Hyperbaric Nursing

**traumaRUs**, MSN, APRN

Overview

Hyperbaric oxygen therapy (HBO2) is the intervention in which a patient is placed in a hyperbaric chamber and breathes close to 100% oxygen intermittently. The chamber is pressurized to greater than sea level pressure. This therapy can be a primary treatment or in combination with surgical or pharmacologic interventions.

Hyperbaric nursing has a long history. It originated well over 100 years ago as some type of life-prolonging "treatment" for the rich and famous. As time progressed, it was used in dive medicine. The care of the patient was handled by technicians, medical students and scientists interested in the physics of hyperbaric care. In the 1960's, nurses began to take over the duties of these people. Approximately 20 years ago, nurses came to the forefront of hyperbaric medicine. In 1978, the first US hyperbaric conference included workshops specifically for nurses. It was sponsored by the Baromedical Department at Memorial Medical Center in Long Beach, CA. In 2002, the first Hyperbaric Nursing Textbook was published.

Though hyperbaric care is often associated with dive medicine, most nurses associate it with wound care. It is known to promote higher tissue oxygenation and to speed healing of wounds that have failed conventional care. Medicare has recognized that hyperbaric therapy has a place in wound care and is now reimbursing for this service. This has allowed many more patients to take advantage of this care.

Indications for Hyperbaric Therapy (not all-inclusive)

air/gas embolism
gas gangrene
wounds
crush injuries
decompression sickness

Qualities / Duties

Varied experiences can be helpful for becoming a successful hyperbaric nurse.

cross-training in ED, ICU, Critical-Care, Med-Surg
patient advocate
quick assessment skills
technical aptitude
working knowledge of physics behind hyperbaric medicine
astute ability operating the chambers
ability to adapt to rapidly changing situations

Education

RNs and LPN/LVNs who have graduated from an accredited nursing program, successfully passed their individual NCLEX, and possess a current, unencumbered U.S. nursing license can work as hyperbaric nurses.

Wound care utilizes hyperbaric therapy to help to heal stubborn wounds in a time saving and money saving manner. Advanced Practice Registered Nurses (APRN) are frequently involved in the care of wound clinic patients. They direct the care, coordinate with other providers and provide education to patients, family members and other members of the healthcare team.

Certification and Associations

The American Board of Wound Healing (ABWH)

The ABWH offers certification as a Certified Hyperbaric & Wound Specialist (CHWS). RNs, as well as LPNs, are eligible for certification. The ABWH Certified Hyperbaric & Wound Care Specialist Examination is endorsed by the American College of Hyperbaric Medicine and the American Professional Wound Care Association.

Eligibility (not all-inclusive)

Minimum 2 years experience in hospital setting or outpatient facility as a Hyperbaric Technician with cross-training as a Wound Care Assistant or equivalent clinical position
Minimum 500 hours clinical experience per year for the prior 2 years
Experience includes time shared between hyperbaric chamber operations and actual participation in wound-related patient care and management
Completion of a 40-hour introductory hyperbaric medicine course or 40-hour primary training program approved by either the American College of Hyperbaric Medicine, the Undersea and Hyperbaric Medical Society, or the US Department of Defense
Completion of Core Competencies in Hyperbaric Therapy and Wound Care, verified and endorsed by the employer, Medical Director or Program Manager validating clinical experience detailed in the Core Competency Checklists

National Board of Diving and Hyperbaric Medical Technology (NBDHMT)

The NBDHMT is a certification organization for those who support the delivery of undersea medicine and hyperbaric oxygen therapy. In the early 1990's, the NBDHMT, invited the Baromedical Nurses Association (BNA) to be a part of the NBDHMT certification process.

Baromedical Nurses Association (BNA)

The BNA, established in June 1985, is a very detailed website regarding the care of the patient undergoing hyperbaric therapy for a variety of diagnoses. The website includes a care plan with appropriate nursing diagnoses and provides a formal organization within which nurses can develop networking opportunities as well as receive professional support.

Those seeking certification may achieve the level of CHRN (Certified Hyperbaric Registered Nurse), ACHRN (Advanced Certified Hyperbaric Registered Nurse) or CHRNC (Certified Hyperbaric Registered Nurse Clinician).

Wound, Ostomy and Continence Nurses Society

This professional association encompasses wound care including hyperbaric nursing and provides a wide variety of useful information for both the novice and the experienced nurse.

Job Outlook / Salary (2020)

Opportunities for hyperbaric medicine nurses are expected to be varied. Much will depend on how reimbursement covers this care as to how many new jobs will be created. Nurses that are multi-skilled will be in the most demand. Nurses that can care for wounds, ostomies, continence, dive medicine, and hyperbaric care will have the highest chance of landing a good position.

According to ZipRecruiter.com, the average annual pay for a Hyperbaric Nurse in the U.S. is $61,306 a year. Annual salaries are as high as $119,500 and as low as $20,500; ranging between $37,500 to $75,500 across the U.S.