Burn Care Nursing: Interview with Alison Gavin, RN

My Specialty

Burn Care Nursing: Interview with Alison Gavin, RN

Healing the patient's physical and emotional wounds

By Keith Carlson, RN, BSN
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Alison Gavin, RN
Charge Nurse
The Grossman Burn Center at West Hills Hospital, West Hills, CA

How long have you been a nurse, and what is your career history?I have been a nurse since 1981. I received my training in Scotland and worked in Med/Surg and Ortho, and then did a six-month post-graduate certification in burn nursing. During my training in Scotland, I worked in a burn clinic in the ER several times per week. I always liked wounds, and also spent some time in a vascular clinic. I then worked in a military hospital burn center in Saudi Arabia for a year and a half. Still young and adventurous at the time, I came to America 23 years ago and have been employed at Grossman ever since.

Does your facility require any special certifications for nurses to be employed there?
Our unit requires Advanced Burn Life Support (ABLS), Advanced Cardiac Life Support (ACLS) and Pediatric Life Support (PALS) certification for all of our nurses, and they prefer new applicants to have both ICU and pediatric experience. Some of our nurses also pursue CCRN (Critical Care RN) certification.

What is most challenging about your work?
Witnessing big burns and catastrophic injury can be challenging. You have to help patients and their families through an emotional rollercoaster ride. Patients experience scars on the inside as well as on the outside, and burn injuries are incredibly life altering. People see something in the mirror that does not conform to the image that they hold of themselves, and this is not an easy experience to digest and recover from.

Sometimes we have pediatric patients who have been abused, and that is never easy. We have to perform very painful procedures and dressing changes on our patients, and you have to stay positive and help people by being realistic without being negative.

After an acute traumatic burn injury, you’re often supporting the family more at first, since the new patient may be on a vent and heavily sedated. We get very close to our families. We have a psychologist on the unit, as well as a Child Life Specialist who sees every pediatric burn patient as well as the children of adult burn patients in order to prepare them for the experience of seeing their parents after a burn injury, something that can be both overwhelming and frightening.

What keeps you coming back to work every day? What feeds your spirit?

I think the courage of the patients keeps me coming back. We have a four-day family camp every year for staff, patients and their families. Former patients volunteer, and we have arts and crafts and other fun activities. We also have holiday parties for adult and pediatric patients, and Doctor Grossman opens his home to patients and their families for special events. We have a condo near the hospital where out-of-town families can stay free of charge. The camps, parties and the condo are all made possible by the generosity of several charitable organizations. And when you see patients coming back over the years with children of their own, it drives home the fact that we’re all a big family.

How has burn nursing changed, or how do you see it changing in the future?

The technology changes over time. The types of dressings that we use changes, and medications and pain management continue to evolve. Our facility has adopted a philosophy of early aggressive surgery with fairly good outcomes, and we are also aggressive with the use of ventilators for smoke inhalation injuries.

Bearing HIPPA in mind, is there a story or anecdote about a particular patient or situation you would like to share?
We once had a little girl as a patient who had been scalded as a form of abuse. She had no family to visit her, and she would sit beside us at the nurses station during our shifts. At night, I would call my son (who happened to be about the same age as this little girl) and they would chat and say good night to each other. Years later, they met at a gathering and I reminded them that they used to talk on the phone when she was on our unit. I have a sweet photo of the three of us together.

Some firefighters and other former patients volunteer on our unit and come to visit current patients with acute burns. We have burn survivor groups as well. No matter how many years pass, I can still see the faces of many of our former patients, even those who died.

What do you do for self-care in between doing such intense work?
I talk to co-workers, exercise, spend time with my children, and also take time to think about and remember my patients. As colleagues, we do a lot of reminiscing, and remind ourselves of the good work we’ve done over the years.

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Erin Kill, RN
Torrance Memorial Medical Center Burn Center
Torrance, CA

How long have you been a nurse, and what is your career history?
I started nursing in 2005. My first position was on a Med/Surg unit where I found that I had a passion for wound care. I believe that it’s the “hands on” skills that I enjoy the most, and this makes sense having been an art major for many years.

What brought you to Burn Nursing as a specialty?

Although I really wanted to do wound care, I always preferred 12-hour rather than 8-hour shifts, and most wound clinics offered only 8-hour shifts. Then I learned about the TMCC Burn Unit from one of my nursing instructors, and although I had never previously considered burn nursing as a specialty, I began working 12-hour shifts there exactly three weeks later. 

What is most challenging about your work?
Working with kids and teens who are burned by fire is very difficult. Because of the pressure imposed by society and the media on appearances and self-image, having a burn scar doesn’t help an already fragile self-esteem. However, I’m happy to say that there are many support groups out there, including burn camps such as the Alisa Ann Ranch Burn Foundation’s “Champ Camp,” which celebrated 25 years in 2010. This is an inspiration and great fun for the kids.

What keeps you coming back to work every day? What feeds your spirit?
The wound care, the healing process and the teaching, as well as watching our patients heal and return to their lives, usually with more love in their hearts for their life and loved ones. Teaching patients and their families how to do the wound care is like teaching arts and crafts.

My ultimate moment as a Burn Nurse is when I have a patient with full body dressing changes from head to toe. The patient is usually sedated if they have such severe burns, so the nurse is able to methodically perform the dressing change, which can sometimes take three or four hours. Our retired burn doctor used to say “the lone nurse with her patient” as she entered the room, comparing the nurse to an artist who has been painting for three hours and yet it only feels like 30 minutes have gone by.

Fortunately, burns of this magnitude are decreasing, thanks to smoke detectors, prevention programs and OSHA safety standards in the workplace.

What advice would you give to nurses or student nurses wishing to explore Burn Nursing as a career option?
If you like critical care, enjoy hands-on wound care, and have a strong nose and stomach, go for it. This job requires a lot of lifting, so a strong back is also crucial.

Where do you see yourself in five or 10 years, professionally speaking?

TMMC is building a new hospital with a larger Burn Center, so I’m looking forward to seeing what advanced systems we can have in our burn unit. We also just partnered with the Manhattan Beach Burn Foundation who donated a Wii to the unit. Even though we don’t want anyone to get burned, we know that burns do occur, so we’re looking forward to playing some Wii games with the kids as they heal.             Professionally I’m just taking it one day at a time, enjoying the moment.  

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Did You Know? BURN CARE NURSING

Overview  Burn care nursing is a specialty that requires sharp clinical skills including triage, the stabilization of acutely burned patients, fluid balance, pain management, critical care, rehabilitation and trauma recovery.

Certification  Although no specific certification is required to work as a nurse in a burn unit, there are certifications and educational opportunities that provide essential skills and advanced training. Some burn units may require certain certifications prior to employment, while others may provide on-the-job training.

Your Patient  Nurses can expect to encounter individuals who have experienced electrical burns, chemical burns, household injuries, victims of automobile accidents and industrial accidents, as well as other traumatic situations. For those nurses who seek nursing experience with the military, burn injuries in the field can be sustained as the result of a wide variety of explosive materials, and can often be complicated by other traumatic injuries.

Challenges The physical condition of patients who have experienced acute burns can be gruesome. Disfigurement, intense pain, multiple skin grafts and plastic surgery can make the recovery process a great challenge for the patient. The psychological effects of burn injuries require compassion and a nuanced understanding of post-traumatic stress. Nurses must expect to provide crucial psychosocial support for patients and their families.

Advanced Practice  Advanced education including a Master’s Degree in Nursing (MSN) can provide specialized training in acute care, trauma nursing, and emergency nursing. Advanced Practice Nurses who seek intensive advanced education in these areas of specialization often find increased opportunities for professional advancement.

RESOURCES

Certifications and Trainings:
ACLS: Advanced Cardiac Life Support Certification
CCRN: Certification in Critical Care Nursing (American Assoc. of Critical Care Nurses)
PALS: Pediatric Advanced Life Support
ABLS: Advanced Burn Life Support (American Burn Association or American Association of Critical Care Nurses)
TNCC: Trauma Nursing Core Course (Emergency Nurses Association)

Web Resources:

American Association of Critical Care Nurses: www.aacn.org
American Burn Association: www.ameriburn.org
Emergency Nurses Association: www.ena.org
International Society for Burn Injuries: www.worldburn.org
The Phoenix Society: www.phoenix-society.org
The Grossman Burn Foundation: www.grossmanburnfoundation.org
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Keith Carlson, RN, BSN, is a registered nurse, writer and blogger. He writes for a variety of nursing and health websites, and has been included in several nonfiction nursing books by Kaplan Publishing. He is editorial contributor to BlackDoctor.org. His own blog can be found at digitaldoorway.blogspot.com

This article is from workingnurse.com.

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