News | May 30, 2001

CAREER CORNER: Trauma Coordinator - A Multifaceted Career Opportunity for Nurses, Part I

CAREER CORNER: Case Management - A Career With Unlimited Opportunities

By Patricia Carroll, RN,C, CEN, RRT, MS

In the last three columns (See Case Management - A Career With Unlimited Opportunities, Meet the Case Manager, Part I and Part II), we introduced you to a career path with almost unlimited opportunities: nurse case manager, who acts as liaison between patients and families and insurance providers, to provide the most effective, most cost efficient care. This time and next, we'll discuss another fascinating—and virtually unlimited—career opportunity: coordinating trauma care. This is an ideal job for nurses who want to use their nursing, teaching, facilitating, coordinating, administrating, supervising, and community outreach skills to facilitate the care of patients who have been injured.

Every Hospital Has Trauma Service
According to the American College of Surgeons, the job of the trauma team is "to provide a structure of care for injured patients. This service includes personnel and other resources necessary to ensure appropriate and efficient care delivery." Each hospital—no matter how large or small—has a trauma team, consisting of physicians, nurses, and various health personnel such as respiratory therapists. The size of the team and the number of layers it has depends on the size of the hospital and the level of trauma care it is equipped to provide.

Hospitals with high-level trauma response have a wide array of available staff: general and specialist surgeons, emergency physicians, surgical and emergency residents, ED nurses, lab and radiology technicians, critical care nurses, respiratory therapists, anesthesiologists or Certified Registered Nurse Anesthetists (CRNA), OR nurses, security officers, chaplains, and social workers. A trauma coordinator is absolutely essential to keep these complex teams running efficiently so that nothing falls through the cracks.

Hospitals with lower level trauma resources draw team members from available physician, nursing, and allied health staff. The team leader is usually a general surgeon. These mid-sized hospitals also offer opportunities for trauma coordinators—who may be the only person who deals with trauma care from start to finish.

In the smallest hospitals, where no general surgeon is available, the trauma team leader can be a primary care physician, physician assistant, nurse practitioner or registered nurse. Opportunities are obviously fewer here than in larger settings. However, someone must oversee and coordinate care, which often includes effectively bringing together resources to stabilize patients and then transfer them to a hospital that provides higher-level trauma services.

Perfect Job for a Nurse
The American College of Surgeons (ACS) is clear in its support for this role, noting that a trauma program's structure "must allow the trauma director to have oversight authority for the care of these injured patients." This oversight can include a number of activities including identifying the injured patients, monitoring the provision of services to them, making periodic rounds, and communicating with individual practitioners about the patient's care. Trauma teams need someone who can get involved as well as step back for a clearer view; someone who understands both the medical end and the patient care end, who can coordinate, multi-task, communicate, and facilitate—what better job description for a nurse?

What a Trauma Coordinator Does
According to the ACS, a trauma coordinator should be a registered nurse with certification and clinical experience in care of the injured. He or she should also have related educational preparation, with a minimum of 15 hours of trauma-related continuing education per year.

The ACS Committee on Trauma has also developed a list of the activities that the trauma coordinator or program manager should perform:

  • Clinical
    • coordinate trauma care management across the continuum of care
    • plan and implement clinical protocols and practice management guidelines
    • monitor care of patients in hospital
    • serve as resource for clinical practice

  • Education
    • provide staff development in facility as well as in area or region
    • participate in case review
    • standardize practice guidelines
    • direct community trauma and prevention programs

  • Performance Improvement
    • monitor clinical outcomes
    • monitor systems issues related to quality of care delivery
    • develop quality filters, audits, and case reviews
    • identify trends and sentinel events
    • help outline remedial actions while maintaining confidentiality

  • Administration
    • maintain operational, personnel, and financial aspects of the trauma program as appropriate
    • serve as liaison between trauma staff and administration
    • represent trauma program on hospital committees or community boards to foster and enhance optimal trauma care provision and management

  • Supervision of Trauma Registry
    • collect, code, score, and develop processes for validating data
    • design registry to facilitate performance improvement, trend reports, and research while maintaining confidentiality

  • Consultant/Liaison
    • stabilize the complex network of people and disciplines who work together to provide quality trauma care
    • serve as internal resource for staff in all departments
    • act as extended liaison for Emergency Medical Services, the community, and nationally, if appropriate

  • Research
    • be involved in research selection and analysis
    • facilitate distribution of research findings
    • facilitate protocol design for accurate data collection, feedback, and analysis

  • Community/National Involvement
    • participate in the development of trauma care systems at all levels, from local to national

In the next column I'll introduce you to a nurse who loves her job as a trauma coordinator. In the meantime, you might want to check out a couple of web sites. The American Trauma Society web site (www.amtrauma.org) offers ATS professional education courses, including Trauma Coordinator Core and Advanced Courses, and beginning and advanced courses on trauma registry. The site provides links to a number of related sites. Or visit the Society of Trauma Nurses web site (www.traumanurses.org). This site lets you look at conference presentations, portions of their publication Journal of Trauma Nursing. You can also e-mail questions to regional trauma coordinators.

If you know of someone (including you!) who has a unique nursing career, please e-mail me at pcarroll@nurses.com. I want to provide you with information about the many variety of roles available to nurses. One of them might be just what you've been looking for.

Click here for more Career Corner.

Click here to subscribe to our free newsletter