Burn Care Takes Many Hands, Minds and Hearts
If there is one word to describe our patients, it is “heroic.” They come to our intensive care unit burned after a car accident, industrial explosion or house fire. Others are suffering from significant skin damage caused by a severe allergic reaction to a drug or invasive bacteria. In many cases, all epidermal tissues have been injured — the skin, linings of the mouth, digestive tract and respiratory tract.
Our response needs to be just as heroic. But no single person or specialty could possibly meet these patients’ dire needs. At BWH’s Burn and Trauma Unit, efforts are orchestrated by a large team — intensivists, surgeons, internists, nurses, psychiatrists, social workers and others. Our primary job is to nurture and protect the body so it can heal on its own.
Each patient’s condition and emotional needs vary, so we customize clinical care and respect individual differences. I am forever reminded of a man who had sustained third-degree burns over 95 percent of his body from a work explosion. Despite the severity of his injuries, he requested to be fully conscious during all aspects of his care, including the insertion of the breathing tube and dressing changes, which can be excruciatingly painful. He was convinced that if he lost even a little control, he would not make it. We honored that request, despite the difficulty of looking in his eyes as he endured the pain we knew our hands were inadvertently inflicting.
As his skin grafts and condition improved, we helped his two young daughters transition to the unit for a visit. We initially sent them masks, hats and gloves to try on at home. For the first visit, they came as far as the unit’s front door, later to his room. He made it with flying colors. He now is coaching their hockey team and pursuing a PhD in chemical engineering. He occasionally is my golf partner, beating me consistently. And like many of our patients, he regularly returns to our unit to encourage other burn patients.
Sadly, not all our patients are success stories. We recently cared for a woman and her fiancé, both badly burned in a house fire. She lived, but he did not. As her condition improved, the clinical team met to discuss when and how to tell her. When the time came, we provided a consistent, honest and compassionate message that helped her cope with her loss and also supported her will to live.
Teamwork binds us together as a unit, a hospital and a profession. Together, we rejoice when patients regain vitality and grieve when they do not. We pool our ideas to raise the standard of care to new heights. We learn from ourselves and our patients, who never cease to inspire our utmost respect and admiration.
-Patricia Moran, RN
Senior Staff Nurse, Burn and Trauma Unit, Tower 7D