Critical Burn Care: Learning Amid Crisis

Critical Burn Care: Learning Amid Crisis

Recall a clinical learning experience you enjoyed. Describe the experience and identify specific aspects such as educational setting, motivational strategy, learning theory, and delivery of content (how was the material presented).

I have worked as RN in a level one trauma center for about 3 years now, working in the Burn ICU has been one of the biggest challenges I have faced in my nursing career. Some people may assume that the Burn ICU does not care for very sick patients like other units, but in actuality it is so specialized that a well-trained CTICU nurse would struggle. One of the biggest learning experiences I faced since being in the Burn ICU was during a horrible burn trauma activation involving 6 male individuals that were burned while working at the local power plant. It was about 5:45pm, when the charge nurse pager went off with a burn trauma alert. Yes, I happened to have taken over charge nurse at 3:00pm, while managing one patient in the ICU. Back to back the pager went off 6 times, with different burn trauma alerts. Before I knew it, my charge phone was ringing and it was the hospital supervisor informing me that we were going to be transferring out all the patients in our 6 bed ICU to other ICU’s to make room for the 6 burn victims arriving. Suddenly, before we knew it we moved all of our patients and the new burn victims came rolling in. All of the burns were ranging from 60-90% total body surface. I individually managed one of the patients while navigating the unit and med-surg burn floor. It was about 6:30pm, I called in 4 nurses to come in early to help assist with debriding these patients. By the end of the shift at 7pm, all 6 patients were being lined and started on CRRT, along with arterial lines placed and central lines. I somehow had to manage my nursing skills appropriately and take charge of the entire unit. At 7:15p, I lost pulses on my all 4 extremities and my patients bladder pressure was sky rocketing. After about 10 minutes, the plastic surgery team was at the bedside performing fasciotomies and trauma surgery was opening up my patients’ abdomen at beside to help relieve bladder pressure.

During this one individual experience I learned so much about myself. My time management, assessment skills, nursing knowledge and team leadership skills were all put to a test. Thinking back I thought I would have fallen apart, I had only been a RN for a little under two years at this time and I was still questioning all of my skills and abilities. Walking out of the hospital that night I could have not been any more exhausted and discouraged, wondering if I had messed something up or forgotten something. I tried my best to think to myself “you are leaving and you kept this 90% full thickness burn victim alive, that is what you are here for.”