August 27, 2018

Trauma Unit celebrates 20th anniversary; longtime employees share two decades of memories

“It is the people and not the bricks and mortar that make this unit the special place that it is.”

20th anniversary of the opening of the Trauma Intensive Care Unit

Longtime staff members gathered recently for an anniversary celebration, including, from left, John Morris, MD, associate chief of staff of the Vanderbilt Health System and former chief of the Division of Trauma and Surgical Critical Care, who oversaw the creation and the opening of the unit in 1998; Marcia Burns, a VUPD officer assigned to the unit; Beth Mills, RD, dietitian; Veleria East, medical receptionist; Richard Miller, MD, chief of the Division of Trauma and Surgical Critical Care; Linda Wilkinson, ACNP-BC, nurse practitioner; and Shannon Godby, RN. Mills, East, Wilkinson and Godby have worked in the unit since its founding. Photo by Anne Rayner

The Trauma Intensive Care Unit opened on 10 North in Vanderbilt University Adult Hospital 20 years ago this month, August 1998. Since that time, thousands of patients and family members have passed through its doors, and hundreds of employees — nurses, physicians, medical receptionists, social workers, care partners and many others — have worked there.

Over the past 20 years, close to 60,000 patients from Middle Tennessee have been admitted to the 32-bed unit, the region’s only Level I Trauma Center. Currently, the unit cares for about 5,000 patients a year.

“It is a cohesive, smooth-running team working together with a common goal to supply the best care possible in one of the busiest trauma units in the country.”

John Morris, MD, associate chief of staff of the Vanderbilt Health System and professor of Surgery, was the first director of the Division of Trauma and Surgical Critical Care. He oversaw the creation and the opening of the unit and stepped down from that position in 2013.

“When I look back on my career, the highlight is the caliber of people I’ve had the privilege to work with, operate with and train,” Morris said. “It is the people and not the bricks and mortar that make this unit the special place that it is.”

In the unit’s 20 years of change and flux, there have been some constants, too — among them the people quoted below, who were all there at the beginning, and have stayed for two decades. These employees reflected on their time working in the unit, their co-workers, the patients and their families, and how it has affected them.

“I have a bird’s eye view of the remarkable team busy at work continually on their quest to save lives and help critically ill patients recover from major injuries,” said Richard Miller, MD, Chief of the Division of Trauma, Surgical Critical Care and Emergency General Surgery. “It is a cohesive, smooth-running team working together with a common goal to supply the best care possible in one of the busiest trauma units in the country.

“Thanks to all that have weathered the 20 years since inception of our Trauma Unit. We are forever indebted for your wisdom and longevity in this special place.”

The interviews are condensed and edited for clarity.

Shelley Atkinson, MSN, ANP-BC, ACNP-BC, is lead nurse practitioner in Trauma Surgery. She has been at VUMC 27 years and works the 6 a.m. to 6 p.m. shift.

The first day that the trauma center opened, we filled up every bed. Dr. John Morris was there all weekend with very little sleep to assure the success of the Trauma Center. He obtained approval for five positions for Trauma Nurse Practitioners. I had no idea what I was getting myself into.

 The Trauma service requires a large team of people to coordinate care for the critically ill multiply injured patient. The goal of the team is to provide care that is consistent, efficient and safe for the patients suffering from traumatic injuries. For over 20 years, I have watched trauma care delivery improve through evidence-based practice. A group who significantly impacts patient care are the Trauma Nurse Practitioners, who efficiently coordinate patient care, deliver evidence-based practice, and reduce complications and readmissions.

 I have the privilege of working with an amazing, hard-working group of people. We are a family. We battle together to save lives and continue to strive to have the best Trauma Center in the country. Dr. Richard Miller tells new residents “We work hard every day and we work hard to do the right thing.” It is incredible to experience patients that survive a traumatic injury with a 1 percent chance of survival, or people who overcome horrific injuries.

Trauma patients have provided a unique experience with challenges to provide care to diverse populations across different life spans. In trauma, we have a saying: “Normalizing a patient.” That is our goal for every patient, every time. We are not always successful due to the injury severity; however, watching the injured get better, be able to get up and move, work hard to get stronger. I love that. It is a pleasure to get to make a difference.

Veleria East is a medical receptionist who typically works the day shift. She is known to co-workers as “Mama V.”

Veleria East

To be honest [at first] I didn’t know anything about the Trauma Unit. My mother called me one day to tell me about a new floor opening [and that ] I needed  to come on and apply for it — so I did. I’d never worked in a hospital before, but I have been here ever since.

 The co-workers that I have befriended in all these years I still keep in touch with. We are all Facebook friends. The ones that are here now, I adore. I love working with them.

 Some patients stick to your heart; some families you just want to help them so much. I know how they are feeling because I have been in their shoes, when my mom [was a patient] in the Critical Care Tower. I remember the case of a young mother who was thrown from a horse and had a very bad TBI (traumatic brain injury). She was passing and they called her husband and let him know. He came in with their two children, and she held on until they arrived. When he got here he told her he would be fine, that she could leave. She took one breath and that was it; she passed on like she was waiting for him to get here. The whole floor was crying it was so special and sad at the same time. It was an experience I will never forget. The power of love.

 Seeing past patients walk back in to see us is the most rewarding feeling. I love it when families feel like I’ve helped them. The smile on their face is great.

Shannon Godby, RN, TCRN, has been at Vanderbilt since April 1995. She worked in the Surgical Intensive Care Unit (SICU), and moved to Trauma when it opened.

Shannon Godby

Being a trauma nurse has truly become my calling. When I made the decision to transfer to “just” trauma, I was worried I would get bored with the same thing day in and day out. I was wrong, I love what I do, and … I still get surprised by something new every now and then.

 I do make a difference in peoples lives and that matters to me. I train new nurses and have a friendship with them and look over them, that also makes me feel a sense of ownership and makes me feel that I can help those feel like they also make a difference. I also connect with families, even some of the difficult ones, and help them through these tough times.

 There are many families that I have connected with over the years, some of which I am still in contact with to this day. There was a young girl that had a bad MVA. I was training a new nurse, we busted our butts to save this girl’s life. She was here for about four weeks, then went to rehab. Her family was from out of town, but every time I was here they came and found me to tell me how well she was doing and how thankful they are for how hard we worked that day. This was one of those cases that reminded me that I am here and this is my purpose and I am damn good at what I do.

 The trauma team is a great team. This is not an easy place to work, or even stay for a long time. For the staff that has been here a long time, we are the ones that were the best of the best, not to mention a little — O.K. a lot — crazy for staying so long. I am proud to have been here this long and think that it is important.

 Brenda J. Lytle is a medical receptionist who works the night shift on the Trauma Unit. She began working at Vanderbilt part-time in 1971, and has been full time since 1972.

 Before I came to trauma I worked on the 11 South Neuro Unit. I was working eight- hour shifts and I needed to work fewer days because of sickness in my family. Trauma was offering three days of 12 hours. I was set.

 I’ve stayed on trauma because of the workflow and the patient load and because of the people I work with. Most of the workers I work with on trauma I have enjoyed so much.

 Working on trauma is a experience I will never forget — watching the patients come into the ICU so sick, get better and move to stepdown, and then home or to rehab.

 The day I leave Vanderbilt for good I will always know that no matter where I have worked in all of these years, I did my best.

 Veronica McGuire is a night shift medical receptionist. She started at Vanderbilt in 1994 in the SICU, and moved to the Trauma Unit when it opened.

 My mother worked at Vanderbilt and told me it was a good place to work and offered great benefits for yourself and your family.

 I enjoy helping others and learning new things. I like the people I work with and they do such an amazing job. I am able to assist families and staff with providing crucial information when needed. 

 I have experienced viewing people in traumatic situations and sometimes feeling there is no hope — but amazing things happen and [often] patients are able to leave with their loved ones. 

Beth Mills, MS, RD, CNSC, LDN, works the day shift in the Trauma Unit as the registered dietitian 4 clinical coordinator. She has been at Vanderbilt 26 years. She worked in SICU and moved with the trauma patients to 10 North when the Trauma Unit opened 20 years ago.

Beth Mills

I had a brother killed in a motor vehicle crash back in 1981 when I was in undergraduate in nutrition.  Each patient I treat is the care I would have wanted my brother to have received if he had made it to a Level 1 Trauma unit.

Nutrition is a vital part of the support and recovery care of traumatically injured patients and I wanted to be involved with progressing the care of these patients. Delivery of nutrition care has improved over the years. From a collaborative effort working with a trauma attending that had a special interest in nutrition, an anesthesiologist during his critical care fellowship and the nurse management and bedside RNs, a performance improvement project was undertaken to improve the delivery of nutrition to the trauma patients — with the result of increasing and improving the percentage of meeting the patients estimated caloric and protein needs.

[The most rewarding thing about my job is] the fabulous interdisciplinary teamwork that occurs on the trauma unit daily to promote the best outcomes possible for our patients. I have had the privilege of working with a wide variety of co-workers from many disciplines over the last 20 years. It takes a large team of staff to provide the intense care required by trauma patients. Having a clean environment for patients, meals, oral supplements and enteral/parenteral feedings delivered for nourishment along with the best medical care practiced with intention by the MDs, RNs, care partners, case managers, pharmacists, RTs, PTs, OTs, SLPs and social workers leads to a true measure of success — successful outcomes for the patients for whom we provide care.

Linda Wilkinson, ACNP-BC, ACHPN, is a nurse practitioner in the Trauma Unit. She started out as a staff nurse (RN) in the SICU (when it was on 3 North) starting in 1995, and transitioned up to the Trauma Unit into a Clinical Nurse Specialist role when it opened in 1998.

Linda Wilkinson

I was one of the “original” nurse practitioners (Shelley Atkinson is the other) that helped carve out the role of the NP on the Trauma Service. At that time there were five of us and we rotated 12-hour days and nights to cover the unit 24/7. Since then, the NP’s have branched out to be primary providers (reporting to the attending MD) for the Trauma patients who are housed off of 10N. I love watching the Trauma unit team (MD, NP, RN, CP, MR, Case Management, Social Work, Housekeeping, PT, OT, SLP – everyone!) work together for the patients and families we serve. 

I also am Adjunct Faculty with the School of Nursing (in the Acute Care NP track), and lead clinical rotations with students on the Trauma Unit. I love giving students the opportunity to witness this environment first hand.

 We give so much — physically, emotionally — to care for these patients, it’s essential to find a way to “fill my cup” so I can continue to “pour into” those that we care for. I like to spend time outside, being still at my hillside in Kentucky, gardening, walking/training (physical exercise) and spending time with family. I’ve had my share of compassion fatigue over the years, and self care is what has allowed my longevity.

 We have to be a team. This is not individual work. We stand beside each other, jump in where needed, lighten the load for each other.  We laugh together, cry together. Nurses stay with patients who have no family, so they don’t have to die alone. Nurses cheer on the patient taking one more step with therapy. Physicians stand by nurses and NPs and work collaboratively.

 We know our patients don’t want to be with us. We hate it that they are — but are grateful to be able to serve their needs as best as we can.  Not everyone returns to their pre-trauma life.  Not everyone lives. Meeting them where they are with what they need is the goal.

 The most rewarding thing is watching and assisting people work through their challenges.  Sometimes it’s dealing with their injuries, sometimes it’s saying goodbye to a family member. It’s an honor and a privilege to be present with someone in the midst of a crisis, and at end of life.  It’s especially challenging when it’s unexpected.  Being in the Trauma Unit is not how anyone plans to spend their day, so making that experience a little more tolerable, and providing the encouragement to work toward their best life or best death is what I love most.

 One of my most memorable patients is the woman years ago who said I “gave back her voice” on Christmas Day by taking out her trach. Her first question to me, “Will you help me call my son? I want to wish him Merry Christmas!” We were all in tears.

 A final word from Richard Miller, MD: “People like these continue to share their years of expertise with those who are new at this craft. Dr. Morris helped create this unique Trauma Unit 20 years ago and we continue his mission to this day caring for more than double the number of patients, yet our safety and outcomes are better than ever. We have learned from our mentors and teachers and I am personally very proud of this amazing accomplishment.”

Trauma Unit staff on rounds with a patient. Photo by Joe Howell