Here Comes the 4th—and the Fireworks Injuries

The Fourth of July is upon us (happy birthday, America!) and, with it, no shortage fireworks—and the injuries that come with them.

The Fourth of July is upon us and, with it, no shortage fireworks—and the injuries that come with them. If you work in emergency care, you have likely already seen quite a few patients with burns, loss of fingers, or worse.

According to the U.S. Consumer Product Safety Commission, an estimated 9,100 Americans were treated in U.S. emergency departments for fireworks-related injuries in 2018. Of these injuries, which most commonly included burns to the hands, fingers, and arms, about 62% of them occurred around the Fourth of July. That is roughly 190 injuries per day between June 22 and July 22.

Of these injuries, most occurred among children aged 10 to 14, and for children under 5 years of age, sparklers accounted for more than half of the total estimated injuries.

“Each year, too many emergency room doctors see too many fireworks-related injuries. Don’t make the emergency room part of your holiday; don’t let children play with fireworks,” Dr. Sarah Combs, an emergency room doctor from Children’s National Medical Center, said in a statement released by the CPSC.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The State of Emergency Nursing

There is not exactly a state of emergency when it comes to the field of emergency/trauma/transport nursing, but one may be on the way.

A recently released study took an in-depth look at the state of emergency, trauma, and transport nurses in the United States in an effort to gain an understanding of the landscape of the field, as well as the issues facing these nurses. The comprehensive study, which is the first of its kind, provides important insights about the current workforce and the future demands of the profession.

Here are some highlights from the report.

Demographics

  • The majority of the workforce is under the age of 40 (43%), female (78%), and Caucasian (87%).
  • Transport nurses are more likely to be male than emergency or trauma nurses.
  • Compared to the overall nursing workforce, emergency/trauma/transport nurses are more likely to be male and white.
  • More than 50% of respondents have previously worked in an Emergency Department.
  • 10% of respondents report previous military experience.
  • 78% of respondents hold a BSN or higher.

On the Job

  • Respondents indicated that 60% of their time is spent on direct patient care, while 25% of their time is spent on documentation.
  • 65% of respondents stated they are satisfied or very satisfied with their jobs.
  • 39% of respondents report the workload is too heavy or overwhelming.

Salary & Career Path

  • For emergency nurses, the median salary is $77,500.
  • For trauma nurses, the median salary is $82,500.
  • For transport nurses, the median salary is $82,500.
  • The majority of survey respondents expect a shortage or extreme shortage of nurses in the next 5 to 10 years, though most report plans to continue in their current role for the next 5 to 10 years.
  • The most common planned career change among respondents is to obtain a specialty certification or become an APRN.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Mass Shootings and Trauma — the New Normal

Nurses, physicians, and other professionals working in trauma centers know fully well that, at any time of day or night, ambulances and vehicles filled with victims could arrive after a violent situation unfolds.

From Nurse Keith’s Digital Doorway

Mass shootings and similar tragic events are so frequent here in the United States that they appear to be the new normal. There were apparently more than 250 mass shootings in the U.S. in the first 9 months of 2017. As nurses and healthcare professionals, how do we cope, respond, and prepare for such seemingly commonplace yet traumatic events?

Mass shootings are generally defined as events wherein a minimum of four people are injured or killed, and by this definition, an event with three people shot is not considered a mass casualty. So if we changed the definition, these situations would be even more statistically frequent than they are now.

Healthcare professionals throughout the world treat victims of violence on a daily basis. Whether wartime casualties or civilians shot by strangers or family members, gun violence and other forms of aberrant behavior manifest in our cities and towns on a frighteningly frequent basis.

Being Prepared for the Horrific

Hospital facilities — especially those designated as trauma centers — are prepared to handle large numbers of casualties, and many run drills that keep the skills of rapid response teams as sharp as possible.

Nurses, physicians, and other professionals working in trauma centers know fully well that, at any time of day or night, ambulances and vehicles filled with victims could arrive after a violent situation unfolds. The recent Las Vegas shooting was just one such scenario, and stories have emerged of hospitals veritably overwhelmed with the number of seriously injured patients being brought for emergent care on that fateful day, even as off-duty personnel raced to their places of employment to lend a hand.

Most of us can only imagine what might run through our own heads if we were ourselves at the scene of such a shooting. If bullets were raining down, would you be willing to risk your own health and safety to help a bleeding person across the parking lot who is suffering from a gunshot wound? Could you think clearly, stay focused, and compartmentalize the experience enough to get the job done? If you were exposed to live gun fire and the resulting chaos, would your desire to help others supersede your own safety concerns to the extent that you could take action?

Each one of us needs to ask ourselves salient questions when it comes to these types of situations. Here are some I’ve been thinking about lately:

  • What skills am I prepared to put into action if I’m on the scene when a mass casualty event occurs?
  • What related skills do I need to improve and refresh — or learn for the first time?
  • If I wouldn’t or couldn’t help out with immediate hands-on trauma response, do I have other skills that might be helpful? (eg: crisis debriefing, logistical support, etc)
  • What organizations doing this type of work would I like to support?
  • Is there more I can do in preparation for these types of situations, either as a citizen or as a healthcare professional?

You may also want to ponder and research how (and if) your workplace is prepared for such eventualities by asking related questions, such as:

  • Is my workplace prepared for mass casualties and other disaster scenarios?
  • Does my place of employment carefully prepare and run drills in anticipation of these types of circumstances?
  • If myself and my colleagues were called on to respond to such an event, would our employer provide aftercare and crisis debriefing for us?

However you contribute is fine — not everyone has the skills, knowledge, or even the physical stamina and strength to pitch in directly when disaster strikes. We can all choose our path for making a difference in our own way. We just want to make sure we have the training, backup, and follow up care to make it through the crisis in one piece, emotionally and otherwise.

Healing From Vicarious Traumatization

When a nurse, doctor, fire fighter, police officer, or other responder interfaces with some aspect of a mass casualty event, those individuals’ lives can be inextricably altered. Vicarious traumatization involves the empathic response and countertransference experienced by rescue workers, first responders, ER staff, or anyone who has witnessed, or attempted to mitigate, the suffering of others.

Being faced with two hundred incoming patients with acute bullet wounds from an active shooter can be overwhelming on multiple levels for a nurse in the ED. For those with experience in combat, this may not seem so far-fetched, but to a nurse who has only seen normal emergency department scenarios, a mass casualty can be an entirely different experience.

When I was living in Western Massachusetts, my wife and I were trained in a crisis debriefing model developed by the military and subsequently adapted for civilian use. We provided emergency debriefings following a rape, a murder, and even a bank robbery, This type of intervention following a trauma can be very helpful for victims, for responders, as well as others experiencing a more peripheral impact of these types of events.

Vicarious traumatization feels as real as any other trauma, and healthcare workers and first responders need trained professionals to walk them through a debriefing process that moves them in the direction of healing. After all, healed healthcare workers are healthy and productive healthcare workers.

An Unpredictable World

We nurses can volunteer in the face of disasters such as Hurricanes Harvey or Irma. We can also find ourselves in the middle of unfolding events that put us in both imminent danger and the potential to lend a helping hand at a crucial moment. It is an unpredictable world, and we need to be as well prepared as we can be for the unimaginable.

Nursing skills and the nursing process are crucial components of emergency response. When faced with a dire situation, many of us nurses would likely act without thinking, turning on our “nurse’s brain” and snapping into action in coordination with other healthcare professionals and first responders.

In this age of seemingly escalating violence, each nursing professional must know his or her own limits and boundaries when it comes to volunteerism and to the ability and willingness to respond in an imminent crisis such as a mass shooting. It’s a sad but true reality that we haven’t seen the last of unthinkable situations where ordinary citizens come unhinged and wreak havoc. Even so, nurses and other courageous souls will always be there to lean in wherever help is needed.


Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind NurseKeith.com and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is co-host of RNFMRadio.com, a wildly popular nursing podcast; he also hosts The Nurse Keith Show, his own podcast focused on career advice and inspiration for nurses.

A widely published nurse writer, Keith is the author of “Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century,” and has contributed chapters to a number of books related to the nursing profession. Keith has written for Nurse.com, Nurse.org, MultiViews News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University, the ANA blog, Working Nurse Magazine, and other online publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, online nurse personality, podcaster, holistic career coach, writer, and well-known successful nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Digital Apps for Emergency Medicine, Pediatrics

Emergency medicine and pediatrics are two areas where an array of apps help physicians do their jobs.

from HealthcareDive

Doctors across the hospital spectrum are using digital tools to support clinical decision-making, increase patient engagement and improve quality of care. More than half (51%) of recently interviewed healthcare professionals are using an app at the point of care, according to a new KLAS Research report.

Read More →

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.