Trauma centers and emergency rooms across the country respond every day to serious, life-threatening emergencies affecting people of all ages and of all walks of life. Trauma nurses, or critical care nurses, are the specialty nurses found in these centers. Nurses in this field work not only in trauma centers, but also in hospital transport settings – on medical helicopters, planes, and occasionally in ambulances, caring for those patients with immediate, critical needs that require more than the first aid a paramedic is qualified to give.

Understanding Trauma Centers

While some nurses in trauma care work in transport settings, most work in trauma centers. Trauma centers differ by the types of patients they are qualified to handle. Hospitals are designated as Level 1 to Level 4 trauma centers by the American College of Surgeons based on how qualified they are to handle major trauma. Level 4 trauma centers deal with the least severe emergencies, while Level 1 trauma centers deal with the most critical cases. Because trauma centers are difficult and expensive to operate, not all states have a Level 1 trauma center, so patients are often flown in to the larger regional centers from neighboring states. In Seattle, for example, the Level 1 trauma center of Harborview Medical Center serves the states of Washington, Idaho, Montana, and Alaska. This should be considered when considering whether or not to pursue a career in trauma nursing -- where these jobs can be found may be a major consideration.

The Role of Trauma Nurses

Who comes into the trauma center? Everyone. Heart attack and stroke victims, car accident victims, people experiencing asthma attacks and symptoms of accidental poisoning, children who have been severely abused, people in fires, people in work related accidents, old people, young people, men, women, infants, and toddlers – the emergency room nurse sees it all.

Trauma nurses have to be quick on their feet, able to make split second decisions about health care for a patient that could make the difference between life and death. Therefore, although the field of trauma nursing is very rewarding, it’s not for everyone, as stress levels can be very high and nurses in this field come to accept a higher rate of mortality for their patients than in other nursing specialties.

Trauma center nurses care for patients during the admission process, they assist surgeons getting patients in and out of the OR, and they care for patients with serious injuries and life-threatening conditions after admission.

Becoming a Trauma Nurse

Trauma nurses are registered nurses (RNs) with a two year associate’s degree or four year bachelor’s degree in nursing who have also completed additional courses to become a trauma care nurse. Some nurses working in this field are nurse practitioners, or nurses with master’s degrees and a great deal of experience. Many hospitals who hire new nurses require the nurses to go through a residency program to train them to their hospital’s specifications. In addition, virtually all trauma centers require that trauma nurses must be CPR certified, and many also require both PALS certification (pediatric advanced life support) and ACLS certification (advanced cardiac life support).

The Emergency Nurses Association (ENA) developed Trauma Nursing Core Courses, or TNCC. The philosophy behind TNCC is to provide a systematic, standardized action plan for nurses working in trauma centers, so that there is not a great variation in trauma care practices from state to state. Both universities with nursing programs and hospitals with trauma centers offer training to nurses in the TNCC. Once nurses pass these core courses, they are eligible to work in a trauma center. TNCC is a sixteen hour, two day course; for members of the ENA the course is generally $300, and for non-members $350. The ENA frequently offers these courses within hospital settings for existing nurses.

Also, the American Association of Critical Care Nurses (AACCN) offers its own credentialing program for critical care / emergency room nurses. Like other nurse certifications offered by nursing associations, the certification is not necessary but shows a higher level of commitment to and education within the field of trauma nursing.

Job Prospects for Trauma Nurses

There is a national shortage of registered nurses in all fields, and it is no different in the field of trauma nursing. However, trauma nurses who have completed the TNCC coursework still fall within the lower brackets of the pay scale compared to RNs working in other fields. It is not unusual for these nurses to earn between $27 to $37 (for highly educated and experienced nurses) in this field. By comparison, RNs in other specialties can earn as much as $50 per hour.

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