The Making of a Burn Nurse

SandBetweenMyToes, BSN, RN

I started out as a shiny new Grad Nurse in the Burn ICU. What an overwhelming, yet thrilling rite of passage that time was. Learning so many new skills...from basic nursing to ICU, to burn patient specific nursing kept me humble, to say the least. I will never forget "Stan." Stan came to our unit when I had been there maybe a month and a half. He was a "95 percenter" with 2nd and 3rd degree burns over his whole body...I was told his chance of survival was next to nil. It was customary on our unit to give the most critical patients to the newest nurse (with resources of course) so that we could be exposed to various experiences and hone our new skills.

I was terrified. How would I take care of this poor man when I knew so little? My preceptor was awesome and taught me not to fear the ICU burn patient. "Don't be afraid to move the lines...trace them back and find out what they are for...ask questions." I learned so much so quickly and I was hooked. Stan was, looking back, the most influential patient I ever had because he taught me to be a nurse.

He was in a drug-induced coma for the first three months. I worked midnights and had many long conversations with his wife, who was allowed to stay with him from time to time. Later when he was awake, she was a constant fixture in his room. I learned that as a nurse, you are there to treat the family and the patient, especially on the burn unit, where if a patient survived, he was likely to be there for a long time. Stan was with us for 14 months.

His dressing changes were BID, and excruciatingly painful for him. I learned to work quickly and effectively and to be generous with the PRN pain meds. His dressing changes were often a 3-4 hour procedure, from the Hubbard tub debridement to the final wrap. It was an art form just to know how to estimate the number of burn gauzes and cling wraps and jars (yes JARS) of Silvadene. His genitals were badly burned and it was inspiring to see how much his wife wanted to know everything about his care, and how affectionate she was with him. His fingers were fused and many had to be amputated. He narrowly avoided amputation of his legs.

Once he was off the ventilator, many months into his stay with us, he became very depressed. There were many nights when he would weep. On more than one occasion he would summon me to his air-filled Clinitron bed and say, "Please...you have the power...take my life. Turn up the morphine and Ativan and let me go. My life is not worth living." I would hold his hand and let him talk...gently reminding him of all the people who loved him, and the progress he had made. He was such an inspiration. He beat the odds. He got through all of it...the depression, the burns, the countless skin graft, and contracture release surgeries, the PT and OT...even an emergency cholecystectomy.

When the day came 14 months later for him to go home, he was proudly sitting in the wheelchair and motioned me over to him. He said, "Thank you...you have made all the difference to me. You and the other nurses here have made me want to live. I have so many opportunities. I know now that if I can get through this, I can do anything!"

Thank you, Stan, for helping to make me the nurse I am today. I will never forget you.

The Making of a Burn Nurse

About SandBetweenMyToes, BSN, RN

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