Ep. 32 | Chelsea Carter, Trauma Program Manager, SGMC Health

Transcript

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- Welcome to another episode of What

- Brings You in Today? I'm Erika Bennett. And I'm

- Taylor Fisher.

- And we just wanna thank everyone for listening to our podcast. Be sure to like and subscribe so that you can stay informed when a new episode releases.

- And if you have any questions or topics you would like to submit, you can do that at sgmc.org/podcast.

- All right, well, we are here today with Chelsea Carter. Hi, who's our registered nurse and our trauma program coordinator here at SGMC Health. So Chelsea, what brings you in today?

- I am here to share a little bit of information about our trauma program.

- All right. Well, tell us a little bit about your background personally, and kind of how you got to where you are.

- Yes. So I started many, many years ago as a tech at Wolfson's in the er, and my mom was a nurse. She always came home sharing really, really great stories about her day, and it just always felt like regardless of how her day went, she always had a win for the day. And I just wanted to have that, you know, so I, I wanted to be a pediatric nurse. I wanted to work in the er, and I did my one year and learned very quickly that that was not for me. I love all the babies, don't love caring for the babies. So, fast forward a few years, I went back to nursing school, and I'm from Jacksonville, so I started clinicals in a, in a level two trauma center in Jacksonville, in the middle of, of Duval. And fell in love with the ER there, and was offered a position once I graduated school, started there. And I was very, very fortunate to have some great mentors in that hospital. I had a couple that I just wanted to be like, you know, you always have that kind of example of you just wanna grow up and be, you know, that cool as a cucumber person responding, doesn't matter what they put in their room, they're just happy to be and, you know, know what to do in every environment. And I just wanted to grow up and be that way. I'm still working on it to work, you know, to work in progress. But so long story short, that's where really I fell in love with ER nursing and my, I'm not, like I said, not from here. My husband's from here, we've moved, and I thought coming to Valdosta that I was just gonna work in this small slow paced, calm, quiet emergency room, and it was just gonna be fun and, you know, easy peasy. Yeah. And I was humbled very quickly, but in, in reality, I, I mean, I love it. It was just, it was a big difference coming from a city to a town, you know, city and, and just not realizing the differences. But that's kind of what got my foot in the door here. I started night shift as a charge nurse, kind of worked around to the ed educator manager, and then the opportunity presented itself for me to come back as the trauma program manager. And I'm not usually one to say no to a challenge. And that's where I'm at now.

- All right. Well, and speaking of the trauma program here at SGMC Health, so I could imagine why you, you know, thought our hospital was a little bit smaller, obviously, but over the few years, these most recent years, we've grown significantly in, in trauma capability. And just most recently, a year or so ago, got certified as a trauma center. So were, how, how long have you been in this role or been back in our organization?

- So I started again in December of 23. Okay. In the trauma program. Been okay. And we were designated in June of 23. Okay. Through the state. So the way that the state evaluates you is you kind of have to put all those processes in place, and you have to prove that they're working, you know, their expectations, and then they'll come and, and evaluate your system and your program, and they'll grant you that designation. So coming from training at a level two center

- Where

- That's just the way that I learned things went right,

- Yeah.

- Coming and working here, I had a different perspective and respect for what a trauma center can do and, and the role that it can provide, and how those resources are then pulled together in different ways to improve the patient care. And that was a big shift for me. So that's kind of what we've been growing to do. It takes a lot of time and effort, but like you said, one of the, the interesting parts about our area is we have a, we, we funnel all of these patients from these, our service area is huge, and it's been a struggle a little bit for our hospital to keep up with de the demands of, of meeting all the needs of our patients. But that's where that trauma program really comes into a, a critical role, because if you have a patient that meets certain criteria, their injuries, that trauma activation pulls those resources together and a, a systematic approach to respond very quickly upon arrival within 30 minutes of that patient being here. So we've always gotten these patients, right. The, the patients have always come here because we're an hour and a half north or south away from a larger center with more capabilities or more specialties. We're very fortunate to have the specialties that we have here. But what it does is it just kind of takes our resources and, and puts them in an organized response, you know, really fine tune some of those processes to ensure that the patient's receiving that level of care within an appropriate amount of time.

- Because time certainly matters in a traumatic event. Right. Absolutely. That's what it's most important. And then, like you said, us serving such a large region, probably 15 counties, we get patients from a lot of those rural communities, and so they're having to travel so naturally they're already having to travel, take that time to get here. So important to take out any unnecessary steps and be as quick as possible. So we're ready for that.

- Yeah, definitely. To get here, what kind of traumas do we see most often, do you think? Or is there one that we see more than others?

- Yep. So that our injury prevention program really focuses on looking at that data routinely. So for all of 24, our falls, were gonna be the highest. That's, that's pretty standard across the state. Your NVCs are, our VCs are significant. We're ride on 70, 75 crash. Yes. I'm just assuming. I'm just, I'm sorry. Yes. I know I use a lot of and stuff here. Sorry. Our, our, yes. Our, our car accidents are going to be a large number. We have a lot of people traveling. We also have quite a few assaults, penetrating injuries. So we have a good variety. You know, we have a farming community, so it's not, you know, uncommon for us to have our fair share of agricultural injuries, farming injuries. So we get a, we get a good variety.

- Okay. And what do you, what would you say is the most important thing for ensuring that a trauma program is successful

- For everyone to understand in the health system? That they are a part of the team? So, if you know me, I, I take advocating very seriously. I've always been passionate about that. I loved being the educator in the er because that was kind of that middle person between management and, you know, your team where you could just help everyone be their best self, right? Provide that resource. The trauma program is, especially my role is, is really the same, the same foundation where it's not, trauma doesn't only happen in the er, it doesn't only happen with EMS, it doesn't only happen in the ICU, it's the, our whole system really. So it's taking this one department, we look at that patient from pre-hospital care injury, we're evaluating that care. We extract all of that data all the way through or and recovery to discharge and rehab. And we are making sure that the care is appropriate, that it's timely, that it's, you know, evidence-based best practice. And if we identify an area of need or we focus a lot on process improvement, where then, okay, how do we fix it? And that, that trauma program in general is almost that intersection of, of critical thinking, teamwork, and advocacy all in one, because I love to advocate for those nurses. And what do you need? Yeah. What do you, if you have the tools you need to do your job, you have the education, you have the resources, you'll confidently show up to work and feel good about what you're able to provide at the bedside. But in the same token, you know, our patients are, this is their worst day. Yeah. This is, They're, they're unsure about what's happening. They don't, they don't even have a lot of times a frame of reference to understand the impact that this injury is gonna have into their day-to-day life. How do they, how do they get through today? They're in pain, they're anxious, they're scared. How is it gonna impact their family, their jobs, their ability to provide, you know, long, long after Yeah. You go out, get out of surgery and you're stable again. You know? And so taking that moment, you, you really have the ability to step back and, and realize the impact that you can have on your team in the hospital. And that includes everybody and the patient, and then bringing all of that together.

- Yeah. That's

- Powerful.

- And I hadn't even thought about like that as from the nursing perspective and too, like when, I mean, obviously you have your patient, a trauma happens. It is, you know, all these things are happening coming in. But like for a nurse to feel confident and secure in that any moment a trauma could come through and I feel comfortable to do my job and I'm not like nervous about that or

- Right.

- I've never really thought about that.

- Yeah. I mean, I would be nervous, but I'm not, I nurse and I'm not trained for it, which is why I'm not a nurse. Can we talk about injury prevention? Because I know that is a piece of what you do is going into the community and making sure people know how to prevent these different injuries.

- Yes. So we have done a lot of, we're happy, first of all, anytime anyone calls and asks, even if they have a need in their, from daycare to schools, to businesses, if it's, you know, whatever, whatever form or fashion that that might come in, we're always happy to go and, and provide what resources we can or, or bring other community partners to the table. But we do a lot of stop the bleed education. The Georgia Trauma Commission gives us the stop the bleed kits. We can go out and teach how to apply tourniquets in the event of, you know, a an injury, how to pack wounds appropriately in order to, you know, apply pressure. We've done, I believe every school in Lowndes County, Valdosta City, we've educated most bus drivers. All of our local police has been educated. We will go, I think it's all, we've gone all the way up to Moultrie, obviously Brooks County. Now we're, we're kind of that hub for providing those resources. We've done libraries in town. And one of the things that I always teach when I'm, I'm giving those resources out is it's, it's always the first line of, of thought sometimes that these injuries occur in car accidents and these injuries occur, you know, big, big major tragedies. And we forget that lawnmowers have very, very strong, powerful blades. And in the summertime, I can't tell you how many times we have, you know, people are just trying to just get through the weekend and handle their normal day to day responsibilities. But that's where injury prevention comes in, because we're more relaxed at home, you know, are we unloading the dishwasher and the kids are running by and we trip and fall on a knife? Unfortunately, those things happen. But you, you wouldn't necessarily be on guard at home. Right, right.

- So just an accident in the kitchen, it it's accident. Just chopping up Exactly. Or something. Or getting on the roof

- And

- Yep. Cleaning out gutters and you fall off the ladder. I mean, and that's kind of, we, we talk about it all the time, but you know, you, you've got this collection of trauma patients who sometimes don't make great decisions. Yeah. Or, you know, maybe they're, they're unsafe and they might have injuries because they've made unsafe decisions. However, you have all these other trauma patients where it's truly an accident.

- Yeah.

- And, you know, you can, you can take every, you know,

- Precaution,

- Precaution sometimes, and an accident still happens. But we're, we're here for both.

- Yeah. I didn't even think about the, just making yourself more comfortable at your house Yeah. And stuff higher down, not really guard guards, down guard. Yeah. I know. I've like been trimming hedges before and on a ladder and I know that was like super unsafe, but you tend to just like, oh, let me get that little, lemme reach over lean just a little more. That little bit. So definitely see how that can with happen, this powerful blade I'm using. You get that little superhero mentality like, oh, that's not

- Gonna happen to me. But Right. But you also talk about summer safety too. Yes. Don't you, can we talk about that since we're heading into summer too? Yes. Hopefully.

- So we laugh 'cause you know, er volumes kind of tend to go up through like cold and flu season, you know, you'll see that increase. And then trauma volume kind of definitely ticks up through the summertime, but everybody's moving around. It's, it's time to have fun. Everybody wants to be in the sun and, and the sun slip sons toys and you know, your four wheelers and your kids are outta school and you're on vacation and you're getting in the boat and you're having all these other, you know, it's, it's meant to enjoy. However, we definitely see an increase in, in injuries throughout the summertime with kids being outta school, then maybe not having parents watch as much as they normally do. You know, mom and dad still have to work. All of their friends and buddies are around. 'cause you know, they're all spending the weeks together. And so with our younger population, especially when we go to career fairs or we go to injury events at schools, we talk a lot about distracted driving, staying off your phone. Even music or conversations with teens in the car is, is a really big deal. It doesn't matter how far you're going in the car, put your seatbelt on.

- Yes. - If you are on golf carts, do not, you know, don't pack it down with everybody in the whole crowd. If there's not a space for you to sit, just wait for the next turn. No sharp, fast, you know, curves where people are gonna fall out, wear your helmets. Helmets are a big, big, big deal.

- Yeah. I feel like the golf cart thing has kind of been more and more prevalent. I've heard more and more people about, you know, their children having accidents. I think people think, oh, golf carts are safe. Definitely four wheelers and stuff safer than four wheelers, but they can tip over

- Still. Well, and and that's kind of why trauma and criteria exist. So when you kind of get into that, that scientific nerdy part of my brain where you're looking at the biomechanics of injury and the force and traject, you know, trajectory, and it doesn't take a lot of extra energy to greatly impact the amount of force that the body takes. And so sometimes those cause very significant injuries, even though it doesn't seem like, you know, the speed was that fast or the fall was that high. It, it can still be life threatening.

- Well, I just wanna take a second to plug our safe sitter program, because you were talking about kids being home during the summer. We do offer a safe sitter program. It, it's for middle school aged children who can come take a one day course here in partnership with the YMCA and learn safety tips for while they're home, while they're, even if they're not babysitting another child, it still is beneficial for them to come and just learn safe how to be safe alone at the house. But it's a very good course. It, it, it always fills up every year. So if someone's interested in learning more about that, they can go to our website and sign up for that. But we do that every summer.

- I made my, I

- Dropped out with that,

- Just my son to it last year, and yeah, he was kicking and screaming. I said, Nope. Coming. Yeah. I mean, you can never,

- That's great. You can never teach 'em enough. Right?

- No. And, and, and when it comes to injury prevention, you know, preparation is key. Preparation, preparedness prevents tragedy. So it's, it's, it's just that mindset. You just have to, you know, always just be thinking about what your plan would be or you know, how to mitigate some of those preventable things.

- Yeah. So do you have any, I know we've shared some tips, but do you have any more specific tips like that, you know, that come to the top of your mind about injury prevention or preparedness? We can go

- On and on and on. So, things that I've implemented in my own home, my, we live on a lake and so my doors have the most of obnoxious alarm on them, But for good reason because I have a little one, I have a 2-year-old who loves to go outside. And so even though it's obnoxious and I, it drives me nuts every time it goes off and I have a heart attack that's just about being prepared. I need to know if those doors open. Right. A lot of times though, drownings with that, you know, younger kids, they're not, they're just, they're innocent and they don't have that, you know, that fear yet. And they don't understand that it's even a possibility and they're just wanting to go get another toy or, you know, just touch the water and then they're top heavy and they're mechanics of their body. Yeah. It just, it leads itself to, to, to have that perfect scenario where it's an accident and it doesn't take long to happen at all. But also gun safety is a big deal. Making sure that, you know, in our homes that we are, if we have them, that they're stored correctly, preferably locked away obviously from, you know, out of reach from children being able to access them.

- Yeah, definitely. That's a big one. And not even just children, just Right. In general. General. Anyone that's not supposed to have them. Right.

- Yeah. I mean I've, from what I've heard from EMS professionals is that oftentimes the gunshot wounds that they respond to are not from someone trying to shoot someone there just accidentally shooting themselves. Like, because happens, it happens a lot. Take taking proper precautions.

- Yes. Yes. I like the door alarms too, especially with you living near the water.

- But - You know, people also have swimming pools

- Right.

- And things in their backyards and you can't be everywhere all the time and yeah. A child could wander out the back door.

- Well, and if you're a mom of four like me, I'm chasing someone and it just might not be the 2-year-old at that

- Moment. Yeah. It's not that you're neglecting your children, right. You're just, just trying to survive. I'm just doing all the other things. Yeah, exactly. And the gun safety too, with us being a big hunting community. Yes. Right. A lot of seasonal hunts. So a lot of people utilizing those guns. So make sure they Yeah, for sure. And I'm sure there's classes you can take for either of these things. I know that there's several Yes. Local swim safety courses that people can get involved with, even with children as little as like six months old. You know, you've seen the, the terrifying where you have to let your kid jump off and or fall off in the pool and see if they can roll over. But in it is on the spirit of being prepared safe. Safe is key. Yeah. Better safe than sorry as Absolutely.

- Definitely. I know we have a great EMS team here and I'm assuming you work closely with them, right? We do. So how does, and this is probably pretty basic, but how does the EMS, the ER and the trauma department, how do they all work together? So we

- Are, we are siblings and you know, sometimes siblings they, they, you know, there might be some friction. They aggravate each other, they aggravate each other, they pick on each other. But it really is all in good fun. We have a very good relationship with our EMS. We do a lot of training joint, sometimes we've been involved in active shooter drills with our local schools where I'll go out and participate sometimes, you know, if I'm in preparation or trying to think through, if we were to, you know, have like a mass casualty incident locally, what would that require of me in the hospital? And in order to, for me to be prepared, I need to have a foundation to understanding what EMS is, is having to deal with on scene as well. So we do some joint training, but when it comes down to our trauma protocol, we, we really, this is a benefit that I didn't have in Jacksonville that we do have here. With us having a hospital-based EMS service, we have a lot more ability, you know, to really kind of have more conversations to drive process improvement. A lot of times if I'm hearing something on the radio and I just, I just have more questions, I can go out to the charge desk and when they come in I can talk to 'em. I have an open door policy. I tell everybody if they, if you have questions, I probably, I might have it too. You know, let's figure it out. If I don't know it, I'll find the answer. But let's learn it together. Yeah. Come talk to me, come to everybody's got my number. And I think that that's, it's just important. We're talking about our whole system is trauma and so it, yeah. And it starts from the moment the patient's injured and the care that they are given on scene. And so that it really requires us to, to make sure that we are providing resources to EMS and them. They're giving us their feedback. And that's a open conversation.

- And that extends too to other first responders, right?

- Absolutely. Yeah. The trauma program sends out feedback letters to other hospitals even and other EMS services. So we, not just our hospital based EMS, but absolutely our other local, we rely heavily on, you know, to transport some of our patients. We rely on those services to help us. And so we, we try to provide, you know, as much feedback as we can and details of, of being that, like I said, that middle ground, that person that can advocate for both sides.

- Yeah. It's a big partnership With a lot of people and a lot of wheels spinning to make everything work the way. That's right. It needs to be, that's right. So probably organized chaos would be the correct term. I would that any other way. Yeah. Yes. I always felt like the ER operated like that, you know, naturally. Absolutely. It's organized chaos, but y'all know what y'all are doing. So that's the, that's the best part. Any kind of advice you would give to community or, I mean, just in regards to trauma prevention. I mean, I know you've probably hit on most of that, but

- Yeah, no, we've, I mean we've hit a couple of, of injury prevention specifics for sure. I just, I really respect the work that our, our team does because we are really trying to play catch up in, in some form. You know, our community has exploded. Yeah. And the benefits of having that trauma program is, you know, being able to provide those resources that's needed. But we do take good care of our patients, you know, that. And it always comes back to that. It always comes back to what, what's the patient's experience? Did we do what we needed to do When it comes down to injury prevention, if there is any way that we can help, you know, that's, i I, we extract out this data out of our registry and we send it to the state and we send it to national registries and they give us feedback on areas that we need to improve. But if there is a, a space within our community that we can be more active or involved in, I will take all, all of those, that feedback. If, you know, someone posts on our on

- Yeah.

- On our site or anything that there's a need, I'm happy to, to jump in, you know? Yeah. And figure that out and, and be that, that resource.

- Yeah. Yeah. Definitely. Do you have any memorable success stories from our trauma program that, that come to mind that you're really proud of?

- We've actually had a, a number recently that I, I was really, really proud of. One specifically that probably I will remember for the rest of my career. And it was probably just the environment in general. You, I think did a story on him. But it was Steve Wise and he was our, he was a,

- A hurricane relief worker, relief worker

- That came in to help us when our community was in shambles. And, you know, I, we all did our, our, our stent here in the e in the hospital. We were here for days just trying to, to whatever needed to be done. We were willing to help. Right. And Steve is actually a perfect example of, you can be prepared. He took all the safety measures, he had all the protective gear, he had the helmet on. He, you know, was very experienced at what he did and an injury still occurred. But he was help removing trees from a local person's home in our community. And it was a mishap. It fell wrong, it landed on his head. The, the helmet protected his head, but the weight of impact fell to his shoulder. So he had a lot, all of his ribs on one side were broken. And this is where that advocacy comes in. Or just being able to be a resource in that moment because we were able to have all of the, the team at bedside, his wife dropped everything and flew here with within 12 hours she was at, 'cause he was here by himself with his team.

- And he was from Texas. He

- Was from Texas. Yes. Yep. So came a long way, but it was so encouraging. That was really one of the first examples that I really got to see through the inpatient. And rounding him, rounding on him in the ICU and following up with that care. It was a remarkable story of recovery and resilience. And even as y'all know, as he was being discharged, he didn't want any of the recognition or, you know. Yeah. He was just wanted his team to be honored for the work that they were doing. And I just think that we were in our own state of uncertainty, you know, as healthcare workers, that's kind of what we're called to do, is to jump in and help our community. And here was someone that came to help us in our moment of need. And then he's, you know, sustained a, a life threatening injury that he had to, he had to give a lot of work. Yeah. And he went to rehab and he's back home with his family. His, his wife texts me every now and then, you know, but his, they sent a thank you care package to all the nurses upstairs. It was just, it was, it was really sweet.

- That was a really sweet story. We got to talk to him and interview him and he really was, like you said, not wanting to take any credit for anything at all and just wanted to make sure that, you know, his team got credit and, and he was Yes.

- Yes. It was. So if you're interested in learning about his story, I'll just do a plug. Yes. We are sharing his story in our annual report, which will be located on our website. So, and I think he was the one, we were able to do that fun discharge celebration. Yes. So oftentimes if we, if we have a patient that has been here for a very long time for like traumatic, you know, situations like that, that really gets close to our team, we, it's a fun thing to be able to celebrate them going home or go into their next level of care. So we all kind of gather down the hallway saying Yeah. Because that's why we do it.

- You know, it's, we don't always get to pull that back together and, and, and have the happy endings and so we gotta celebrate those. 'cause that's,

- Yeah, absolutely.

- That's hard work that the team put in that needs to be recognized. So that was fun.

- Yes. So I have one last question for you that wasn't on your list.

- Oh gosh.

- And it is an easy one. We like to ask all of our guests what your favorite thing to eat here is either in the spice or in the cafeteria. 'cause we know you guys spend so much time here.

- Oh my goodness. Ooh, what's it

- Gonna be

- Like lunch or anything? Meal, anything. Anything

- That they make.

- Okay. The Oreo pudding.

- Yeah. I don't know what

- It's called. Whatever that is. Some kind of Oreo deliciousness.

- Yes.

- I,

- I can't, if it's there, I'm getting it. Well

- We haven't had anyone say that one. So That'ss

- Good.

- Oh good. Yeah.

- No, that's good. I am. That's my favorite. I don't think I've had it. Yeah. Is it in the cafeteria? It is life changing. I'll for I want to warn you for that. Yeah. It's life changing.

- I'll look for it. Maybe don't ever try it. 'cause then you don't have to, you know, you won't want it if you don't know how good it is. Yes. That's all I'm

- Saying. Well thank you so much for being here today, Chelsea. Thanks for having me.

- Yeah. We appreciate everything you do and everything your team does to keep all of us safe and confident and that we're gonna get the care we need should something happen. So

- Thank you for

- Having me. And thank you to all of our listeners for tuning in. And you can like and subscribe to make sure you're getting all of our episodes and submit your questions or topics for us to talk about at sgmc.org/podcast.