Life in The Fast Lane BYy Diane M. Goodman, RN, MSN-C, CCRN, CNRN

Working Level I Trauma
It could be the snap of a bitterly cold January morning, or the flames from a horrifying Christmas morning fire. It could be the screams and shock of another school shooting that surprises a sleepy, rural community in anywhere USA. But suddenly, the glare and shriek of ambulance sirens awaken a community as they speed towards assistance, carrying two teenage boys whose only hope for survival might lie within the resources that are anxiously waiting for their arrival.
They’re in luck. The car versus truck motor vehicle accident (MVA) from which they were carefully extricated was within a few minutes from a Level I Trauma facility. Paul (name changed for privacy), totally unresponsive, was by far the worse of the two, but he was intubated at the scene. His brother was lucid but tremulous, unable to answer questions. Both required full assessment by a trauma service.
Trauma services are comprised of many specialties, dependent upon what level of Trauma rating the hospital has obtained. Trauma centers are identified in two fashions, by designation, or by verification. The different levels (I, II, III, IV, or V) refer to not only the kind of resources available in a hospital, but also the number of trauma patients seen per year. The standards are defined nationally and are unique to both Adult and Pediatric facilities.1
A Trauma Center designation is done at the state or municipal level and lasts three years. These designations are evaluated and performed by the American College of Surgeons and meet regional needs as well as regulatory authority. They may vary from state to state, but Performance Improvement is included as well as a commitment to improving overall trauma care and outcomes.
The team waiting for Paul and his brother’s arrival was topnotch. Of the 190 Level I Trauma Centers across the nation, they arrived at one of the best. (It is not a coincidence that within the Nation’s Top Hospitals, several premiere institutions are Level I Trauma Providers). Although Paul had significant facial lacerations and suspected rib fractures, it was his head injury that required the most immediate attention.3,6
Closed head injuries from MVA’s can be frighteningly devastating, depending upon the amount of damage. Being at a Level I Trauma center meant that both Neurology and Neurosurgery were readily available should Paul need intervention for elevated intracranial pressure or bleeding. Additionally, Plastic surgeons would be available for repair of his facial wounds once surgery was determined to be appropriate. Oral and maxillofacial surgeons could be consulted if needed. As Paul was being assessed and examined, around the clock care (by both Trauma Nurses and experts in Critical Care) was being provided, so prevention of future complications could be avoided at every opportunity.
But what of Paul’s younger brother? Had he (amazingly) walked away from a motor vehicle crash that might have killed him?
Yes, he did! But, overcome with guilt, he peppered the nurse with questions as he waited for Paul to open his eyes. What, he wanted to know, was the difference between a “regular” Emergency Room RN and a Trauma Nurse? Good question, the team answered, but no, it wasn’t as simple as attending a seminar. It was a lot of training. A Trauma Nurse must be prepared for whatever could come through the door, which might include burns, hypothermic drowning victims, gunshot wounds, MVA’s, falls, industrial accidents, acts of terrorism, natural disasters, even suspected cases of emotional or physical abuse.2
Emergency Room nurses typically work with patients who arrive in stable condition and are prioritized based on condition, although that is a generalization that often doesn’t occur. Anyone who has spent five minutes working in an ER knows it only takes that length of time for a stable, coherent patient to walk in and collapse into full cardiopulmonary arrest. But in general, the ER nurse cares for patients who arrive with an “illness or sickness” and the Trauma Nurse will work closely with the “Trauma Center to care for patients who are brought in by ambulance” from MVA’s and/or have more serious injuries requiring advanced interdisciplinary assessment and support.
Trauma Nurses, while having increased responsibility for dealing with severely ill patients entering the Emergency Room, also have an immense amount of respect for their field of expertise. In fact, by the year 2024, Trauma Nursing as a specialty is expected to grow as much as 16%, a larger increase than many specialty areas in nursing. The requirements for this specialty are steep. Not only does the Trauma Nurse come from a variety of backgrounds, from vocational nurse to Nurse Practitioner, but they must also be current in ACLS, BLS, and depending upon the institution, possibly PALS.10
There is a great deal of overlap between Emergency care and Trauma Nurse certification, consequently many institutions require emergency medical training (internship) of their Trauma Nurses. Trauma Nurses, once certified, may work in a variety of areas within the institution, including the ICU, the OR, Step-down Units, with the Trauma Team, or rounding on patients throughout. The actual Trauma Nursing Core Course (TNCC) is a two-day certification program. It provides hands-on didactic classroom learning, with a certification that is valid for four years. There is an equivalent course (ENPC) for Pediatrics: The Emergency Nursing Pediatric Course. Pediatric certification is also valid for four years.
But, before the Emergency Room nurses could explain to Paul’s brother that there was an additional National certification for Trauma Nurses, Paul began to deteriorate, and all conversation ceased…
The interdisciplinary team rushed to Paul’s bedside. His limbs had begun a spastic shaking as his BP began to spike and then plummet erratically. He had no nuchal rigidity, but an ICP sensor was indicated for monitoring. The neurologist and neurosurgeon consulted on the risks/benefits of surgery if bleeding should occur. They decided to wait and keep the patient on multiple infusions. Diffuse axonal injury was suspected. The family was updated and reassured. Paul was young, and he was in the best of hands.
So, what about the other Trauma Certification, his brother wanted to know? (He seemed intent on keeping anxiety at bay by learning as much as he could about the hospital environment, to the nurses’ wry amusement). Could any nurse decide to take the exam? Well, yes, they could if they had at least 1,000 hours of practice with trauma patients (direct and indirect patient care) and an active unrestricted RN license, as well as 20-30 hours of trauma-specific coursework. A BSN would not be required to sit for the exam. This Certification was called the Trauma Certified Registered Nurse (TCRN) and once achieved, is also valid for four years.
Going forward, the nurses stayed on their toes with this complex case, because Paul’s brother and family not only continued to ask as many questions as possible, they also kept a bedside notebook and media page (which they updated every day Paul remained in the hospital!). The nurses never knew when their trauma facts might be displayed on social media, or if their knowledge of brain recovery might be tested and subsequently stored as family memorabilia!
As luck would have it, although Paul was eventually diagnosed with Grade III Diffuse Axonal Injury (DAI) to his brain, he finally made it home and is continuing therapy for gait and muscle strengthening, exactly 13 months after his initial injury. As neuro nurses would realize, Grade III is the most severe form of DAI, and functional recovery is not always possible.4 Because Paul was treated at a Level I Trauma Center, where his brain injury could immediately be assessed, diagnosed, and stabilized by an interdisciplinary team of experts committed to continually improving Trauma outcomes, he is home, working towards recovery.

That’s life in the fast lane. The stress is relentless, the rewards limitless.

Should you give it a try?
“Extended Anatomical Grading in Diffuse Axonal Injury Using MRI: Hemorrhagic Lesions in the Substantia Nigra and Mesenthalic Tegmentum Indicate Poor Long-Term Outcome”, Sami, A, Niklas, M., (…), and Per Enblad, Journal of Neurotrauma, available
“How is an Emergency room nurse and a Trauma nurse different?” (Emergency Nurse Association/ENA).
“National Inventory of Hospital Trauma Centers”, JAMA Network, Original contribution March 26th, 2003,
Trauma Levels Explained: “designation versus verification”. (American Trauma Society/ATS).
“U.S. News Announces 2018-19 Best Hospitals”, August 14th, 2018,
“What is a Trauma Nurse?”, Information on Certification, TCRN, ENPC, TCRN, registered
Source: Nursing.Advanceweb

West African College of Nursing Call for Abstracts 2019

West African College of Nursing 15th Biennial General Meeting, 24th Scientific Session and 38th Council Meeting, March, 2019 – Freetown, Sierra Leone

The West African College of Nursing (WACN) will hold its 15th Biennial General Meeting, 24th Scientific Session and 38th Council meeting in March 2019 in Freetown, Sierra Leone. The international programme will offer nurses, midwives, other healthcare professionals and the general public an opportunity to come together to discuss community and health workforce responses to current health issues.

The WACN cordially invites submission of abstracts that explore the theme and sub-themes for the programme in the area of nursing and midwifery research, education and practice; community health, and other relevant health domains to be considered for presentation at the 2019 scientific session. Papers may be presented in the symposium, oral/podium, or poster sessions.

The Sierra Leone Chapter of the West African College of Nursing will be hosting the 15th Biennial General Meeting and 24th Scientific sessions in March 2019 with the theme as “Health service Partnership’’: The Role of Nurse and Midwife in Building Global Health Security”.

THEME FOR WACN BGM 2019: “Health service Partnership: The Role of Nurses and Midwives in Building Global Health Security.”


1. Overview of Health Service Partnership

2. Inter-professional Global Health Competencies

3. Interconnectedness of health professions (e.g. medicine, public health, nursing)

4. Interconnectedness of global health systems, including structural inequities

5. Trends in Global Health Security

6. Cross-cultural communication

7. National Policies on Nursing/Midwifery in Global Health Security

8. Strategies for reduction/eradication of epidemic /pandemic through Health Service Partnership

9. Capacity building of Nurses/Midwives in Epidemic /pandemic preparedness, response and resilience to minimize vulnerability of the population.

10. Investing in Midwives Programmes: The Sierra Leone Situation

Submission Details

Deadline for submission of abstracts is 2PM on 7th December Friday, 2019.

No extension will be granted. Late submissions will not be considered.

All abstracts, font Arial 12, not exceeding 300 words, should be submitted as attachment in word document and sent to the following.

WACN’s online abstract submission site:

Dr. Joan H. Shepherd

Executive Secretary, WACN: /

The author’s name, qualifications, email and address should be written in Arial 10.

All authors with accepted abstracts MUST register for the programme before 30th January, 2019.

For abstracts with multiple authors, the presenting author’s name should be highlighted.

Multiple author abstracts will only be accepted if at least one of the authors is registered and present at the conference.

Abstract Selection and Notification

The Programme Committee will meet mid-December 2019 to peer review and select abstracts that meet the requirements. Selected abstracts shall be confirmed by email. For each accepted symposium, oral/podium, and poster abstract, the Programme Committee will assign the time and date of presentation on the conference schedule. The Committee reserves the right to accept abstracts as symposium, oral/podium or poster presentations. The presentation schedule will be available to presenters via email by January 15th, 2019.

Only the presenting authors will be communicated.

Conference Registration


Any substituting author, other than the primary author must register for the conference and pay the applicable fee.

The 15th BGM, 24rd Scientific Session and 39th Council meeting registration form will be available on WACN’s website ( by November 12th, 2018. All other information regarding the programme, including the schedule will be available on the website in due course.


Oral/Podium: Each abstract for oral/podium session is allotted 10 minutes for presentation, with 5 minutes for audience questions. Oral/podium presenters are expected to attend the entire session in which their paper is featured.


ABSTRACT SUBMISSION OPENS 2PM on 7th December Friday, 2018. Click here to access the 2018 online abstract submission forms.


Exhibitors are also invited and should contact the Executive Secretary by email on and Chairman WACN Sierra Leone for discussion and registration.

NOUN Admission Requirement For Nursing Programme

I am excited that you are interested in pursuing a Nursing degree at National Open University Of Nigeria NOUN. Nursing is a discipline, a profession, and a service.

This article is basically all about the requirements for admission into Nursing schools in NOUN. I realize that many students who are aspiring to pursue a career in Nursing lack the general knowledge about the nursing career, NOUN nursing programme, admission requirements and how to enroll to study nursing in NOUN.

What Is Nursing?

Nursing is a profession within the health care sector that focus on the care of individuals, families and communities. As we all know, the ratio of nurses to patients in Nigeria is very low compare to other advanced countries. Hence, the rush for the services of nurses in Nigeria.

What do nurses do? They save lives, prevent complications and prevent sufferings of patients. Just like Doctors, nurses are indispensable sets of people we can not do without.

Admission Requirements For Nursing Programme in NOUN

NOUN nursing programme is an accredited program, so you don’t need to worry about completing your nursing program at the university. Your degree award is safe and secured.

NOUN offered admission into nursing programme without JAMB, in other words, you don’t need to pass or sit for jamb before you can apply.

Admission Requirements

1. Admission is available for 100 Level only.

2. A minimum of 5 credits in O’ levels.

3. Compulsory courses required in O’levels are Mathematics, English Language, Biology, Chemistry and Physics.

4. Registered Nurse Licence/Certificate is required.

5. Duration of study: Five (5) Calendar years with one year internship in a recognized health care institution.

6. Registration obtained: Registered Nurse (RN), Registered Midwife (RM), Registered Public Health Nurse (RPHN) and Registered Psychiatric Nurse (RPN).

7. Academic qualification: Bachelor of Nursing Science Degree (

Special Admission Consideration(s)

Recruitment of Medical Officers into the Ghana Health Service 2019

The Ghana Health Service wishes to inform the general public, particularly, newly qualified Medical Officers that it will commence recruitment process on *Monday, 14th January, 2019*.

Medical Officers who are part of the group whose financial clearance has been received and intend to work in the various health facilities under the service are kindly requested to formally apply online by logging onto the *_GHS online application portal_* and follow relevant instructions.

The online portal system comes with instructions as to what applicants are supposed to do at any point.

Other health professionals including Nurse Assistant Preventives and Nurse Assistant Clinicians who completed in 2016 and have been given financial clearance will be given update on their recruitment process to the service this month.

For further enquiries kindly contact :
*By :
*The Public Relations Unit*
*Ghana Health Service*

Tytana’s Manila Doctors College of Nursing to hold 12th Research Congress 2019

A grand academic gathering for nursing research is once again happening this February 2019 as Tytana’s Manila Doctors College of Nursing (MDCON) will hold its 12th Reseach Congress.

With the theme “HEALTH AND WELLNESS FOR ALL: NURSING RESEARCH AND THE UNIVERSAL HEALTH CARE”, 12th MDCONRC will happen on February 22, 2019, FRIDAY, 8AM–5PM, at the GT Foundation Auditorium, 7th Floor, Doña Tytana Tower, Manila Tytana Colleges, Pres. Diosdado Macapagal Blvd., Pasay City, Philippines.

The MDCONRC intends to continue its advocacy of promoting excellence in nursing research by featuring student and professional nursing research studies from different colleges, universities, hospitals and medical centers nationwide to showcase how nursing research has strengthen its position in support of evidence-based practice.

The congress activities include keynote speeches from distinguished research experts, plenary sessions, and concurrent oral and poster research presentations. The congress will recognize the best research studies and posters refereed by local and international research luminaries; thus, we invite your students or your staff to send their research studies for an opportunity to present their papers and be involved in an engaging academic exchange of knowledge and ideas.

Should you need further information, you may visit the 12th MDCONRC webpage at and Facebook page,, or you may contact us through mobile 0933-8164749, landline (02) 859-0812 or 75, or email

The Manila Doctors College of Nursing (MDCON) has unceasingly promoted the value and importance of research in nursing through its annual Research Congress (MDCONRC). The Research Congress intends to continue this advocacy of promoting excellence in nursing research by featuring student and professional nursing research studies from different academic and healthcare institutions all over the country so as to express the progress of the science and practice of nursing through innovative evidence-based discourse in research.

Last year, the MDCONRC hosted over 500 nursing students and professionals from more than 30 nursing colleges and 20 medical institutions nationwide, featured keynote and plenary speakers, and recognized best papers refereed by local and international nursing experts. This grand academic gathering aims to further inspire nursing students and professionals to be involved in nursing research as research knowledge helps them become excellent nursing professionals.


The 12th Manila Doctors College of Nursing Research Congress aims to:

1. Provide a venue for student and professional nurses to exhibit their research expertise among their peers through various research studies;
2. Describe the role of nurses and nursing research in the realization of the universal health care and health for all;
3. Emphasize the need for evidence-based strategies to achieve health for all, development of leadership capabilities to strengthen delivery of services and establish nursing research as a contribution to health policy-making;
4. Enhance competencies in the conduct of research in pursuit of nursing care excellence towards improved healthcare outcomes, client satisfaction, quality measurement, and administrative management; and
5. Promote collaborative nursing opportunities through strong linkages and networks.


Participants Registration Fees
Early-bird (until January 25, 2019) On-site(February 22, 2019)
Students Php 600.00 Php 700.00
Professionals Php 700.00 Php 800.00

• For EARLY-BIRD REGISTRATION, payments may be deposited to the following Metrobank Account in any Metrobank Branch:

o Account Name: Manila Tytana Colleges, Inc.
o Metrobank Branch: Metropolitan Park, Pasay City
o Account No.: 715-3-71513337-8

• After payment, early-bird participants are required to send the scanned or photographed copy of the machine validated DEPOSIT SLIPS to The name/s and school affiliation must be included in the email.

• Early-bird participants must register online by visiting the congress official website:


The 12th MDCONRC will showcase research posters and oral presentations and recognize the best research papers refereed by local and international nursing research experts. Only abstracts who meet the set guidelines shall be considered.

• Participants may submit research papers for poster and oral presentation via electronic mail to:
• There is no limit to the submission of entries per school.
• Abstracts should be based on any of the following nursing fields:
o Nursing Practice
o Nursing Education
o Nursing Administration
o Community Health

• A 400-WORD ABSTRACT is required to be submitted with the following information and headings:
a. Title
b. Author/s
c. School/Hospital Affiliation
d. Introduction | Objective and Purpose of the Study
e. Methods | Design, Sampling Technique, Statistical Treatment, Ethical Considerations, and Data Gathering Overview
f. Results and Findings
g. Conclusions | Summary of recommendations

• The deadline for the submission of research abstracts is on JANUARY 25, 2019.
• Participants for Oral Presentation and Poster Presentation will be notified on or before FEBRUARY 1, 2019.

• The BEST RESEARCH POSTERS, BEST RESEARCH PAPERS, and BEST ORAL PRESENTERS will be recognized during the awarding ceremony of the Congress.

2019 PNA Seminars with CPD Credit Point

Philippine Nurses Association (PNA), the accredited professional organization of registered nurses in the country, has released the schedule of their seminars this 2019. The initial offerings run from January to March.

Professional Regulation Commission (PRC) recognizes PNA as an accredited provider of Continuing Professional Development (CPD) programs for nurses. The recently implemented Republic Act 10912 or the Continuing Professional Development Act of 2016 requires all regulated professionals, including nurses, to comply with CPD unit requirements for renewal of their Professional Identification Cards (PIC).

Nurses need 15 units of CPD a year, or 45 CPD units in the 3-year renewal period. (Note: PRC exercises maximum flexibility in implementing the requirement by allowing renewal without full CPD compliance provided professionals sign affidavit of undertaking.)

If you want to enhance or update your nursing knowledge and skills and start collecting units, here’s the PNA CPD Seminars schedule for 2019:

January 18 – COPD Management: A Team Approach
January 25 – Evidence-based Nursing: Competencies, Challenges and Directions
February 1 – Coronary Artery Disease (CAD): Implications to Care
February 8 – Understanding the World of Research and its Uptake on the Local and Global Trend
February 15 – OB Bonanza! Updates in Obstetric and Gynecologic Nursing Care
February 22 – Performance Improvement: Strategies that will make a difference in the way people perform
March 1 – Clinical Pathway: Roadmap to effective patient care
March 8 – An Introduction to Qualitative Research for Nurses
March 15 – Glimpses of Legal Aspects in Nursing Practice
March 22 – Improving Healthcare using DMAIC Approach
March 29 – Recovery and Self Management: Navigating Support in Patients wit Type 2 Diabetes

Venue: PNA-AGT Auditorium, Phil. Nurses Association, 1663 F.T Benitez St., Malate, Manila
Time: 8:00 AM — 12:00 NN

All seminars have been applied for Continuing Professional Development (CPD) units to Professional Regulation Commission – CPD Council.

(NO refund / NO chanqe of seminars)
• PNA Member P 400.00
• PNA Non Member P 800.00
– 1st 10 Registered Participants 30% Discount P280.00
– 2nd 10 Registered Participants 15% Discount P340.00
– For Every Three (3) attended PAID seminars 1 Free Seminar
– Renewal of PNA Membership 1 Free Seminar

INCLUSION: Certificate and Snacks

For further inquiries and confirmation, please contact Ms. Sherell Tabafunda at Tel. nos. 5210937 & 4004430 loc. 205. or Cell # 09286605503.

Note: Scheduled seminars are subject to changes with prior notice. It is advisable to call/verify at least a day prior to the conduct of the chosen seminar.

Mulago School of Nursing and Midwifery 2019/2020 Palliative Care Admission Form

Mulago School of Nursing and Midwifery is currently accepting applications for admission into it 2019/2020 Palliative Care nursing program. Below is the application details

The Transition From Student To A Registered Nurse By Linus Paul RN

The transition from student nurse to Registered nurse can be fraught with many emotions. Not only happiness and excitement, but also fear, anxiety and uncertainty. It can be a time when new gradNurses are questioning everything from their ability, to whether they made the right career choice, and whether they will ever be like the nurses they are now working with on their new ward.

This transition period is often described by people as a complete reality shock, and let’s face it, apart from nursing not many other occupations come with the added chance that you can severely hurt or kill another human being. But fear not! Every nurse, at one point or another, has experienced these feelings.

It is common for new nurses to feel insecure and unsure about their ability to be a registered nurse, and there is a multitude of issues that may arise, which only serve to add to these feelings of insecurity.

“Issues Faced by New Nurses”
Some of the common issues that occur during this transition period from student nurse to registered nurse include:
Theory-to-practice gaps
Caring for increasingly complex patients with multiple comorbidities
Time management
Medicines administration
Patient assessment skills
Documentation skills
Limited proficiency in managing and executing technical skills
Working and collaborating within teams
Developing competency in planning and organising
Prioritising and coping with unexpected events
Lack of access to experienced mentors and coaches
Performance anxiety

“Benefits Registered Nurses Bring to the Ward”
It is also important to acknowledge that during this transition period, graduate nurses will also bring many benefits to the workforce.
Research has found that new nursing graduates often had considerable strengths in the following areas:
Communication skills with the patients
Psychosocial assessment skills
Accountability for their own practice
They are very aware of the importance of their role as a professional, registered nurse and uphold their professional values accordingly.

New nurses display an awareness of the different roles a nurse must play, such as being a teacher, a provider of care, a communicator, an advocate, a coordinator, a decision-maker, and also, being able to suggest changes in practice.

Points for a Positive Transition:
Some other strategies and factors that have been found to facilitate a positive transition from student nurse to registered nurse include:

Adequate staffing patterns
Open communication
Good administration
Leaders who are approachable and responsive
Support when dealing with deteriorating patients, death and dying
Orientation programs with realistic goals
Timely provision of constructive feedback
Appropriate guidance from senior staff
Continuing staff development opportunities
The availability of support and counselling for staff
Reduction of stress levels in the new graduate by using personal strategies such as exercise or meditation.
Any graduate or newly registered nurses are experiencing difficulties during their transition period, it is important that they seek help from SERVCOM

Source: (Chang & Daly 2012; Hofler & Thomas 2016; Kaihlanen et al. 2013).

Compiled by:

Coaching and Mentoring of intern nurses, Nursing and Midwifery Students on Clinical Posting on the Wards.

Actually I am very happy with this circular and hope that henceforth, coaching/mentoring of nursing and midwifery students is the province of NURSE CLINICIANS. I was a student at both Basic and BNSc level and I have a lot to say about Nurse-student relationship.

As a nurse clinician, the undermentioned are my suggestions for you:

1. Respect:
Respect is reciprocal. You have to respect the students; address them by their name (s). Some nurse clinicians are in the habit of addressing their student by his/her courses like BNSc student, Midwifery student, ENT student, intern nurse etc instead by his/her name. If they misbehave, you should never harass or shout at them in front of patients, coworkers etc.

2. Knowledge:
As a nurse clinician you must be knowledgeable enough of a competent teacher. You must know how to translate theoretical aspect of nursing into practice (praxis). You must keep abreast of the latest developments in nursing and be ready for unexpected question (s) from your students.

3. Neatness:
Always appear neat and package yourself elegantly.

4. Be an exceptional nurse:
It is common norm that regardless of your program of study (BNSc, Basic or post-basic), students are just posted to the wards to assist nurse clinicians in carrying out their monotonous tasks/duties such as serving of medication, dressing, taking of Vital signs, conducting deliveries etc. So always be different teach your students something new such as Evidence-based Nursing practice. Engage them in discussion, assignments, seminar presentations, researches etc.

5. Don’t bully them:
Student nurses are nurses in the making so take them as your colleagues and also take yourself as one among equal.
An injury to student nurse is an injury to all nurses. I envy the way our nursing managers respect medical students during their clinical/Exams postings in our hospital wards and I always expect them to extend same to nursing students.

There is need for attitudinal changes toward Nurse-Student relationship in our hospitals.

Part two (STUDENT side) and part 3 ( NMCN/GOVT side) coming soon.

Thank you.

By Ismail Gwarzo RN