Burn Nursing

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    Burn nurses serve a wide selection of patients. They might be caring for a teenager with multi-system trauma or a 27 year old who was injured when he came into contact with high voltage lines or a child who was the victim of non-accidental trauma. Therefore, the skills needed run the gamut also. And, burn nurses are needed to educate their fellow non-burn nurses in the very special assessments skills needed to care for these patients. This article will discuss the general work environments of the burn nurse, some skills and qualities necessary to be successful and some general duties and responsibilities. Finally, I have provided a few resources to further your interest in burn nursing.

    Burn Nursing

    Burn nursing covers a wide range of patient diagnoses. When a patient comes into contact with high voltage, it results in entrance and exit wounds. When a patient survives a house fire with inhalation injuries, they become a burn patient. Other mechanisms of burn injuries include: car accidents, falls and workplace accidents

    Work Environment

    The work environment of burn nurses varies as much as the mechanism of injury. Working in an emergency department, you are often the first caregiver of the burn patient. As they move through their care, they often encounter ICU nurses, rehab nurses and sometimes dedicated burn center nurses. After the acute phase of burn care has been survived, there are often long term care needs too so burn nurses can work in offices too.

    Skills and Qualities of Burn Nurses

    Nowhere in nursing is it more important to be able to see the long-range goal of care then in burn nursing. Burns require many phases to survival. Important qualities of burn nurses include compassion and ability to connect with the patient and family. Skills include excellent assessment skills, strong IV placement technique, knowledge of fluids/electrolytes and pain control. Burn nurses must be strong advocates for their patients.

    Duties and Responsibilities

    These can vary greatly depending on the severity of injury, age of the patient, co-morbidities and mechanism of injury. Certainly in the immediate post-trauma event, the emergency department (ED) RN will be responsible for assisting to stabilize the patient, identify all injuries, perhaps make transfer arrangements and communicating with the family. As the patient moves from unit to unit and perhaps hospital to hospital, it is incumbent on the nurse to ensure transfer of care is seamless. This involves discussing patient needs with the patient, family, other care providers as well as accepting nurses and providers if the patient is transferred.

    Job Outlook

    The job outlook will be high for burn nurses, especially at national burn centers. Since burn care of the seriously injured is segregated at a burn center, it will be important for burn center nurses to educate other nurses and staff regarding the care of the burn patient.


    The American Burn Association is the non-profit organization providing education and care for patients and families affected by burn injuries. They host conferences on burn care and provide guidelines for transferring patients to burn centers. This website also contains lists of US burn centers. It also covers the Advanced Burn Life Support (ABLS) course and provides resources for this certification. And, in this day and age of capitation, case management and increasingly tight healthcare budgets, this website offers coding assistance which can be invaluable when trying to obtain care for your patient.

    The Society of Trauma Nurses covers all facets of trauma care which includes burn injuries. Many patients sustain multi-organ and multi-system trauma. This organization also publishes a well-respected journal.

    The American Nursing Association (ANA) covers many facets of nursing. For burn nurses, ethics issues can be the forefront of care. The ANA offers many resources regarding ethics and possible care limitations.
    Last edit by traumaRUs on Jun 15, '18
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  3. by   Guttercat
    Thanks for this, Trauma.

    My worst patient in the ED (and I subsequently cared for him in the ICU) was a victim of a house fire. I'll never, ever forget him.

    It was horrific.

    Speaking of "strong IV placement skills...." Ever try to put a line in an arm that peels like a toasted marshmallow when you pick it up?

    I salute burn nurses. I couldn't do it.
  4. by   traumaRUs
    My experience with burns is also limited to ER.....and couldn't agree with you more. Seemed to take forever to get the smell off of me. And sooooo sad.
  5. by   dirtyhippiegirl
    Burn center RN here.

    I would not necessarily say that job outlook is high for dedicated burn RNs. Many dedicated burn centers are closing, have closed, or are becoming smaller. Overall *need* for burn beds has generally decreased simply because of public safety promotions and stricter regulations on everything from building codes to clothing. More importantly (unfortunately) -- burn centers are *very* costly to operate and more often than not have a large percentage of patients who are uninsured.

    On the flip side, turnover on burn units is generally very high so there are usually positions open.


    Also, if it's a dedicated burn center, the patient probably will not move from unit to unit. Many burn units are set up to provide a continuum of care from ICU to floor and RNs are trained to care for a patient at any point in that journey.


    I would also like to suggest a mention of our wound care skills, arguably what makes a burn RN different from a general trauma RN. Anyone can compute out the Parkland formula and there may even be some RNs out there who are totally comfortably pushing 400 mcg of fentanyl in twenty minutes -- but can you make an entire suit out of netting? I THINK NOT.
  6. by   traumaRUs
    Excellent post dirtyhippiegirl! Thanks for the great additions!
  7. by   NurseDirtyBird
    This might be a dumb question, but I've never worked acute care, or anywhere near a hospital with a burn unit. Are there usually separate peds and adult units? Are they in the same unit? Or do the kids usually get transferred to children's hospitals? Just curious.
  8. by   HazelLPN
    I did more than my fair share of burn nursing when I was a PICU nurse. I could hold my own with them, but I was always happy for the burn unit nurses to come down and help with my dressing changes...I learned something new every time. I always though that bad burns were some of the most challenging of all critical patients. For me, watching an experienced burn nurse doing a dressing change is truly like watching Martha Stewart cooking. No nonsense, no shortcuts, do it right or don't do it at all....and no matter what you do....it will never look as good as hers.
  9. by   traumaRUs
    There are specialized units and sometimes hospitals which treat adult and peds burn pts. For instance, in the state of IL, adult burn pts go to Springfield Memorial and peds burn pts go to Cook County.

    Yep, only two burn units in the whole state!
  10. by   Guttercat
    Quote from traumaRUs
    My experience with burns is also limited to ER.....and couldn't agree with you more. Seemed to take forever to get the smell off of me. And sooooo sad.

    That "charred smell" stays in your nose forever. .
  11. by   2ndchanceRN
    I think it just depends on the Burn Center. I am an RN on a Burn Step Down and we take both adult and pediatric patients. The Burn ICU also takes adult and pediatric patients.
  12. by   dirtyhippiegirl
    We also take pediatric and adult patients on the same unit.
  13. by   Pudnluv
    God bless you burn nurses! I know I couldn't do it and I am glad you are there.