Page 19 - QARANC Vol 14 No 11 2015

As part of the Emergency Care Specialist training, exposure to Major trauma is essential in order to fulfil the learning outcomes of the Major Trauma and Acutely unwell module. A four-week placement was arranged in the Emergency Department (ED) at St Mary’s Hospital for three specialist Emergency Nursing trainees (Cpl Horton, Parker and Wood). St Mary’s is a Major Trauma Centre and a vital part of the London-wide trauma system. It has a reputation as one of the busiest trauma centres in London and this was certainly borne out by the experience of the three QA’s who descended on the department in May 2015!
Although we were on different shifts, our experiences of the staff and department were very similar. We were each allocated a band 7 mentor whose shifts we mirrored and who helped us achieve our aims and objectives for the placement. On day one, our induction commenced with a Trauma Simulation where we were included straight away as part of the trauma team. This set the tone for the placement and characterised the ‘can do’ approach of the ED.
Our primary focus was major trauma and we were predominantly based in the Resuscitation (Resus) room of the ED; this was a 4-bedded bay, staffed by 2 nurses and a consultant Trauma Team Leader. From the first shift we were exposed to a wide range of significant traumatic injuries, including gunshot wounds, road traffic collisions with multiple fractures, multiple stab wounds and cardiac arrests. However, it wasn’t just trauma patients that we dealt with. St Mary’s does not routinely treat Stroke and Cardiology patients as they have their own specialist centres, so the acutely unwell patients we treated differed significantly different from that seen daily at our parent trust, including many severely septic patients, class A drug overdoses and the generally unwell with multiple co-morbidities.
Patient demographic seen around North West London was different to that in leafy Surrey and it was evident this impacted on the nature of injuries seen. Gang crime such as gunshot wounds and stabbings were a daily occurrence. We quickly became familiarised with the trauma protocol for these patients, including the referral process for the younger patients who were often believed to be affiliated to gangs. Such patients required liaison with a range external agencies such as the police, youth workers and drug liaison staff, helping increase our awareness of these issues.
The placement as a whole was an extremely positive learning experience that allowed us a significant amount of exposure to major trauma not seen day to day in our home
Cpl Parker, Horton and Wood outside the ED at St Mary’s Hospital.
Unit and gave us plenty to reflect on. This robust emergency department easily provided us with the essential training and knowledge that will not only help complete our academic module but also help prepare us for contingency operations as Emergency Nurses.
Cpl’s Parker, Wood and Horton: Specialist Emergency Nursing trainees
THE GAZETTE QARANC 17
Developing Essential Trauma
Skills: Secondment to St Mary’s
Hospital Emergency Department
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