The Physical and Emotional Demands of Being a Burn Nurse

A quick look into the demands of being a Burn Nurse.

The Physical and Emotional Demands of Being a Burn Nurse

“The Burn Unit? That sounds terrifying.” “Wow, you are so brave.” “How do you deal with treating those kinds of patients?” “How do you handle putting people through so much pain?”

I am a Registered Nurse on a Burn Intensive Care Unit at a Level 1 Trauma Center. The comments above are all examples of reactions to my job I get on a regular basis. This was never the type of unit I planned on working on, but if I could go back in time, I wouldn’t change a thing. We are a sixteen-bed unit that cares for adult and pediatric patients. This is unique compared to most units in hospitals as most nurses are not cross-trained in adults and pediatrics.

Being a nurse on a burn unit requires a special type of person. The job is not only very physically demanding, but emotionally as well. We are a surgical unit, so like other surgical floors we are trained to care for patients pre and post-op, but the most unique thing about the burn unit is the length of stay. We have patients stay anywhere from one day to over a year. We see a patient go from critically ill in the ICU, requiring extensive wound care and surgeries, to walking off the unit with their wounds almost completely healed. It is incredibly rewarding to see the healing process and watch patients overcome things over the course of their hospital stay.

Patients who are severely burned require daily wound care. Wound care is performed in the mornings on our unit and consists of a thorough debridement and dressing of the wounds. A patient’s wound care can range from five minutes to five hours depending on the severity of the burns, different products and treatments being used, number of staff to assist, and patient tolerance. It doesn’t sound like much but holding someone’s leg in the air for thirty minutes at a time while it is being debrided and dressed is very physically demanding. No matter how good your body mechanics are, you are probably going to have a sore back after a big wound care. In the early stages of their injury, burn patients can be very immobile and require a lot of assistance with even moving in the bed, better yet having to get them up out of the bed.

Being a nurse is emotionally draining for all nurses, but I want to talk specifically about burn nurses. Most of our patients are injured doing something they’ve done every day for their entire life, whether it’s cooking, burning their trash, driving their car, smoking, and much more. A lot of our patients have no medical history and are just thrown into the hospital for an extended amount of time. They have to drop everything; their job, their kids, their pets, all of their responsibilities, and sometimes be hospitalized for weeks to months. A lot of these patients have no coping skills because they have never been through anything similar. This can be very emotionally draining for the nurses because we are the main advocate for our patients and spend the most time with them. We have patients come to us who just lost their entire home in a house fire, or their dog died in the fire, or a loved one died in the fire. I can’t tell you how many times I have witnessed someone being extubated and being told that their family member or pet has died in the accident.

As a nurse, we must stay calm and be there for our patient, even when our heart is breaking for them. Every nurse must witness sad situations, but there is just something different about your patient losing everything they own. Since we are the only burn unit in the area, we often have multiple family members, or couples admitted to our unit. It is heartbreaking to watch a husband break down at the door of his dying wife’s hospital room because he isn’t allowed to go in because he is also burned, but not as bad as she.

It will never get easier seeing these types of situations, and that is why there is a high burnout rate in burn nurses.

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MackenzieHolbrook

About MackenzieHolbrook

MackenzieHolbrook specializes in Burn ICU.

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Wow. This sounds like one of the most emotional floors I could ever imagine working on. When you mentioned extubating a pt and seeing them be told their family member or pet died crushed me. Thank you for all you do! Brings a tear to my eye. 

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Specializes in ICU/ER/Med-Surg/Case Management/Manageme.

My first few years out of school I worked in a Burn ICU in a major medical center.  Yes, I received then and still do now, the same types of questions and comments you noted. Every word you wrote is exactly accurate except back then, we did burn care/debridement twice daily as I recall.  Also, we worked in sterile scrubs/mask/hair covers/gloves, etc., but during wound care we also wore plastic gowns with sterile OR gowns over them.  HOT!!  Honestly, you could lose 5-6 pounds of fluid in a shift!

Like you, I never dreamed I would go into the world of burn nursing.  It does take a physical and emotional toll on the entire staff.  For me, I entered the field in great part after working (during my rotations) with one of the most fantastic nurses I've ever known - then the Assistant Head Nurse, later became the Head Nurse. She literally taught me what it meant to be a "nurse" - aside from just skills that were so important to a new grad.  Forever and always she will rank up there as one of my most admired mentors and a person I've always compared myself and other nurses to.

Best of luck to you as you go forward in your career.

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I could not deal with the Burn Unit.  Just too, too awful.  The smell, the suffering, the woefully inadequate pain "relief".  Even today the treatment of pain is completely inadequate in the BU.  I think a lot of burn patients should likely be kept unconscious as much as possible, certainly during the torture they call dressing changes.

One BU nurse told me that the way she dealt with it was to see every dressing change as taking the patient one step closer to recovery.

May God bless all of you who help patients in this terrifying aspect of Nursing.

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