A trauma nurse treats patients in the minutes, hours, and weeks following an accident, assault, or injury. They can work anywhere from ERs to ICUs to helicopters. A trauma nurse must have a solid knowledge of every body system because a traumatic injury can happen anywhere. Trauma nurses are required to have advanced certifications in resuscitation so they can work as an integral part of the team bringing people back from the brink of death or permanent injury.
Trauma nurses work well under pressure and can keep a cool head in the midst of chaos. This role can be exciting, demanding, and fulfilling all at once. People of all ages experience trauma. A trauma nurse could find themselves treating a two-year-old with a femur fracture one minute and working on a middle-aged man banged up from a motorcycle crash the next. Trauma nurses know how to treat the most dire medical situations and are experienced in many aspects of nursing.
Where Do Trauma Nurses Work?
Trauma nurses have some choices on where they work. The first most obvious setting might be the emergency room (ER). In the United States, hospitals are given a hospital trauma level ranking, from one to five. Level I trauma centers are open 24 hours a day, can offer every physician specialty, and can provide care from prevention to rehabilitation.
The trauma center rankings go down as hospitals are able to offer fewer specialties, and can’t keep their emergency departments (EDs) open all night. Trauma nurses can work at any of these facilities but may treat different types of injuries depending on their hospital’s trauma ranking.
ERs are not the only employment opportunities for trauma nurses. After ER staff stabilize a patient, they send them up to a trauma unit or an intensive care unit (ICU). Trauma nurses in these settings may not work with patients in the first hours after their injury event, but they perform an important role in their recovery.
Trauma nurses may also take to the sky as flight nurses. Like EMTs, flight trauma nurses serve as first responders to trauma sites in the field. If an injury cannot wait for an ambulance ride, a helicopter may be dispatched to pick them up and get them to a trauma center much more quickly. The trauma nurse on that helicopter will be able to treat the patient en route, ensuring a better outcome.
What Does a Trauma Nurse Do?
Because traumatic injury can occur anywhere in the body, a trauma nurse’s duties can vary widely. Depending on where they work, a trauma nurse may be asked to do more than a typical nurse. For example, trauma flight nurses can be trained to insert chest tubes and intubate patients, tasks normally performed by physicians. Typically, though, trauma nurses’ tasks look similar to any other nurse:
Administering medications
Collaborating with physicians, nurse practitioners, patients, and families
Coordinating care with other departments
Collecting laboratory samples of blood and other bodily fluids
Dressing changes
Emergency resuscitation
Head-to-toe assessment
Inserting and managing foley catheters
Keeping patients clean and comfortable
Managing central lines like ports and PICCs
Managing tracheostomies
Monitoring and taking vital signs
Patient and family education
Starting and accessing IVs
Transporting patients
Trauma nurses who work in the ER typically rotate between stations. In triage, they are the first to lay eyes on a new patient that walks into the waiting room. They take vital signs, perform an initial assessment, and decide how urgent their need is.
If an ER trauma nurse has a patient assignment, they will work with the health team to get labs, take the patient for imaging tests, continually assess the patient, and work with social workers as needed. A trauma nurse has to stay on their toes, as patients in the ER can deteriorate quickly.
ER trauma nurses can also be assigned to a trauma bay, which can have an entire team ready for fresh emergencies coming by ambulance. In a trauma bay, the nurse will assist the physicians, respiratory therapists, and other team members to stabilize patients.
A trauma nurse on a hospital unit or in an ICU will have a roster of patients for the day, from one to five, depending on the unit. They may need to perform dressing changes, reposition patients, manage pain, and monitor vital signs.
For a flight trauma nurse, a shift may look very quiet until they get a call. The helicopter EMS crew waits at the ready for an emergency to strike, then mobilize quickly to get to the site. On the way there, the trauma nurse may look over their supplies to make sure everything is ready for their patient. Once they arrive, they will help assess and stabilize the patient in the field, load the patient onto the helicopter, and keep them stable until they arrive at the hospital.
How Do I Become a Trauma Nurse?
Nursing school provides the first step to becoming a trauma nurse. Once a nurse graduates from an accredited nursing program with their Bachelor of Science in Nursing (BSN), they may apply to a trauma unit or emergency room as a new graduate. An experienced preceptor will take a graduate nurse (GN) under their wing, and teach them the ins and outs of trauma, whether they are in an ER or on a unit.
To practice independently, a GN must pass the state licensing exam: the NCLEX-RN. A series of multiple-choice questions, this standardized test proves a nurse’s clinical knowledge and capability to begin practicing on their own as a registered nurse (RN).
After passing the NCLEX, a new RN may need to complete more orientation or obtain additional certifications, like Advanced Cardiac Life Support (ACLS). Once they complete their orientation and certifications, they will be ready to take on their own trauma patients.
The ACLS certification takes CPR training up several notches. To become ACLS certified, a nurse must be able to manage a resuscitation, know which medications to give and when, prove excellent CPR technique, and demonstrate the ability to work quickly and efficiently in a team setting. Most hospitals provide this training onsite.
All the BCEN requires for examination is a current unrestricted RN license. They recommend two years of experience before taking the exam but don’t demand it. They use a voucher program for payment, so the cost can depend on the nurse’s current level of practice and membership.
Trauma nurses may brush up on their specialty through the Emergency Nurses Association (ENA). The ENA offers a trauma nursing core course if a nurse would like some review before obtaining certification. This course also does not require any experience: only an unencumbered RN license.
Trauma nurses may also pursue higher fields of education to become an acute care nurse practitioner (ACNP) or a doctor of nursing practice specializing in trauma. To become an ACNP, a nurse must obtain a Master of Science in Nursing degree. Once graduated, a nurse practitioner can choose between two board exams for the Acute Care Nurse Practitioner:
After an ACNP has passed their boards, they may practice in a trauma setting.
How Much Does a Trauma Nurse Make Per Year?
A trauma nurse makes the same amount as a registered nurse (RN), averaging $81,220 per year as of 2022, according to the US Bureau of Labor Statistics (BLS). This amount can vary depending on your work setting and the cost of living in the area. The low-end average was $61,250, and the high-end was $129,400. Depending on where you work, your employer may be able to offer higher or lower compensation:
Salaries also vary depending on which state a trauma nurse practices. The west coast generally pays nurses the best, but they also have a higher cost of living.
The west coast, New England states, Minnesota, and Alaska pay trauma nurses the highest wage, but the cost of living in these areas can also be high. The lowest paying states are in the Midwest and some southeastern states.
ACNPs can earn a higher salary, which closely matches the reported salaries of any other nurse practitioner role. The average annual salary of a nurse practitioner was $121,610, according to BLS data from 2022. The low-end average was $87,340, and the high-end was $165,240.
The location of employment can affect trauma nurse practitioners as well, with the differences closely aligning with RNs.
The top paying areas for trauma nurses and ACNPs include:
San Jose-Sunnyvale-Santa Clara, CA
San Francisco-Oakland-Hayward, CA
Napa, CA
Vallejo-Fairfield, CA
New York-Newark-Jersey City, NY-NJ
Yuba City, CA
Sacramento–Roseville–Arden-Arcade, CA
Certified trauma nurses can be paid more than a nurse who is not certified, depending on the facility. In general, the more experience and proof of expertise, the more a trauma nurse will be able to earn.
Are Trauma Nurses in High Demand?
Working in trauma can be exhilarating, but it can also take a toll. Some trauma nurses stick with it for life, but others need to move on. This turnover provides plenty of opportunities for nurses wanting to break into this field.
In general, all nurses in the United States are in high demand. According to the US Department of Health and Human Services, 24% of US hospitals have reported critical staffing shortages, and at least eight states have had to call in help from the military for staffing. Trauma nurses hold a wide array of skills and knowledge that will stay in high demand for many years.
Additional Resources About Becoming a Trauma Nurse
To learn more about becoming a trauma nurse, these additional resources may help:
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