Take a look at the fast-paced field of emergency nursing including sub-specialties in trauma care. In this episode, we brought together a panel of emergency and trauma nurses to discuss the roles nurses can play in this field and what they can look forward to in terms of advances in case which can impact emergency departments and their patients. We were joined by Elizabeth Seislove, Director of the Trauma Program at Lehigh Valley Health Network in Allentown, Pennsylvania and Randy Smith, Director of the Emergency Department at Nationwide Children’s Hospital in Columbus Ohio.

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Jamie:                  I’m here with Randy Smith and Betsy Seislove to talk about advances and changes in trauma care and emergency nursing care – what kind of things are on the horizon. I guess I’ll start with Randy talking a little bit about – nursing, in general, have come so far but emergency nursing really has advanced right alongside of all the other things going on in the nursing career path in general. Many aspects of emergency care, the nurse is just an integral part of the process in assessment, in providing treatment and also instructions for someone that is not going to be your patient maybe ever again. There are some things that have changed over the years. What have you seen come along that has really changed the way that nurses have interacted with their patients and advanced the way that emergency nurses and trauma nurses care for their patients?

Respondent:          I guess, from my perspective, I don’t know that up until maybe the last five, ten years or so that you [won’t] to see trauma nursing really had a true identity. I think that the certification piece, that’s really evolved the advanced training piece of that. It really helped to drive emergency nursing and trauma forward. I’ll give you an example. I know here at Nationwide Children’s, on the trauma side for example, we developed what is called a “Trauma Nurse Leader” role. This is a nurse that is chosen by their peer group as well as recommendations from our physician colleagues to go to one-year internship in trauma nursing. These TNLs have really drive to include the calling of the level of the trauma here at Nationwide Children’s. That’s certainly wasn’t the case five years ago. I don’t know that there really was a lot of value given to the trauma nurses in their role to not only in the initiation of the trauma but the care of the patients. A lot of things are being initiated and driven by the TNLs. I think we have that kind of a role that’s carved out because I don’t always think that nursing has done a good job of carving out roles for themselves. At times, I think [unintelligible] gets placed upon us because of necessity. I think we’ve been much more proactive as a profession to take more ownership in carving out and driving those roles inside the profession versus from a multidisciplinary group as a result of a [root] cause or unfortunately a bad outcome.

Jamie:                  Betsy, what are your thoughts?

Betsy:                   Well, I have to kind of echo some of what Randy has just spoken about his institution. What we did about – it was probably about five or six years ago – we also identified that trauma is such a complex disease process that if you throw a nurse back in a trauma bay and expect them to know exactly what to do without a lot of experience behind them, they felt loss. The team felt loss. What we did is we put together what we call our “Core Trauma Nursing Team.” They again are the select few nurses who are identified by their peers an...

This month’s Nursing Notes newsletter takes a look at the fast-paced field of emergency nursing including sub-specialties in trauma care. I got a chance to sit down with two experienced emergency care nurses to talk about the differences between emergency department nursing care and the specialized emergency field of a trauma nurse. Paul Bond is an emergency nurse with over 20 years experience in the field. He’s also the host of a bi-weekly online radio show found at EmergencyNursingToday.com. We were joined by Susan Cox, a trauma nurse at Rady Children’s Hospital in San Diego where she is Director of Trauma and Volunteer Services. Susan is also the President of the Society of Trauma Nurses.

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Interview with Paul Bond and Susan Cox on Emergency and Trauma Nursing

Jamie:                  Susan and Paul, I’m happy to have you on the show here at Nursing Notes Live. I’m excited mostly because I think it’s important to draw distinction between the specialty of emergency department nurse and the subspecialty or its own specialty in its own right of trauma nursing. So Susan I thought I would start off with asking you, what do you see is the key differences between being a trauma nurse and perhaps being an ER nurse?

Susan:                  Yes. I’d be glad to help with that. Actually trauma is a subspecialty of nursing. It is specific to the phase of care that you’re talking about. The emergency department or the emergency center phase of care is one phase of care in trauma nursing. So there are people who work in the emergency department. Sometimes all of the people who work in the emergency department function as trauma nurses. But there also trauma nurses in all of the other phases of care in the hospital or outpatient setting. We have trauma nurses who function on our floors. We have trauma nurses who function in a radiology department and our critical care units. They are all caring for trauma patients and have a subset of clinical expertise and knowledge that is specific to trauma patients and anticipatory knowledge and expertise in anticipating what might occur ongoingly with the trauma patient related to mechanisms of injury and what has happened to the patient. So the difference between an emergency department nurse and a trauma nurse is basically that a trauma nurse can be an emergency department nurse but there are also trauma nurses in many other phases of care in a hospital.

Jamie:                  It’s interesting that you say that, Susan, because I didn’t know that the trauma nurses extended beyond, say, a specific trauma center or beyond the emergency department setting but that’s very interesting that they extend into other realms.

Paul:                    I really didn’t either, Jamie. I understood that trauma nurses were not just in the emergency department. But my understanding was more the critical care post-ER like in a trauma ICU or those types of things – the OR. I didn’t realized that they went into radiology and the regular force too which I think was great because trauma is its own continuum of care. Since the ‘60s with the advent of the Golden Hour and everything that R. Adams Cowley did through shock trauma, we’ve noted that there’s a major difference in how you care for trauma patients versus medical patients or simple trauma patients, if you will, somebody’s just had a broken leg as compared to somebody who was stabbed or shot or fell of a building or whatever it may be.

This month’s issue of Nursing Notes looks at the field of oncology nursing. In this show, we gathered a group of Oncology Nurses to share what they think it means to be an “Oncology Nurse.” Our guests include Carlton Brown, the President of the Oncology Nursing Society, and Jacquelyn Grandt, Program Director, Outpatient Oncology Services at Long Beach Memorial Medical Center in California.

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Oncology Nurse Panel Discussion

Jamie:                  One of the things I’d like to just touch on first off is the treatment of cancer patients seems to have changed so dramatically over the last twenty years. You must have seen a whole lot of change where we’ve moved from inpatient treatments and lots of surgeries to more targeted treatments and outpatient treatment programs. Tell me a little bit about some of the changes that have occurred that really you’ve noticed most over the last twenty years.

Jackie Grandt:       Yes. I can answer that. Actually, I’ve been in oncology nursing for about 30 years. My beginning in oncology nursing was inpatient. At that time we had mostly inpatient patients that we managed. There wasn’t really the outpatient arena that exists today. Over the course of my career, I got into outpatient practice and spent a good portion of my time in private practices and, in doing that, really saw the transition of patients from inpatient care to outpatient care and providing them with chemotherapy treatments which was the primary area that I was in and outpatient office. Initially when I started, all treatments we did in the hospital. It was like patients had to be monitored and followed extensively. Now, we’re giving them these treatments and then sending them home and monitoring them from an outpatient status. That was a significant change. Also the types of treatments have changed. We have now targeted therapies. We also now do combination therapies with chemo and radiation together or do neo-adjuvant treatments which when I first started those kinds of things didn’t exist.

Carlton Brown:      Yes. I agree. I recently heard somebody say that, “Yes, you are an inpatient. If you are a patient in an inpatient arena now, you are really the sickest of the sick.” The future of the next three or four years of inpatient care will really become mini-ICUs or intensive care units because the inpatient facilities will be mostly held for those patients that are very ill. I agree that we’ve seen a lot of our treatments – even within the last three years of seeing how – even the care now is moving from the outpatient arena really to the home so it’s not uncommon for patients to be treated in their own homes for cancer and certainly a move more towards the oral chemotherapies or oral medications that certainly have their own special side-effects. I agree with Jackie that we’ve really seen quite a change over the last 30 years and even the last 5 years.

Jamie:                  I saw on one of the pieces you commented on for the Nursing Notes newsletter that’s coming out this month that you talked about some of the challenges and rewards for oncology nurses based on breakthroughs and cancer treatments. Could you talk a little bit about how those breakthroughs are affecting the oncology nurses here in the United States?

Carlton:                Well, the breakthroughs – I think I was talking about the move towards more oral chemotherapy or oral agents. There are probably 50 to 100 chemotherapies out there that each come with their own very individual special symptoms.

This month’s issue of Nursing Notes looks at the rewards and challenges presented by a career in Oncology Nursing. This month, I chatted with Oncology Nurse Jacquelyn Grandt, Program Director, Outpatient Oncology Services at Long Beach Memorial Medical Center in California. Jackie is featured in this month’s Nursing Notes newsletter as our “Get to Know”...

A former college English Professor, Theresa Brown, RN, lives and works in the Pittsburgh area. She received her BSN from the University of Pittsburgh, and during what she calls her past life, a PhD in English from the University of Chicago. Brown is a regular contributor to the New York Times blog “Well.” Her essay...

Info for nurses from people you trust, this is “Nursing Notes Live.” Visit http://www.DiscoverNursing.com for the monthly eNewsletter, Nursing Notes and for other episodes of this podcast the Nursing Notes Facebook page, visit http://NursingNotesLive.com. Subscribe to the show via iTunes. http://itunes.apple.com/us/podcast/nursing-notes-live/id408728865 *** In this episode of Nursing Notes Live, the panel discussion revolves around those...

Info for nurses from people you trust, this is “Nursing Notes Live.” Visit http://www.DiscoverNursing.com for the monthly eNewsletter, Nursing Notes and for other episodes of this podcast the Nursing Notes Facebook page, visit http://NursingNotesLive.com. Subscribe to the show via iTunes. http://itunes.apple.com/us/podcast/nursing-notes-live/id408728865 *** Transcript of interview of pediatric nurse Kelli Anderson Jamie: Kelli, welcome to Nursing...

Info for nurses from people you trust, this is “Nursing Notes Live.” Visit http://www.DiscoverNursing.com for the monthly eNewsletter, Nursing Notes and for other episodes of this podcast the Nursing Notes Facebook page, visit http://NursingNotesLive.com. Subscribe to the show via iTunes. http://itunes.apple.com/us/podcast/nursing-notes-live/id408728865 *** Transcript of discussion on pediatric specialized nursing Jamie: I’m really excited with the...

Info for nurses from people you trust, this is “Nursing Notes Live.” Visit http://www.DiscoverNursing.com for the monthly eNewsletter, Nursing Notes and for other episodes of this podcast the Nursing Notes Facebook page, visit http://NursingNotesLive.com. Subscribe to the show via iTunes. http://itunes.apple.com/us/podcast/nursing-notes-live/id408728865 *** Interview with Kim McAllister, Author of the Emergiblog The latest nursing news and...