A group of nurses in the Emergency Department at Iredell Memorial Hospital
have a problem to solve. They are gathered around a child who was hurt
in an automobile accident. The group has to determine how badly the child
was hurt and the best course of treatment – and they don’t
have time to waste.
In this case, the patient is a dummy and the ‘emergency’ is
a part of a training exercise, but the situation is one the staff at Iredell
Memorial has to be ready to face. That’s why Iredell Health System
offers the Trauma Nursing Core Course (TNCC) to its staff, a two-day intensive
program which presents true-to-life situations and teaches participants
the most current protocols for responding to a trauma.
Nine Iredell Memorial nurses received their TNCC certification after taking
the course in April, bringing the total of TNCC certified nurses in the
hospital to 25. Emergency Department Clinical Educator Shellie Bumgarner
calls the TNCC the “gold standard” of trauma education. She
taught the most recent course, along with John Duskey, a Clinical Educator
with Duke Health.
After a day of lectures, the participants get hands on training. They work
as a team to figure out how to help patients in a number of scenarios,
like an elderly person who fell and hit their head or someone who was
hurt in a dirt bike crash. Bumgarner explained how the training works.
“It’s a back and forth dialogue with the instructors,”
she said. “They have to actually be in the situation and verbalize
‘this is what I’m doing, this is what would be needed.’”
Bumgarner pointed out that the TNCC teaches nurses to focus on the patient
from head to toe and not just the most obvious injury.
“If your foot was turned completely in the opposite direction and
it looks really threatening, to get people to focus not solely on that,”
According to the training program, things like circulation and breathing
need to take priority.
The TNCC has evolved since it was first developed in the 1980s. The course
contains the latest research and best practices for trauma care. For example,
the latest version teaches nurses to look for uncontrolled bleeding first,
before they check problems with breathing. Emergency department nurses
at Iredell Memorial must renew their TNCC certification every four years.
Bumgarner said the knowledge gained from the TNCC helps nurses in stressful
and urgent situations.
“If you have a standardized way of doing things, it’s automatic,"
she said. "You may be birthing a baby one minute, but as soon a trauma
comes in, this training kicks in. It gets quick, efficient, knowledgeable
care in a trauma setting.”
PHOTO: Mary Lippard, RN at Iredell Memorial Hospital, assesses a practice patient
during a skills section of training that was part of a recent Trauma Nursing