I have been a trauma nurse for over 20 years now. I have worked prehospital and in the emergency department. I have managed a trauma center and a state trauma system; I have worked at a civilian trauma center and a military trauma center. I guess I am a trauma nurse. I think a lot of nurses define what they are, by where they are. You work in a cardiac care unit; you must be a cardiac nurse. Spend most of your shift in the operating room [horizontal ellipsis] you are an operating room nurse. Work anywhere in a children's hospital, you are a pediatric nurse. So[horizontal ellipsis], to be a trauma nurse, you must have to work in a trauma center, right? Wrong!!

Over the past year, I have come to see trauma nursing through a very different lens. The conflicts in Afghanistan and Iraq have created trauma nurses where none thought they existed before. Nurses from all branches of the military are being deployed to medical treatment facilities "In-theater" (the war zones of Afghanistan and Iraq). Many of these nurses came from various, nontrauma, clinical backgrounds, and did not work in a trauma center back in the states, yet they are on the front lines resuscitating and stabilizing horribly injured patients on a daily basis. I have worked with nurses at Landstuhl, Germany, who did not work at a trauma center back in the states, yet they are screening patients for traumatic brain injury and collecting data vital to the research that will one day improve trauma care for military and civilian victims alike. I see nurses in the states that never worked in a trauma center, yet they are assessing the rehabilitation and family needs of a 20-year-old triple amputee. There are nurses working in VA hospitals that never worked in a trauma center, yet they are following the clinical course of a patient who has had a dozen operations to both legs and suffers chronic pain.

I cannot count the number of times I have heard these nurses say, "But I'm not a trauma nurse." What they do not understand is that it is not about where you work; it is about what you do. It is about caring for the injured patient-from the moment they roll into your resuscitation area to the moment they leave that last clinic appointment.

You may take care of an injured patient for just a few intense minutes at a time, or for months on end, but you are a trauma nurse. You may wear scrubs and carry a stethoscope, or you may sit at a computer and collect data, but you are a trauma nurse. You may work in a fast-paced urban emergency department, or a sleepy rural clinic, or even in a tent in the middle of the desert, but you are a trauma nurse. Your patients may have broken legs, injured spleens, or bruised brains, but you are a trauma nurse. You might work in a helicopter or an emergency department, in the intensive care unit or in the operating room, on the floor or in a rehabilitation facility, but you are a trauma nurse. You may never set foot inside a verified or designated trauma center, but you are a trauma nurse nevertheless.

You see-it is not about where you work or your hospital's designation level. It is about what you do [horizontal ellipsis] and what you do is to care for the injured patient, anywhere, anytime. That is what a trauma nurse is.