Starting My Career as an RN on a Burn ICU in a Level 1 Trauma Center

Burn nursing is physically and emotionally demanding, but the pros always outweigh the cons. Specialties Burn Knowledge

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Starting My Career as an RN on a Burn ICU in a Level 1 Trauma Center

I was told by a professor in nursing school not to start in an intensive care unit (ICU) but instead, to start on a step-down floor for a year so that I could better my nursing practice before graduating up to the ICU. I was told that I needed "the right personality" to be able to work in the ICU. I did not take that advice and started my career as a registered nurse on a Burn ICU in a Level 1 trauma center.

This particular burn center is not only an ICU but is also a progressive care floor and includes acute care pediatric patients as well. We see the patient go from a sick ICU patient that may require intensive treatments and hours of wound care, then being downgraded to a lower status of acuity and then eventually sent home or to a rehabilitation facility. However, unlike a lot of other units, we also have an outpatient clinic attached to the unit that allows us to see patients after they have been normalizing themselves at home and getting adjusted to their new bodies and functionalities. It is an amazing thing to be able to see the progress of these patients come full circle.

I am currently considered a new graduate nurse and have been working on this unit for 6 months. I was previously a patient care tech in the same unit for 3 years while I worked through nursing school, which gave me the advantage of obtaining the role of a registered nurse upon graduation. As a patient care tech, I was able to see what an important role the nurses had in burn care and decided that is exactly what I wanted to do.

Physically Demanding for Patient and Nurse

Burn patients require daily wound care, depending on the severity and depths of the burns; this wound care can require multiple people and can take many hours to complete. This can also be a traumatic experience for the patients because a thorough cleaning of the wounds is required every day to prevent infection and conversion of the burns. Wound care can be physically demanding for nurses because some patients lack mobility related to their injuries. Holding a leg up in the air for 30 minutes might sound easy, but when the patient is unable to assist in holding their weight, and the room is 90 degrees because of the inability of patients to regulate their temperatures, and you are wearing a plastic gown that only traps heat, many people have fainted due to the physical demands it has on the body. After wound care, it is time to get these patients moving and up and out of bed; physical and occupational therapies are always following but not always available to work with patients, so it is the nurse's responsibility to get these patients out of bed, which can also be very physically demanding for nurses.

Emotionally Demanding for Patient and Nurse

It is safe to say that nursing is not an easy job and is emotionally draining, no matter what field or specialty you may be in. Burn nursing can be particularly emotionally demanding because these people have experienced a traumatic event from something they likely did every day of their lives. Cooking accidents, burning leaves or trash, and smoking are some of the many and most common reasons why our patients come to us. They often are hospitalized for weeks to months while they undergo multiple surgeries and leave their families, jobs, and lives behind. Nurses take on the role of patient advocate and are constantly reassuring patients that 'this too shall pass. Oftentimes, pets, family members, and homes are lost in these accidents, which is another mental strain on these patients who are already going through enough physical pain. Then there is the aspect of self-image that comes into play for these patients. Burns may require skin grafting to ensure proper healing; these grafts and the donor sites from which the grafted skin is taken can leave scars. For young people, in particular, this can be detrimental to their self-image. Luckily, we have a trauma psychologist who works with all of our patients, but it often falls to the nurse who is in the room almost 24 hours a day to ensure these patients are not only healing physically and medically but also mentally too.

FACT: The demands this job has is not for the faint of heart; it is also a rewarding one.

To see your patient who was unable to walk 6 months ago come into the unit practically jogging to you to say hello during their clinic appointment is such a great feeling. These are the days that we work for. To see the patients live their life happy and healthy after such a life-altering event.

makers has 1-year of RN experience; specializes in Burn ICU.

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Specializes in Community health.

Even the words “burn unit” make me hurt. However, I am so glad we have good nurses who want to do it!

Specializes in Tele, ICU, Staff Development.

Thank you for sharing, I really enjoyed it. I hope you'll write more in the future.