Published Jul 12, 2007
anvano412
8 Posts
Hey all
New to the site and fresh off my 5th shift in 6 days...and I'm back tonight! Yikes!
Anyway, I was just wondering what everyone else thought bout burn nursing and what there experiences were. I graduated last year and went straight into burn and I love it. Know that sounds weird to others, but not when its your passion.
On our unit, the nurses are responsible for most first drsg changes ( and all other drsg changes). We are certified, but have one PCA (nursing asst) who was laid off cuz we were slow.(pathetic thing is we have the stupid magnet thing..but thats another story! We take all burned pts. infant to elderly 1%-??? , intubated and all. We are responsible for everything.
I guess just wondering how other places treat burns.....We are SSD and Baci heaven. Just starting aquacel (don't like it). Is that what every burn unit uses? I guess just curious bout how other places do there thing
shandsburnRN-CRNA
188 Posts
Sup,
We are an 8 bed burn unit and take burn patients of all ages, sizes, acuity. I have been here for a little of 2 years, came in right out of school, paramedic for 7 years previous. I like it alot, we have the sickest of the sickest at times. Its given me a lot of good experience. Interviewed for CRNA school on Monday, still waiting to hear the outcome. We too are responsible for all dressing changes, even the ones off the unit, like you we only have one PCA. As far as treatment we use SSD, Mafenide Acetate (cream and slurry), Bacitracin, AgNO3, Acticoat and Aquacel. Our peds doc's prefer Bactroban on the grafts rather than the Bacitracin we use with the adults.
Anyway we use aquacel on our donor sites, in short.....IT SUCKS!!! Most of the time the donors stay too wet and the aquacel just gets all gooey and useless. We were using Acticoat previously, which we have been slowly going back to. It seems to work better though it causes more pain for the patient.
Are you guys using the Vitamin C infusion protocol for your burns over 30%?
indigo girl
5,173 Posts
I just wanted to interject that I think that you Burn Nurses are incredible. I could never, ever do the type of work that you routinely do. You deserve more accolades than you will ever get.
Many of our young patients in Rhode Island who attended the illfated Great White concert, and survived the fire that destroyed the nightclub that night, are alive today because they had nurses like you to care for them. I have the utmost respect for your expertise in the care of such patients, and I admire you tremendously.
RazorbackRN, BSN, RN
394 Posts
Sup,We are an 8 bed burn unit and take burn patients of all ages, sizes, acuity. I have been here for a little of 2 years, came in right out of school, paramedic for 7 years previous. I like it alot, we have the sickest of the sickest at times. Its given me a lot of good experience. Interviewed for CRNA school on Monday, still waiting to hear the outcome. We too are responsible for all dressing changes, even the ones off the unit, like you we only have one PCA. As far as treatment we use SSD, Mafenide Acetate (cream and slurry), Bacitracin, AgNO3, Acticoat and Aquacel. Our peds doc's prefer Bactroban on the grafts rather than the Bacitracin we use with the adults.Anyway we use aquacel on our donor sites, in short.....IT SUCKS!!! Most of the time the donors stay too wet and the aquacel just gets all gooey and useless. We were using Acticoat previously, which we have been slowly going back to. It seems to work better though it causes more pain for the patient.Are you guys using the Vitamin C infusion protocol for your burns over 30%?
Can I just ask why you guys aren't using Xeroform on your donor sites?
We do use Xeroform, once the donors are granulating well and aren't as wet. We use Acticoat or Aquacel-Ag initially.
Bluehair
436 Posts
Former burn nurse here - and would go back to it in a second if I lived in an area with a Burn Unit!!! Used to work in Denver years ago. We did not do peds, tho, they went to Childrens hospital in the area. Not sure I could do the pediatric part. The burn aspects aren't the problem, I just don't like doing peds of any sort. Sorry to all peds nurses, it' s just not my thing.
We used xeroform back in the dark ages and it worked great. Usually was applied right in the O.R., can't recall any issues that ever happened from that.
Best wishes!
Our surgeon prefers the antimicrobial action of silver over plain xeroform. Never had a problem with it, on the other hand never used xeroform on new donors so I can't give a good comparison, would be interesting to see the pros/cons.
Anybody else have experience with both on new donors?
mint_julep7
11 Posts
i just have to say i am so grateful to have run across this site tonight. i used to work at the med in memphis, and i miss my burns so much i was scanning the net looking at jobs. a lot of people do not understand how burns can be such a wonderful area to work... i have to say that i do not understand how delivering babies can be such a wonderful place to work... lol. i am so glad to have a place to talk... thanks yall.
granmr
3 Posts
We also use xeroform over the graft site and we keep it wet with sulphamylon solution. Some Doc use interface/ acticoat over grafts and again keep moist with sulphamylon solution. Donors are usuallly in silvadene until it stops bleeding then mepilex AG until healed then glucan pro 3000. Hope that helps.
Hey...We put opsite on our donors and leave it on for as long as humanly possible until it falls off. As it collects fluid we drain them and repatch w/ more opsite. Then, once it falls off or comes off its dressed in SSD and treated like a burn.
I'm confused....you put creams on them fresh post-op? Ouch! Doesn't anyone else use opsite first?
theatredork
229 Posts
Hey, thanks for the shout out.
We have a 40-bed unit, usually split evenly between adults and peds. As far as I know, we only use duoderm on donor sites. Like someone mentioned above, we try to leave it on as long as humanly possible.
This was also my first job out of school, and I can't think of a better job.
Itshamrtym
472 Posts
Hello
And thank you to all of the burn nurses out there. I never even dreamed of doing BICU until about 1 week ago. I had a revalation. My brother-in-law is in the burn unit at TAMPA GENERAL. To hear about what the nurses do there is aweome. I have read all through the threads on this site. I have tried to find other info. but havn't really found anything else except for the book available that is mentioned on allnurses. It seem that all of the burn nurses say the same thing. They love it. It is rewarding, challenging, and hard work. It really makes you feel good when someone is able to walk out of the unit. I am struggling to find my home.. I want to go into a specialty and stay there. Be a part of the team and learn all that I can. From what I'm hearing this is possible with burn nursing???? I don't want to jump into anything. Currently I am PRN in the OR and part time with pediatric private duty (been doing this for 11 years). I have tried NICU and ER.
Didn't stay long at either. It seems that I really like one on one nursing. I know that I could shadow @ a burn unit. I don't know about you guys, but shadowing doesn't give you the whole picture of,
"Will I like this". So, any words of wisdom would be welcomed.. Thank you in advance. Thank you for all that you do.... You are all special people..