Different respirators and filtering cartridges may be required to protect against different airborne hazards.  Some potential hazards are:

  • Gases and vapors, e.g., xylene, isopropyl alcohol
  • Mists and fogs, e.g., aerosol paints
  • Fumes, e.g., welding, brazing, lead, hexavalent chromium
  • Particulates, e.g., asbestos, silica, hexavalent chromium
    • Oxygen deficiencyresp-2-img

Respirator selection options:

  • Air purifying respirators
  • Filtering face piece particulate respirators/cartridges
  • Chemical cartridge respirators
  • Powered air purifying respirators
  • Canister respirators
  • Air supplying respirators:
  • Supplied air systems
  • Self contained breathing apparatus

Employer requirements: Additional employer information and action is required in accordance with the occupational safety and health regulations covering respiratory protection. This includes but is not limited to:

  • Establishing a written respirator program
  • Medical considerations
  • Respirator fit testing
  • Negative and positive pressure user fit checks
  • Comprehensive user training, e.g., procedures for the use, care, maintenance, and storage of the respirator.

What’s on your face can save your lungs and life!

First Aid Basics

photo_of_band-aid_on_thumbThe essential rules of first aid:

• Rule 1: Call 911 if needed.

− Time is important. If it is determined that emergency medical services are needed, call immediately.

• Rule 2: You must be properly trained and certified in first aid and CPR in order to assist an injured person.

− You may do more harm than good if you are not properly trained.

• Rule 3: Do not move an injured person:

− Do not try to move an injured person unless the person is in imminent danger. Improper or careless movement can increase the severity of an injury.

Types of injuries:

• Fractures: Treating broken bones is not for amateurs. Leave the victim in place until a medical professional arrives with proper supplies and equipment.

• Electrical wire contact: If a person has come into contact with a live electrical wire, a properly trained individual may try to free the person if it can be done in a safe manner.

• Chemical splash, burn, or ingestion: Different first aid steps will be required based on the chemical and the part of the body that came in contact with the chemical. Refer to the safety data sheet (SDS) on file for required first aid procedures.

• Minor injuries, such as burns, nicks, cuts, and scratches:
− These are the most common injuries you will encounter.

− Treating minor injuries right away is better than dealing with them after they have gotten worse.

− If a chemical is not involved in the injury, clean the wound with soapy water for three minutes, and cover it with a bandage.

− If the injury involves contact with another person’s bodily fluid, including blood, saliva, or open wound, follow the post-exposure steps in your bloodborne pathogen exposure control plan.

Follow additional workplace guidelines:

• Report all incidents to the supervisor immediately.

• If you do not know how to handle a situation:

− Activate the Emergency Action Plan.
− Call 911.
− Get help immediately.

Happy Nurses Week!

National Nurses Week Logo Banner

National Nurses Week is a time to appreciate all our hard-working nurses and all they do for patient care!

Registry Network wouldn’t be here if it weren’t for you.

In recognition of your dedicated service, a sincere and heartfelt Thank You!!

Stretch It Out

Does your workforce sit for numerous hours throughout the work day? And how about you? Are you doing the same and feeling worn-out? Studies show that this favorite activity amongst many of us is also slowly killing us. “Sedentary behavior is associated with an increased risk of the development of chronic conditions such as type 2 diabetes and cardiovascular disease,” says Dr. I-Min Lee, professor of medicine at Harvard Medical School.


Visual Guide to Office Stretches

Sitting for hours on end every day is damaging for your health. It’s considered the new smoking. That’s the bad news. The good news is, it’s not difficult to counteract, as long as one is aware of how much he is sitting and making a goal to reduce that number a little bit each week.


Undo the Damage of Sitting. Here are simple stretches that can help undo some of the damage that all of that prolonged sitting has done to your body. You can undo some of the damage while you’re at work!


Quite simply put – prevention is the best remedy, so sit less and move more! Basically, even small amounts of physical activity is enough to improve one’s overall wellness. Especially important to note: workers who eat healthy and exercise have better job engagement and performance and increased productivity.