The Firefighters Burn Institute Regional Burn Center is a Burn program serving Southern Oregon, Western Nevada, and Northern California, a population of 14 million. The California fire seasons, over the last few years, have been historic with regards to destruction and injury. This has resulted in multiple burn-related mass casualty incidents leading to burn service census increases that extend beyond the capacity of our 12 bed ICU. This leads to burn patients being housed in various ICUs and medical-surgical units throughout the hospital.
Burn care is a specialty that takes years to learn. As a result of burn patients being cared for in off-unit areas, the burn nursing team has developed a process to collaborate with the other units to deliver the specialized care that these patients require. Daily, burn nurses monitor the burn service census and where patients are placed throughout the hospital. To assist with best practice, improved outcomes, and decreased length of stay, burn nurses have been flexing out of the unit to provide wound care, assess fresh skin grafts or wound coverings, and perform wound care teaching. This is done in addition to the care that we are providing to the patients on our unit.
The nursing staff also acts as a burn and wound resource to other areas of the hospital managing our patients. Recently, supply management has been challenging, and we assist other units in obtaining the necessary supplies and equipment to manage their burn patients. We also work with the emergency department (ED) to assess burn patients during the admission process. When we are in the ED, we assist with the initial care of the burn patient, including debridement, fluid resuscitation, compartment syndrome management, and initiating pain control regimens. In some instances, we perform wound care and teaching in the ED which has prevented unnecessary admissions. Additionally, we have held several unit and hospital-based education consortiums focused on training staff on how to manage a burn patient through the transitions of care. Our burn team goal is to collaborate with other units and teams in order to maintain the highest quality of care to the burn patient wherever they are across the spectrum of care - from burn prevention to care in the prehospital, inpatient, rehabilitation, outpatient, and reintegration settings.