Trauma care challenges the boundaries between professions
The article by Dean Whiting and me on blunt abdominal trauma, published in the March 2015 issue of Emergency Nurse, was written to provide further insight into the skills and knowledge required, as well as better understanding of the issues and problems surrounding trauma.
When I began my nursing journey, emergency nurse practitioners didn’t exist, nurses didn’t prescribe, lead resuscitation or trauma teams, undertake primary survey, take electrocardiographs, take blood or even cannulate patients: skills and roles that are taken for granted in many of our emergency departments (EDs) today.
Since then, nurses in EDs throughout the UK have adapted their skills to meet the needs of patients and to provide high quality care. In doing so, they have continued to blur and reshape role boundaries.
I had an article published in Emergency Nurse back in 1998, which advocated this shift in roles as well as detailing the process involved in undertaking an abdominal assessment, and again with colleagues in 2004, when we explored cranial nerve damage and assessment in the ED and advocated the need for ED nurses to embrace and develop this level of assessment skill further.
We now have a national situation in which there is a crisis in medical cover in our departments and ED nurses are clearly well placed to fill this gap. My vision is for experienced ED nurses to see, assess, manage and discharge all patients, categorised as both major and minor. By doing so, not only will we enhance the service offered, but we will ensure that patients receive the timeliest care.
I believe passionately that ED nurses have a firm foundation to build upon as well as already having the capacity and capability to undertake new and challenging roles. However, to do this they will need to develop and expand their skills and knowledge in the areas of clinical examination and physical assessment.
Our article highlighted the fact that patients with blunt abdominal trauma are not recognised quickly enough and, while the reasons for this are multifactorial, I firmly believe that, if nurses were to carry out the type of assessments described, we could see fewer deaths from blunt abdominal trauma.
About the author
Anthony McGrath is head of department, adult nursing and midwifery studies, at London South Bank University