How to become a Trauma Nurse in The USA

By ShiftMed Team//Nursing Profession
Trauma Nurse in the hospital with a patient

No one is ever prepared for a traumatic injury — except trauma nurses. These specialized nurses are trained to provide emergency first aid and life support to patients in critical condition. They work in ERs and trauma centers around the country and are always ready to respond to anything at a second’s notice. 

If there’s one saying that perfectly captures the life of a trauma nurse, it’s “always expect the unexpected.” 

Trauma nurses treat patients of all ages, dealing with various serious injuries and life-threatening illnesses. They are often on the front lines of treatment, administering life-saving care and stabilizing patients. 

While this line of nursing isn’t for everyone, it is a source of motivation and pride for those who choose it. 

If you envision a career in trauma care, this is your go-to guide. We’ll first look at different types of trauma nurses, then tell you how to become a trauma nurse from nursing school to earning your certification.

Recommended Reading - What is a Trauma Nurse in the USA? 

What type of nurse works in trauma?

TCRNs – Trauma Certified Registered Nurses – deliver the highest level of emergency care. They provide specialized care and life support to patients of all ages with various illnesses and injuries. 

Nurses in trauma often see victims of violence, car accidents, fires, and other serious events. They confront life-threatening situations every shift, usually with emergency transport teams to stabilize patients until trauma doctors can treat them.

Many patients trauma nurses see are unconscious or need life-sustaining procedures. The trauma nurse’s job is to act as quickly as possible, providing emergency life support and interventions at a moment’s notice. 

Trauma nurses’ patients may flat line multiple times, require breathing assistance, or need to be intubated. These nurses see people in their absolute worst conditions, so they have to be able to handle being in close contact with traumatic injuries and working in highly stressful situations. 

Are trauma nurses in demand?

Yes, trauma nurses are in demand, especially after the nursing shortage caused by the COVID-19 pandemic. However, there will always be emergencies, and specialists capable of handling them with the utmost calm and skill will always be needed. 

According to Zippia, there are currently 545,516 registered trauma nurses in the United States. However, following the pandemic, many nurses left the field.

A survey found that one-third of nurses plan to leave their jobs due to burnout in 2022. This means there will be even greater demand for nurses of all types, including trauma specialists, in the coming years. 

Do trauma nurses help in surgery?

Trauma nurses don’t generally work in the OR but often assist trauma surgeons during emergency surgical procedures. There is often little time for patients to be transferred, so the trauma nurse provides support while the trauma surgeon intervenes.

Many patients may be intubated, need IVs inserted, and require additional life support care during surgical procedures. The trauma nurse is first-hand during these life-saving procedures.

You will work directly with ER doctors, trauma specialists, and trauma surgeons as a trauma nurse. You are part of a close team of professionals who take on the most severe cases to save lives.

What are the steps to becoming a qualified Trauma Nurse?

A trauma nurse starts with a degree through an accredited nursing program like every other nursing career. Nursing degrees come from universities, community colleges, and even vocational nursing schools. 

Once you’ve become an RN, you can start working toward your specialty certification in trauma care.

Let’s cover the trauma nurse career path in 5 steps.

Attend Nursing School and Earn an ADSN or BSN

You can become an RN with an associate’s or bachelor’s degree. Either is acceptable to take the NCLEX, the leading nurse licensing exam. During your nursing degree, you’ll learn the fundamentals of nursing, patient care, and health assessment.

Nursing students also study pharmacology, psychology, psychiatry, and human anatomy and physiology. 

Every nursing program has a strong mix of skills and classroom instruction. Associate degrees take two years, while bachelor’s degrees require four years of study. You will gain more advanced nursing education in a bachelor’s program; this includes instruction on nursing theory, case management, and clinical leadership.

Pass the NCLEX-RN Exam

The NCLEX-RN is the leading nursing exam in the United States and Canada. The National Council of State Boards of Nursing (NCSBN) offers this exam, and it uses a complex, comprehensive system to assess your knowledge. 

The pass-fail system for the NCLEX is adaptive, meaning it changes based on your answers. For example, if you show proficiency in one area, the exam will start asking you more complex questions or assess the extent of your knowledge in a particular subject.

The NCLEX tests aspiring nurses on their healthcare and clinical expertise; this is divided into four main categories:

  • Maintaining a safe clinical environment

  • Promoting and maintaining healthcare

  • Psychosocial integrity

  • Physiological integrity

Being a good nurse is far more than knowing the terminology and having the right skills. You need to understand the role and experience of patients in healthcare so you can serve them properly.

The NCLEX will assess your knowledge across these subjects before reaching 95% certainty. Then, you are given a pass or fail result. Don’t worry, though. There is a lot of time to prepare, including practice exams and plenty of NCLEX-RN study guides.

Register for Your State RN License

After passing the NCLEX, you must apply for an RN license through your state’s nursing board. You can quickly find this online by Googling the “[Your State Name] board of nursing.” 

After you are given your nursing license, you will need to renew it according to your state’s guidelines. Usually, nurses must renew their RN credentials every 2 to 4 years.

Get Experience in Trauma Care

You’ll need to start gaining experience in the emergency room to prepare for your TCRN certification. The Board of Certification for Emergency Nursing suggests having at least two years of experience in your area of expertise, but it is not a requirement.

We suggest also getting at least 1,000 hours in emergency care before becoming a TCRN. Although you may be able to pass academically, there is a significant difference between having nursing knowledge and nursing experience. 

Trauma care, in particular, is one of the most emotionally and physically demanding nursing roles available. You will have to gain comfort working in the ER and handling the stress of working with patients in critical condition.

Furthermore, gaining the reflexes and mental agility trauma nurses need takes time and practice. 

It takes around two years for any nurse to become comfortable in the ER. So it is normal to feel out of your element and even insecure in your abilities at first. 

Learn from the more skilled nurses and take pride in the journey. As you become the best trauma care nurse you can be, there is so much to learn.

Earn Your Trauma Nursing Certification 

The strictest eligibility requirement for TCRN applicants is a current, unrestricted nursing license in the US or Canada. The BCEN also accepts a nursing certificate equivalent to an RN from other regions.

There are currently 4,300 TCRN holders in the United States. As long as your license is valid, you can sit for the exam, even if you aren’t currently working in clinical care. The BCEN official site offers advice on what to study and how to prepare for your TCRN exam. 

You can also take a 150-question practice exam that is timed or untimed. The untimed TCRN practice exam allows you to work at your own pace and see explanations to answers as you go. The timed version is the closest model to the actual test, but it doesn’t give you any feedback on your responses until you finish.

Can you become a Trauma Nurse online?

You can start your nursing journey online but must perform clinicals and gain work experience in person. Clinical hours in nursing school vary by state; some are 400, others are over 800. 

You need to check with your school and state’s board of nursing to ensure you meet licensing requirements. 

If you attend an online program, ensure it is accredited in your state. While the NCLEX is a broad nursing regulatory board, specific state regulations still exist. 

As you explore your degree options, look for programs recognized by the CCNE or the ACEN. It’s not uncommon for employers to ask to verify your degree, even after passing the NCLEX and getting your license. 

What is the difference between a Trauma Nurse and ER Nurse?

A CEN, or Certified Emergency Nurse, focuses on an emergency but usually non-critical care. The CEN takes care of a wide variety of patients, just like the TCRN, but their work focuses on less intensive trauma or critical care situations. 

TCRNs specialize in critical care, trauma, and life support. If you want to work in a trauma hospital or specialize in trauma care, then you’ll pursue TCNN certification. TCCN, or Trauma Core Courses for Nurses, is the name of the actual certificate that makes you a TCRN. 

The CEN is ideal for nurses who want to be in the emergency room or urgent care. They are still qualified to offer life-saving interventions but focus less on trauma than a trauma nurse.

What can you progress to after becoming a Trauma Nurse?

After becoming a trauma nurse, you may want to take your career even further. Becoming an emergency nurse practitioner (ENP) allows you to provide excellent care to patients in ER and trauma settings. 

To become an emergency nurse practitioner, you’ll need to earn a master’s or doctoral degree in nursing. Then, you can become board-certified with the Emergency Nurse Practitioner-Board Certified (ENP-BC) credential. 

Before gaining board certification as an emergency nurse practitioner, you must first become a family nurse practitioner (FNP) or acute care nurse practitioner (ACNP). ACNPs specialize in life-threatening injuries and illnesses, so it could be ideal for a trauma nurse who wants to continue treating patients in critical care.

However, if you want an additional certification that also opens other career opportunities, the FNP program is a good call. This role tends to focus more on preventative care and non-emergency treatments. For example, an FNP can work in an office and treat patients on their own, or they can work in the ER. 

Do your Trauma Nurse certifications expire?

You will need to renew your TCRN through the BCEN every four years. You can do this by logging onto the BCEN website and applying for recertification. There are two ways to recertify:

  • Perform 100 hours of nursing continued education within the last four years

  • Take a recertification exam 

How much do Trauma Nurses make?

There is no definitive research on how much TCRNs make, but their salary is comparable to an ER nurse. ER nurses earn an average of $78,451.61 annually, which can vary by state and experience level. 

Those who pursue a career as an emergency nurse practitioner expect their salary to increase by an additional $45,000 or more annually. Our research shows the median nurse practitioner earns $116,438.80 annually.

How long does it take to become a Trauma Nurse?

It takes 4 to 6 years to become a TCRN. If you earn an associate’s degree, you can start working as an RN in two years, then gain two years’ experience in ER care. If you earn a bachelor’s, it takes an additional two years to complete your degree.

One option to work sooner is to earn your associate’s, get your RN, and complete an RN to BSN program online. This process allows you to work and earn a registered nurse’s salary while furthering your credentials.

Many trauma nurses will apply for emergency nurses jobs— you’ll need at least two years of work experience to find a suitable position near you. Working in more advanced trauma or critical care centers will require more experience.

Recommended Reading - How Long Is Nursing School in The USA?