Burn-Unit-RN

Typically MGH will only accept RNs who already have ICU experience. What is your nursing background? If you're not already an ICU nurse, I would try to transfer units at your current facility first and then reapply to MGH in a year. The hospital also just opened a new trauma/transplant ICU last fall and have been gradually hiring both internal candidates and well as outside nurses with ICU experience. Unfortunately, most of those positions have already been filled. Likewise, positions posted get hundreds of applications when they are only trying to fill one vacant position. Therefore, you have to make sure your resume is the shining star of the bunch. If you really have a strong desire to work there, I suggest applying for a position on one of the general care units first, and moving to an ICU later in your career. Hope this helps a little.

I got hired on a burn unit as a new grad, and I love it! I worked there first as a nursing assistant, so I did have an idea of what the role of the RN would be like. As far as certifications, there are very few for burn nurses. The American Burn Associates puts out an Advanced Burn Life Support certification, but that is aimed for flight RNs and paramedics and details the initial treatment and fluid resuscitation protocols. Unfortunately, burn units are only typically part of large teaching hospitals within urban areas. I know nothing about Illinois, but definitely consider relocating. If you have a strong interest in burns for a particular reason, make sure you articulate that when applying for the job. If a nurse manager sees someone with a special interest, they will be more likely to hire you. If you cannot get hired as a new grad onto a burn unit, my suggestion would be to apply to surgical floors and get a couple years of experience under your belt. Burn nursing is a surgical specialty too as many of our pts require a trip to the OR. Those years of experience will make you a good candidate. Good luck!

I think that we all enter nursing for different reasons. The OP mentioned that it is his calling, which is very well may be. I will clarify for the OP that nursing is in fact a profession, however one of may have a calling into a profession. On my unit, I work with one nurse who was severely burned as a child and subsequently entered the nursing profession after the comfort and compassion she received from the nurses while recovering. The OP sounds like a very passionate and motivating nurse and as a new grad it would probably be a pleasure to learn from him. For those of you jumping down the OPs throat in stating that he would not consider it a calling if it were for minimum wage for free, that's not true. I volunteer on a homeless van 2 days per week which visits the poorest parts of the city to provide basic care for the homeless. I do not get paid for this. Could I pick up overtime at my job rather than do this? Yes. But I feel as though I have much to offer those who are not as lucky. Other nurses I work with volunteer in other respects. Just because you will not volunteer your knowledge and skills to those less fortunate does not mean others will not. As far as the points the OP is trying to make about new grad orientation, many of those ideas are skewed and idealized. When I started on my unit, it will difficult for the other nurses to help me while they were busy. Some of our full body wound care and dressing changes can take hours. When I have my own dressings as do the other nurses, we can't make more time out of a 12 hour shift for them to both help me and get their work done. However, it would be great to provide these lengthy 1:1 orientations, it's just not possible!!

I know it can be easy to look far ahead into the future, but I think that you should start by focusing on getting through your accelerated BSN program first. Like the above poster stated, ER/ICU experience will be required to be accepted into a program. My real question is what motivates you to want to be both a CRNA and an NP? You're talking a lot of schooling, my friend. I think you should decide which program you would want to do the most and go from there. Also, working in primary care is really busy, especially having your own practice! And then you want to be a CRNA on the weekends! Trust me, you'll want the weekends to rest. Also, I think there are some restrictions in some states on whether an NP can have his/her own practice. Anyway, the way you talk you have A LOT of schooling ahead of you...but again, focus on one thing at a time!

My best advice is to just not give up. Even if a job posting says BSN required, apply anyway. Your 4 years of med/surg/tele experience are VERY valuable, and hospitals who have a immediate position to fill would rather you over a new grad BSN. I would recommend trying BIDMC or Tufts, I know they still take some ADNs. MGH just opened a short stay unit (similar to an ED obs. unit) and that is currently hiring RNs. Someone mentioned spaulding--- do look into there. I have seen recent postings there. Good luck!!

I have actually experienced this many times (though my career has been very short). Many of our mastectomy/breast reconstruction pts will politely ask if they can have a female nurse. Sometimes this can be difficult as it may be an hour into the shift when the request happens, making it difficult to accommodate. Likewise, burn dressing changes on a newly admitted female pt can sometimes be a modesty issue if the breasts have to be exposed. But trust me, after being there a week all modesty has been abandoned. Sometimes male pts will request a male RN to put in a foley. I have come across this a few times. I have actually never put in a female's foley because it makes ME uncomfortable that I could be making the pt uncomfortable. Ultimately though, I am an RN....i have seen the gamit of different peoples bodies and it doesn't even phase me. I'm a nurse...I'm at work to do a job...not see my patient naked. But healthcare is a business, we have to keep the customer happy...so we do what the customer wants. If I was a patient, I want a compassionate, friendly, competent nurse....male, female, black, white, it does not matter. Would you pass up a competent male RN putting in a foley for an incompetent female RN putting in a foley? I understand modesty matters, but the patient should be wishing for a quality nurse over a gender-specific nurse!

I can give a little insight into this. A wet to dry 4x4 covered with a tegaderm would not be the proper way to dress that. The tegaderm does not allow the absess to dry out at all (because ultimately that's why you would I&D it). Honestly, if it looks the way you describe it, the outer skin should be washed with hibiclens and kept open to air to allow it to dry out. If it were more open than you described, a non stick dressing (such as adaptic or even a simple telfa pad) with a thin layer of bacitracin covered with DSD and secured with medipore or paper tape would be indicated. The fact that it appears reddened is slightly concerning, so on your next shift be sure to make note of whether the redness has spread. I am sure this nurse is very experienced, just not with wound care, so next time go with your gut or even consult the MD or wound care RN at your institution.

Honestly as frustrating as it seems, I can understand where some of the CNA/PCTs are coming from. Some of them are assigned to take vital signs q4 for an entire unit, which may include 30+ patients (on top of washing up god knows how many full care patients). As a former PCT while I was in school I can understand how difficult that might be with the constant patient requests. Every patient whom you go in and see needs an extra pillow or glass of water which slows everything down. Any nurse who expects the the CNA to stare at the clock and count respirations for a full minute is being unrealistic. I do however expect at least a 15 second check. As the RN taking care of the patient, it is my job to assess the patient and assure what the CNA wrote is correct.