Trauma nursing is a developing specialty.

Abstract

. The military developed the foundation. The White Paper (19%) identified the civilian need. Injury in America (1985) reaffirms the need. It is well documented that trauma the leading cause is of death for Americans between the ages of 1 and 44 years, and that it causes the loss of more working years of life than all forms of cancer and heart disease combined. It was reported in Injury in America’ that one of every eight hospital beds is occupied by an injured patient and injuries constitute one of our most expensive health problems, with an annual cost of $100 billion. Trauma nursing, now recognized as a nursing specialty, is aligned closely with emergency nursing, critical care, and rehabilitation nursing specialty groups. However, there is a specific body of knowledge for trauma nursing, which includes the human physiologic and phychologic responses to traumatic injury, the relationship of mechanism of injury to severity and types of injury, the complexity of the therapeutic regimen for the multiply injured patient, and the restoration of body functions. Trauma nursing requires integration of knowledge from many specialities, such as the effects of stress and adaptation on the course of illness, the body’s response to shock, and family theory. The need for a specific body of knowledge for trauma nursing was first recognized and documented in the landmark report, Accidental Death and Disability: The Neglected Disease of Modern Society.2 As stated in that publication, a major emergency facility “requires 24 hour staffing by highly competent medical and paramedical personnel trained in resuscitation and other lifesaving measures.” The special education and training needs for trauma nurses were recognized by Boyd and Cowley3 in their development of trauma care systems. Trauma nursing, like the trauma care system, needs to be viewed as a continuum with specific points along it. Trauma nursing begins with the nursing care given to victims immediately after an accident and continues throughout the trauma care continuum until the patient is functioning independently. Nurses from many different nursing specialties may participate in the care and each requires a holistic approach as the patient moves through the cycle of trauma care. Nurses working in prehospital care, emergency departments, operating rooms, postanesthesia care units, intensive care, medical-surgical units, and rehabilitation programs are all involved in some facet of trauma nursing. Trauma nurses recognized a need for information and a forum in which to address system-related issues of trauma nursing such as designation standards and nursing care standards. In 1983, they began organizing the Trauma Nurse Network (TNN) as a forum for information sharing. This group was successful in consensus building and developing a definition of trauma nursing, philosphy statement, standards for designation, and education standards.4, ’ The TNN is evolving into the Society of Trauma Nurses to foster the further development of trauma nursing as a subspecialty. The Society will promote coalition building among nurse specialty groups involved in trauma care in an effort to support federal and state legislation for trauma care, promote trauma nursing research, and further trauma nursing theory development. The TNN defines trauma nursing as follows: