Our Email to Diane
First, we would like to thank you for your tireless work in the trauma room, ED, and beyond. We are grateful for you beyond imagine. We are also grateful for the collaboration with the trauma department. We have worked hard to facilitate and assist in trauma resources, trauma downgrades, medical management of trauma patients and of course, the multiple simultaneous trauma situation. As we had talked earlier this week, the NPs’ role in the trauma room has been a substantial dissatisfier to our staff. I will speak only to the ER physician side. We would like to keep our relationship strong and think a few boundaries are necessary. The bottom line is that we want to be involved in trauma as much as possible. We want to assist in managing these patients. We want to be the resuscitationist helping you in the critical patients and the extra physician needed when multiple traumas come in. We especially want to continue our practice of being actively involved in the procedures associated with these patients. We feel the NPs should not be placing central lines, inserting chest tubes, or intubating patients in the ED. These procedures in a trauma setting are critical to our skillset and are needed to maintain that skillset. We hope that you can understand the significance of this issue with our doctors. Again, you are the best. We are very thankful for you.
The Emergency Physicians of Sharp Memorial
Diane’s Email Back
Surgeons met and agree to the following, so please let me know if we need to go back to the drawing board. Of prime importance is our relationship w you, and we can be flexible w our team, so send back comments if there is still concern:
We prefer to train our NPs in a controlled setting where time is not a crucial issue.
We want NPs proficient in primary/secondary survey and will continue to have them respond to trauma to learn the pace of that workup and the intricacies of flow to CT etc.
We will not have them do any emergent procedures. If an alpha trauma arrives unstable, all procedures will be done exclusively by ED and Trauma surgeons.
If there is a procedure that is being done in a delayed fashion where time is not a critical consideration AND where EDMD would not have been involved, trauma surgeons may use that as an opportunity to train NPs. Nps may close lacs or do other pre-approved (Surgery Supervisory) procedures.
NPs who are proficient may provide benefit to trauma surgeons in simultaneous care in the trauma room, an alternative to bypass, extra hands during disaster, assistance in icu and other areas of need.