[CRNAorBust]

This article claims that many burn units across the US are money losers and that's why some have shut down with the expectation that trauma units would do something similar in the event of a large influx of burn victicms.

I have no experience with Burn units so I'm wondering what others who do think about this.

What's it like in YOUR hospital?

http://www.comcast.net/news/health/i...tn_burncenters

[KR]

I live in a mid sized town in PA. We have roughly 150,000 people I believe. Our burn unit got shut down sometime in the early '90s. I disagree with the article saying that general trauma units can handle burn patients just as good as a burn unit could. I have worked with trauma patients for a long time and there is no way I feel that I could adequately care for a burn patient let alone do as good of a job as a nurse trained in burn patients.

[Quickbeam]

I worked on a pediatric burn floor in the 1990's. The care was so specialized. No one floated to our unit for fear that the protocols were too hard to master. To me, it is kind of like oncology or ortho....very specific skills sets.

[caroladybelle]

Originally Posted by CRNAorBust

This article claims that many burn units across the US are money losers and that's why some have shut down with the expectation that trauma units would do something similar in the event of a large influx of burn victicms.

Unfortunately the same thing is happening to trauma units. Due to the high cost of malpractice insurance and trauma services and extremely limited and inadequate reimbursement, they tend to be big money losers.

Think about it...a large percentage of the "customers" for these services are poorly insured or uninsured. And these are patients requiring lengthy, costly and complicated treatment.

[shandsburnrn-SRNA]

Whoever in that article that said the general trauma units could handle "true" burn care needs to spend some time in a "true" burn center.

I work in a Burn ICU in Florida, we only have 8 beds. These beds mostly get filled with our critical burns, we very often send out our "minor" burns to our "trauma" unit. I can't tell you how many times a moderate burn patient has gotten "sick" because of inadequate care. Not the trauma nurses fault, they are just not used to or trained to treat burns and aren't familiar with adequate resuscitation techniques and aren't used to looking for the suttle signs that a burn patient is becoming over/under resuscitated, may need escharotomies, may be developing airway compromise, etc.

Burn care, like other ICU's, CVICU, ortho, NICU, PICU, etc. and maybe more so is very specialized. As burn nurses we go through a lot of extra training in caring for these patients.

While a SICU could care for a simple burn. Major burns have to be treated in a burn center with properly trained physicians and nurses.

[TrudyRN]

Burn care must be done by those most qualified to give it, like any other specialty, if we want the patients to avoid infection, septic shock, multi-organ failure, and death. What can those who want to shut down these units possibly thinking except the cost?

Have they no fear of God, no reverence for God's creation? I fear that we are living in a hard, hard world, a place where all that matters is "Me" (rich people) and my comfort and my money.

Make no mistake - these greedy persons will give an account before the Maker of Heaven and earth. They will explain to God Himself why they valued money, power, and possessions over helping their fellow man. I pray for their lost souls. I pray that they will come to know the One who loves them so dearly that He gave His life on the cross to cleanse them from sin and to give them His righteousness, if they will only accept it.

With the love of God in our hearts, we will not allow them to shut down the burn units. We will take up the battle to give good care to anyone who needs it.

[caroladybelle]

Originally Posted by TrudyRN

Burn care must be done by those most qualified to give it, like any other specialty, if we want the patients to avoid infection, septic shock, multi-organ failure, and death. What can those who want to shut down these units possibly thinking except the cost?

Have they no fear of God, no reverence for God's creation? I fear that we are living in a hard, hard world, a place where all that matters is "Me" (rich people) and my comfort and my money.

Make no mistake - these greedy persons will give an account before the Maker of Heaven and earth. They will explain to God Himself why they valued money, power, and possessions over helping their fellow man. I pray for their lost souls. I pray that they will come to know the One who loves them so dearly that He gave His life on the cross to cleanse them from sin and to give them His righteousness, if they will only accept it.

Sigh.......

Love of G-d has nothing to do with it.

Cost of providing the service vs lousy reimbursement is the issue.

Perhaps you personally can go out and find enough qualified Nurses, MDs, OR Techs, PTs, RTs, etc. to be on call and work enough hours, donating their ALL of their services for free, whenever insurance fails to pay or the patients are uninsured/underinsured.

Unfortunately, most all of those personnel require a pay check, especially to do that grueling and painful a job. Not to mention, the specialized equipment all have large price tags to them. Are you ponying up to pay for them?

Who is going to pay for this care? Are you going to donate the funds personally or from all of the churches in the area? All healthcare costs. And if it is not coming from your pocket, it is going to come from someone's. Who do you offer up to pay the bill?

Please do not throw G-d into this...s/he doesn't belong in it. This is also not the fault of anonymous "rich people". Per your expressed view, if nurses are not donating, free of charge, care to all of our poor suffering patients, they ARE "those greedy people to appear before their Maker to explain why they valued possessions above people".

[MAISY, RN-ER]

I work in a hospital that is a designated burn center-if you could see the amount of people who are referred to our ER after being treated in other hospitals you'd be amazed. I almost feel that in many cases they should be sent to us first(and these are usually burns not requiring admit). Many hospitals do good dressings and burn care, many others do not. Tetanus boosters are routinely given if not up to date for a burn-many hospitals do not give(who knows why?) Pain relief is another topic of concern-many people receive none and were told to take ibuprofen and tylenol-many of these burns were extensive and deep. We make sure pain control is addressed and followup to our burn clinics are made. Patient teaching is also a major need, some patients wait for days/weeks presenting with dirty bandages/weird ointments etc-then require painful debridement that will most definitely scar. These are the outpatient burns....the inpatient burns are so complex and require so much care that I cannot believe they could be integrated onto a regular floor! Also, what about inhalation injury-very dangerous-needs expert support and same high end care external burns require. I guess we are lucky -there but for the grace of God....hopefully no administer lives to rue the day they eliminated their burn center and their child or grandchild is the recipient of that life altering injury.
Maisy

[TrudyRN]

Originally Posted by caroladybelle

Sigh.......

Love of G-d has nothing to do with it. I believe it has everything to do with how we treat our fellow man. If we revere God, we will realize that we can't very well do evil to other people.

Cost of providing the service vs lousy reimbursement is the issue. And if insurers/reimbursers revered God, they'd be reimbursing at a better rate. This better rate would translate to hospitals being able to focus on the patient rather than on their income.

Perhaps you personally can go out and find enough qualified Nurses, MDs, OR Techs, PTs, RTs, etc. to be on call and work enough hours, donating their ALL of their services for free, whenever insurance fails to pay or the patients are uninsured/underinsured. Again, there is no need for donating anything. See above.

Unfortunately, most all of those personnel require a pay check, especially to do that grueling and painful a job. Not to mention, the specialized equipment all have large price tags to them. Are you ponying up to pay for them? See above.

Who is going to pay for this care? Are you going to donate the funds personally or from all of the churches in the area? All healthcare costs. And if it is not coming from your pocket, it is going to come from someone's. Who do you offer up to pay the bill? Same

Please do not throw G-d into this...s/he doesn't belong in it. This is also not the fault of anonymous "rich people". Per your expressed view, if nurses are not donating, free of charge, care to all of our poor suffering patients, they ARE "those greedy people to appear before their Maker to explain why they valued possessions above people".

I believe God belongs in everything that has to do with people and with life. He made us, He loves us, He does not require us to donate ourselves unreasonably. He does hate crooked business and that is what is happening in our world - some people are enriching themselves at the expense of those who need lifesaving care. You don't have to agree with my view. I'm really not sure where you read that I expect workers to donate their skills and time. What I want is for the powerful money interests in our world to put God first. If they do that, no one will suffer because their hearts will be right with God and they will treat their fellow man with love and respect. Those who worship money can't put God and others first.

[caroladybelle]

Originally Posted by TrudyRN

I believe God belongs in everything that has to do with people and with life. He made us, He loves us, He does not require us to donate ourselves unreasonably. He does hate crooked business and that is what is happening in our world - some people are enriching themselves at the expense of those who need lifesaving care. You don't have to agree with my view. I'm really not sure where you read that I expect workers to donate their skills and time. What I want is for the powerful money interests in our world to put God first. If they do that, no one will suffer because their hearts will be right with God and they will treat their fellow man with love and respect. Those who worship money can't put God and others first.

The money that those insurers pay has to come from somewhere....and that ends up coming from someone's pocket. Are you offering for it to be yours?

It is fine to expect others (those that you label crooked or greedy) to lose pay to provide services, but unless you are willing to shell out your money or your service for free, if you are a HCW that gets a paycheck, you are part of the problem.

Medical care is finite....there is a limit...and unless one personally wants to see nursing wages cut, one needs to recognize that there is a limit. Not all insurers are crooked, but even if they are only making the minimum - there is not enough money to provide all care at its price to all people, unless ALL OF US offer to pay higher insurance rates, higher taxes, donate our services, or work for less. Which do you propose to do, to honor G-d ? Otherwise one is just another greedy person that will be judged lacking before G-d, per your post.

One can look to England to see that health care for all and getting rid of the "greed", means that health care resources are finite and some things will be rationed, especially to the elderly or those with limited prognosis. Is that more in keeping with what G-d wants? So much for honoring your elders and caring for the weak.

We also have to face that many of the advances in healthcare that we see today are the results of someone else's greed. If they did not put in the better parts of their lives to develop vaccines, drugs, equipment and procedures, more people would die of preventable/curable illnesses. And many of these inventors did this in part for money and renown. They may be less likely to work that hard if there is little earthly reward.