PICU thinking of going to Burn ICU

[JeenaB.]

Hey All,

Ive been working in a Peds ICU in a major metropolitan hospital, and thinking of transferring to a major burn center nearby in their Burn ICU. I have already applied, but I want some insight from other burn icu nurses! The peds ICU used to challenge me and now it doesn't. I've taken care of some sick kids, and it was so rewarding and challenging. But other times (and almost ALL of the time now) I hate this unit because of some of the patients we get. Sometimes, our peds ICU doesn't feel like an ICU at all. I'm sick of Q4h chest PT and suctioning, trach to vent, post-ops, etc and other "ICU" assignments that leave your brain rotting away. Most importantly, I'm sick of the nurses competing with each other to get "good" assignments (you ICU nurses will know exactly what Im talking about)

My question is, does this type of stagnant environment happen in Burn ICU's as well? Are the patients true ICU patients and not just some fluff the floors can't accept because of technicalities? Ive been stuck in a rut trying to figure out what my next move should be. Ive done PICU for 3 years now and am ready to move on!

[dirtyhippiegirl, BSN, RN]

I would caution you that while many burn centers will advertise as being "Burn ICU" -- most are set-up as mixed acuity units in order to provide a continuum of care with PT/OT/speech and dressing changes. You'll probably be expected to cross train in both worlds. If you're concerned about taking care of only ICU patients, I would definitely clarify how the unit is run. Your best bet is to also clarify whether they take off-service patients, what kind of off-service...are the attendings/residents mostly plastic surgeons or trauma surgeons? (Because if the unit does take off-service, you're either going to get a bunch of boob jobs or awesome traumas.)

I could tell you how *my* burn unit is run but the nuances tend to differ from hospital to hospital, often depending on the size of the unit and the prestige it carries in the burn world.

[TamTamRN-RRT]

Did you ever apply? I only been in my picu for a year now and I too feel the same way. We get the same patients over!! I have so much to learn however don't feel like I can with the chronic kids and everyone is competing for the critical assignments

[HazelLPN, LPN]

You must have a very low acuity PICU if you feel that your brain is rotting away. I spent 17 years as a PICU nurse, and I found that it was the most challenging type of nursing that I worked in (adult gen med/surg, adult ICU, PICU, NICU and now school nursing). Certainly I had plenty of easy shifts where I had two stable kids....maybe a crain who had to come to PICU before going to the neurosurg flood....maybe a wheezer kid past his moment of glory who would be fine up stairs...but I found I liked that every once and a while vs the shifts when I had two kids crashing at once who should both be on 1:1 care and I ran my behind off all day, skipped lunch and left 4 hours late only to come back and do it all the next morning. Or the early Norwoods back in the 1990s who were came back from surgery so unstable that you had two nurses and the cardiac nurse to help you with that one patient and still didn't get a bathroom break.....that foley starts to look kinda good after a while. Equilibrium and Moderation made me happy.

IMHO, burns are some of the most challenging of all patients. Burn care is just as much art as it is science. I was pretty good with them in my day, but I certainly wouldn't have wanted to spent my career as a burn unit nurse as 1. I liked the variety of patients that I was able to care for in the PICU and it always kept me on my toes and 2. I worked with one of the best burn nurses in history and I am just not made of the same stuff as she was...she had magic in her hands.

Best to you,

Mrs H.