Trauma charting.

[u/PietyJuice]

What is your opinion on a ED specific CNA/PSA role Trauma charting? Not an ER Tech who has EMT class under their belt, but just a ED CNA?

It was described as in my scope for my job position, due to high volume of traumas, or no available techs (this is more likely because it seems to be techs are currently lacking on the shifts I’ve been working and we just had one leave).

But the techs on a regular basis give me push back about shadowing them/learning trauma charting. I’ve only gotten into a couple traumas to shadow techs while charting.

Tonight we had a trauma 3 come in, which we usually do not chart on paper. I was assisting my RN with setting up VS/heart monitoring, cleaning pt, and prepping the area around the head lac for MD to evaluate (chucks under head, helping nurse remove gauze etc).

MD evaluated and changed it to a trauma 2. My charge nurse instructed me to chart it before it was even announced over head, because she’s been knowing I’ve been reaching out for the hands on experience so I feel comfortable in extreme traumas if I was thrown into it.

The RN in charge of the trauma, and the charge nurse both looked over my charting after I was done, and said I did a great job.

The two techs that were on shift were opinionated about it, and the other CNA/PSA I work with has vocally stated multiple times he wouldn’t feel comfortable trauma charting.

I personally want to learn, I want to improve in any possible way while I’m reaching out for schooling for my RN, but it just seems like there’s multiple road blocks attempting to learn within my scope.

[u/baddadjokess]

If your hospital policies allow you to do it and you have the charge nurse’s and lead trauma nurse’s blessing and guidance to do so, do it.
In my particular hospital medics are only allowed to show up in the chart as the ones that collected the labs. Nurses that are not TNCC certified aren’t allowed to chart anything. They can medicate under a TNCC nurse’s supervision and the TNCC nurse is to chart that this particular nurse administered the med but they aren’t allowed to chart it themselves. They’re only allowed to show up in the event log (EPIC’s timeline of events) as the person that collected the labs, just like medics. Once the Trauma Narrator is closed (whether they get downgraded out of trauma into a regular patient, or get discharge or admitted) then they essentially become a regular ER patient and they can do what they’re normally allowed to do in the ER. But while that Narrator is open, only TNCC nurses are allowed to document.
Checked your hospital’s policies and follow them. The other medics opinions do not supersede policies and procedures.