May 2018 • Volume 11, No. 5

From the Editor

May is the month of Memorial Day, a day that has come to mean picnics and swimming pool openings for many of us. But the official holiday (Memorial Day, formerly Decoration Day) was founded after the Civil War as a time for remembering those who died while serving in the U.S. armed forces.

Being in health care, when we think about our troops, our thoughts turn to the traumatic nature of battlefield injuries, whether fatal or not. It’s not much of a jump from there to start thinking about the challenge of treating gunshot wounds and stab wounds closer to home. In any case, it seems timely to devote an issue to traumatic injury—the treatment options for which have come a long way since the Civil War.

Scroll down for articles and videos on the subject as well as an all-new crossword puzzle to sharpen your skills.

Before all that, we bring you a little news from NIFA. And, as usual, at the end of the issue you’ll find our collection of RNFA jobs plus NIFA’s favorite links.

Enjoy, and best wishes for a safe and enjoyable Memorial Day weekend.

Julie Lancaster, Editor
Photo: “An Ambulance Removing the Wounded” from “Letters from a Surgeon of the Civil War.” More info about the image here.


First Grads from NISE™ Program!

We’re pleased to announce that NIFA’s NISE™ (Nurse in Surgery Essentials) program has had success, with its first graduates in April and May.

This course is designed to address the nursing shortage by educating nurses new to the surgical environment. It is marketed to hospitals and surgical clinics rather than directly to RNs.

One manager wrote, “I like the videos that are included. . . . Especially for a rural facility like ours where we don’t have a lot of resources or see things that bigger facilities see. I thought the journal questions were good and liked how they tie into actually being in rooms instead of just ‘book’ questions.”

“The NISE course . . . helped me grasp concepts about the surgical process that I had not ever understood before,” wrote a student. “My course preceptor was very instrumental in my learning process [with coaching along the way].”

If you or a colleague might be interested in this program for your facility, check out the program’s website.

Surgical News

Penetrating Abdominal Trauma

This article, by Patrick Offner, MD, MPH, provides an extensive overview of abdominal gunshot wounds and stab wounds. Different sections cover background, anatomy, epidemiology, treatment and more.  
Read more . . . | photo:

The Surgical Glue That Can Repair an Injury in 60 Seconds 

A research group has developed a sealant made out of naturally occurring proteins in the human body. Currently being tested on rats and pigs, the glue can be applied to open wounds (primarily lacerations) and seals them. It can also be used in surgeries where stitches might not make sense, such as inside the lungs.

“The gel is not yet ready for prime time,” Glatter writes, “but will be a serious contender if future testing in humans is successful.” He goes on to say that the implications “include roles in the operating room and emergency department with wounds involving extensive bleeding, as well as on the battlefield–potentially saving lives and reducing the need for blood transfusions.”
Read more . . . | photo:

Note: You may need to create a guest account on Medscape to access this article. Registration is free.

Gunshot Wounds: A Targeted Approach 

This 2017 article provides an overview about gunshot wounds in the United States. Written by Nicole Cimino-Fiallos, MD, a resident in the Department of Emergency Medicine at the University of Maryland Medical Center, Baltimore, the article is richly illustrated with CT scans and photos.

“Due to advances in emergency medical care and acute care surgery, there has been a 40% decrease in in-hospital deaths following a gunshot wound over the last decade,” writes Cimino-Fiallos. She goes on to describe treatment approaches for different types of gunshot wounds and locations.
Read more . . . | photo:


Gunshot Wound to the Abdomen: Laparoscopic Exploration and Repair of Small Bowel Injury – This video, published by the Society of American Gastrointestinal and Endoscopic Surgeons, offers a very close-up shot of a gunshot surgery. The dialogue is sparse and technical. 
Watch video . . .
Management of gunshot wounds of the abdomen – A 30-minute vintage film by The Committee on Trauma of the American College of Surgeons. It shows the step-by-step process of dealing with a gunshot victim, including positioning and procedures. (You may be asked to confirm you are old enough to see this age-restricted video.)
Watch video . . .

Trauma Surgery Crossword Puzzle

Test your knowledge of trauma surgery procedures with this month’s all-new crossword puzzle.

When you’re ready to check your answers, follow this link to see how well you did. Good luck!


Student Spotlight: Susan Turpin

City & State
Fairfield, CA
Student Status
Current student
Current Position
UCSF Benioff Children’s Hospital – Oakland, as a Cardiology / Cardiac Surgical PNP
Where did you get your RN degree?
University of San Francisco. Received my MS from UCSF.
How did you come to choose perioperative nursing?
Surgery is a major component of my subspecialty, pediatric cardiology/cardiac surgery.
What is the scariest moment you’ve ever seen at the table?
In the rare situation where an incision or suture pulls through at end of pediatric cardiac repair, instability can occur so quickly, the team works to respond and control is amazing.
What is one technique or RNFA trick you’ve learned from NIFA this week that you will use for life?
So many! Burying the knot deep so that the cutaneous incision heals as well as possible!
How do you feel having your RNFA will impact your life/career?
It will expand my area of practice and be an exciting new contribution to patient outcomes.

Jobs Front

Click here for the RNFA job postings we’ve collected for you this month.

NIFA – Office Hours

Monday-Friday, 8:00am – 4:00pm

Practice Resources

Here are several of the most-in-demand sites for our students, prospective students and grads:

ACS Surgery News: Specialty News and Commentaries, Videos and More
RNFA Scope of Practice by State (PDF)
ACS List of Cases that Require an Assistant at Surgery, 2016 (PDF)
Perioperative Nurse Links (state nursing boards & professional associations)
APRN Nurse Links

Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.

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