Trauma Response Team: Interview with Mayra Osuna, RN, BSN, TCRN
Providing medical treatment and crucial outreach services
Where are you employed?
I am employed by St. Francis Medical Center in Lynwood as a trauma nurse clinician. We are a Level II trauma center and a South Los Angeles trauma recovery center, serving the communities of Southeast Los Angeles. Our motto is very simple: “Every patient, every time.”
Please tell us a little about your career path as a nurse.
I’ve been a nurse for 10 years and I’ve always worked for St. Francis Medical Center. I spent the first five years on a medical/surgical floor that specializes in trauma, surgical and orthopedic patients. An opening on the trauma team arose and I jumped at the opportunity.
Tell us about the trauma response team.
The trauma response team manages trauma patients from the moment they enter the emergency department doors until they are discharged from the hospital. Our patients, who are victims of intentional or unintentional trauma, present to us in a myriad of ways. As a trauma center, we have a unique, unmatched opportunity to participate in the lives of our patients. We have challenged ourselves to meet that moment with clinical expertise and compassion.
If a trauma patient signs on to our trauma recovery center program, they will be connected not only with a nurse clinician like myself, but also with an outreach liaison who can provide other crucial services. As a trauma nurse clinician, I not only aid in the treatment and recovery from the physical effects of trauma — I am a staunch believer that our social responsibility extends beyond the walls of our institution.
What crucial outreach services are provided?
In collaboration with our partners at Southern California Crossroads, we provide professional and personal services that help individuals and their families recover from the devastating effects that trauma can have on one’s life. This includes counseling, links to shelters and job placement services if a person has lost employment due to injuries. We also provide tattoo removal, resume assistance, and opportunities to learn marketable skills in many technical trade areas. Our goal is to help our patients find their new normal and return to their lives in the fullest capacity possible.
What is your initial point of contact with the patient?
We first see the patient in the hospital ER. This presents the best teachable moment for our patients. They were just seriously injured, maybe shot or stabbed, but we can take the opportunity to engage with them and offer them a way out of their situation. We of course want them to heal physically, but in our model of care, there’s so much more to it than that.
What was the process to become a certified trauma nurse?
When I first started on the trauma response team, I was in the middle of the TNCC certification process. I came onboard the team and then pursued and achieved ATCN (advanced trauma nurse certification). The ATCN courses for nurses are taught alongside the M.D.s (who earn advanced trauma life support certification), but the labs are different. As I continued to work in trauma, I knew that this was where my heart was and that I could make a difference in the community. Once that became clear, I also pursued and earned my TCRN (trauma certified registered nurse) certification.
What do you do from day to day?
From day to day, I come in and review the patient census with several other clinicians on the team. We round on every single trauma patient with the physicians, whether they’re in the ICU, on the medical floor or elsewhere. When one physician on our service signs off to another, we’re present for that transition in order to assure continuity of care.
Throughout the day, if a trauma is called in, our team is activated. We respond immediately by going down to the ER to await the patient. When the patient arrives, there’s an entire team waiting to get them physically stabilized. If they’re intubated, the outreach liaison from Southern California Crossroads makes contact with them when they’ve been extubated and are able to speak.
We examine patients closely to see if the injuries match up with the story. We notice if the stories don’t match or if the domestic partner is unwilling to leave the room during patient interviews. These are hints that something is going on. We participate in intimate partner violence program monthly meetings, which are under the auspices of L.A. County. We also take part in a review committee that makes us aware of current community situations.
We also work with victims of sex trafficking in partnership with an organization known as Journey Out. They help us to identify women who are being trafficked. These women usually come to the ER as their first point of contact with the healthcare system. This is our opportunity to intervene and break the cycle of the trafficking and exploitation of women.
An important part of what we provide is preventative care. We provide helmet safety education in the local schools. Most people in our community don’t wear helmets, so we see a lot of auto/bike head injuries. Through a partnership with a helmet company, we are able to provide our community with helmets, free of charge. We then educate the public and provide properly fitted helmets and bike safety education.
Do you have concerns working with gang members?
We’re in the middle of South Central, Watts, Lynwood and other communities impacted by gangs. The Crossroads team will let us know if there’s a gang member in the hospital and if there is talk on the street about retribution. We have to be on our toes and stay in close contact with our partner organizations. Without their knowledge, we wouldn’t know what was happening on the street.
Along with Crossroads, we hold a gang violence prevention conference every year. More than 300 people come, from a variety of professional disciplines. Clinicians and others attend from Guatemala, Mexico and other Latin American countries in order to learn, share and collaborate. Prevention is key.
Trauma is preventable when we can reach our community members in meaningful ways.
What’s next for you in terms of your nursing education?
I’m actually in school now. I’m attending Walden University in order to become an acute care nurse practitioner. As an NP, I want to continue to work in trauma and the ICU. Once I’m done with the NP track, my next goal is to begin RNFA (registered nurse first assist) certification. Being a RNFA would extend my role as a trauma nurse clinician to first assistant to the trauma surgeon.
I like to learn; I always want to be moving forward in my nursing career. Eventually, I’d love to become a doctor of nursing practice (DNP).
How do you work with physicians and surgeons now?
In the acute care setting, NPs work with a supervising M.D., who guides their patient care. After demonstrating specific competencies, and in conjunction with the supervising physician’s instructions, NPs can perform certain procedures and order tests and labs.
As an NP, I will be able to be actively involved in both primary and secondary procedures in the care of trauma patients — taking into consideration the scope of practice set by the state board of nursing and the facility’s policies, of course.
How do your personal and professional lives intersect?
I have two kids: a 16-year-old daughter and an 8-year-old son. My daughter understands what I do and that I work very hard. She understands the value of hard work and education. My son understands that I help people and I’m happy with that.
I was born in East L.A. and grew up in Paramount. I can relate to the youth here; this is why being in this community is so important to me. We’re getting involved with girls in junior high. We go into the community and work with these girls to inspire and empower them. We want them to see positive female role models out in the world, showing them examples of the possibilities that are open to them. I can honestly look at them and say, “I grew up like you.”
No matter what type of nursing you do, you need to keep going forward and striving for more. Do your best and give everything you have and someone will appreciate you.
How do you care for yourself in the midst of such intense work?
Trauma is very emotionally intense. You have to be ready to deal with the entire family, not just the patient. However, it’s very fulfilling. My patients come in at their most vulnerable moments and I watch them go home so much healthier and recovered from a significant life event. This is why I do what I do.
Some cases bring me to tears. We see some very hard stuff, but once I get home, that’s it. I spend time with the kids; go to the park; catch a movie; and spend quality time together, talking and laughing. Every now and then, Mommy gets to have a massage. That’s when I can really hit “reset.” Every day I come to work, I don’t know what to expect, but I always feel fulfilled at the end of each shift.
I make a difference in our community, which otherwise might be forgotten or overlooked. It is important to me that everyone — elderly; young teen; or victims of violence, crime or domestic assault — receives the best care possible.
Keith Carlson, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.
This article is from workingnurse.com.