Myth of the Level One Trauma Center

Do you need to work in a level one trauma center to get into CRNA school? MOST ASKED QUESTION EVER.  Let's break it down and answer the question once and for all. Hint - forward this blog to all your besties.

Do you need to work in a level one trauma center to get into CRNA school? MOST ASKED QUESTION EVER. 

Let’s break it down and answer the question once and for all. Hint – forward this blog to all your besties. 

What is a level one trauma center?

According to the American Trauma Society, it is  “A comprehensive regional resource that is a tertiary care facility, essential to the trauma system. A level one trauma center is capable of providing total care for every aspect of injury – from prevention through rehabilitation.

Some of the key elements in this are: 

  • 24-hour in-house coverage by general surgeons, and prompt availability of care in other specialties (calling in neuro, plastics, ortho, cardiac).
  • Referral resources for communities in nearby regions.
  • Hit benchmarks that provide leadership, public education and more.

You can see the full breakdown of Level I trauma center here

Why is it a good thing? 

You are guaranteed that you’ll have a high volume and high acuity of patients. It is probably an academic medical center and get great comprehensive education as a nurse. 

What does high acuity mean?

This is the number two question asked. A high acuity ICU is a large ICU (>12 meds) with greater than 50% of those patients are either mechanically ventilated, on circulatory support, on continued dialysis or on multiple vasopressors. Are more than 50% of the patients under your direct care fall within these guidelines? Then you have that experience. Now, disclaimer time. If you are a new grad nurse and not getting these patients yet (aka being thrown to the wolves)  – IT IS OK. You have to crawl before you can walk. Patient safety comes first. 

Do you NEED a level one trauma center on the resume? 


The one main difference in a level two trauma center is that some of the tertiary needs (such as cardiac surgery) can be transferred out or ER volume. You can see the full breakdown here

What if you work in a more under resourced, potentially rural facility?

The type of experience that you are getting can be unparalleled to someone who is in a Level I Trauma Center. These smaller or more rural hospitals are often times a great foundation. You are likely to see a wide variety of different disease processes. You will have resources, support and opportunities to raise your skills as a nurse. There may not be a physician there all night so the amount of autonomy as a nurse you get is phenomenal. In a large academic medical center, you will have more handholding and micromanaging. The potential for leadership in your role will look great on a CRNA application. 

Creating opportunity for yourself anywhere!

You are your own best cheerleader and the one that can advocate for getting the experience yourself. Create those opportunities. Here are a few ideas. 

  • Start or join a rapid response or code team. You are going to see more sick patients and make rapid decisions on your own. 
  • Join the IV Team. This not only helps your own skillset, but shows leadership and be a resource for your hospital.
  • Start committees, like an evidence based committee. This shows you’ve taken the initiative and changed outcomes for the better. 

In summary, is it a level one trauma center good experience? Absolutely! Is it the ONLY way to get good experience? Absolutely NOT! Program directors want different backgrounds when looking at application packages. They will look at all of the parts, with some focus on the ICU and high acuity experience. 

In the Confident Care Academy membership, we have a mini course all on optimizing your application package along with all of our constantly expanding library of critical care, anesthesia, pharmacology and travel nursing topics. Hint – these clinical and pharmacology lectures will help you significantly with foundations and interviews! Hope to see you “on the inside”.

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