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National Burn Awareness Week and Specialized Work of Burn Nurses

National Burn Awareness Week and Specialized Work of Burn Nurses

February 4th to 10th is National Burn Awareness Week , and Daily Nurse is recognizing the specialized work of burn nurses. Burn nurses are known for their exceptional skills, commitment, and unwavering dedication to patient care. They work tirelessly to treat individuals who have been affected by burn injuries and to advocate for burn injury prevention within their communities.

Meet Emily Werthman, PhD (c), MSN, RN, CBRN, the Burn Program Manager at The Johns Hopkins Burn Center. She is also a member of the Board of Certification for Emergency Nursing (BCEN) board of directors for the 2024-2025 term and shares her insights on burn nursing as a specialized nursing practice.

-What are your title and credentials at The Johns Hopkins Burn Center?

Burn Program Manager

PhD (c), MSN, RN, CBRN

-How long have you worked there?

13 years

-What do you enjoy most about your role as burn program manager?

I love the detective aspect of my job: finding a problem, discovering its root cause, and then developing a plan to fix it. I also work with an amazing interdisciplinary team that makes it exciting to come to work every day.

-Talk about how you ascended to that role.

I started as a BICU nurse and loved our burn program’s research and quality aspects. I knew that burn nursing was where I wanted to practice, but I also wanted to further my career options by pursuing an advanced degree. After about 10 years at the bedside, the burn program manager position became available while I was obtaining my MSN in nursing education. I was so happy to be able to combine my love of research, quality, and bedside burn nursing knowledge into this role. I am also incredibly fortunate to work for a health system that encourages and supports its nurses’ continuing education so I can continue with my PhD.

-What inspired you to become a burn nurse?

My mother died in a house fire shortly after my college graduation. Knowing that her nurses were with her, providing the best possible care, inspired me to do the same for all the families and patients we care for here at the Johns Hopkins Burn Center.

What associations are you a member of, and how have they helped your career?

I am an American Burn Association (ABA) member, serving as the lead nurse planner. I volunteer with the Board of Certification for Emergency Nursing (BCEN), serving as a CBRN Exam Construction Review Committee member, and have just been appointed to BCEN’s board of directors.

These roles have allowed me to work outside of my hospital system to impact the work of burn nurses nationally and internationally. My work with the ABA has allowed me to progress from member to committee member to lead nurse planner. Similarly, at BCEN, I started as an item writer and have continued to work within the organization to support its mission. Both organizations have provided opportunities for professional growth through networking and continuing education.

-What does a burn nurse do?

There is not a typical day in burn. We see patients at their worst on the first day they are injured, their best on the day they are discharged, and everything in between. Burn is unique because we know our patients and their families through one-on-one interactions during daily wound care sessions. A shift in the BICU or BWU will usually involve all your standard nursing interventions but with a healthy dose of specialized wound care, wound vac placement, dressing takedowns, and lots of psychosocial support for our patients and their families.

Burn nurses are more than trauma care. Can you talk about the other types of care they provide patients?

Burn nurses genuinely care for the patient across the entire continuum from admission to discharge and then reconstruction procedures in the years following an injury. In addition to critical care, they provide outstanding psychosocial support to families and patients. Many burn nurses participate in prevention activities like outreach at local schools and partnerships with local firefighters.

-How do you become a burn nurse?

After graduating with a history degree, I returned to school to get my AS in nursing, eventually earning a BSN and MSN. I am currently preparing to defend my PhD dissertation, as well. I knew when I entered nursing school that burn nursing was my calling. I contacted the burn center for my senior honors project to arrange a guest lecture at my nursing school. I kept in touch with them after graduation so that they were aware of my interest in the burn center and to let them know when I applied for an open position there.

Talk about the need for burn nursing and BCEN specialty certification.

I seek to effect change in the field of burn nursing as a subject matter expert, test question writer, and exam content review committee member for the CBRN exam. Specialty certification is an essential part of recognizing burn nurses’ unique work. As more hospitals move toward Magnet certification, standing with other certified nurses offers burn nurses the ability to demonstrate our commitment to quality care.

-What are the benefits of being a burn nurse? 

Burn nursing is a challenging field. But it is just as rewarding as it is difficult. We see patients progress through their recovery, and through our work with the Burn Therapy Program, we continue to see them for years as they return to their lives.

Talk about the reward of being a burn nurse.

The payoff is the outcome. When we see a patient with substantial burn injuries overcome their injuries and go on to live happy, successful lives, it makes all the long, hot days in a tub room worth it.

Talk about being 1 of 12 expert nurses selected by BCEN to serve on the Burn Nursing Role Delineation Study Advisory Committee.

No other specialty provides you with a level of interaction with patients and their families, all while providing life-saving critical care. The burn nurse is truly the best representation of a holistic nurse that I know—integrating critical care with psychosocial care, wound care, focused systems assessments/interventions, and all that comes with the care of surgical patients. Being selected to help define what a burn nurse does was an honor. And to be able to work with some of my role models in burn care (Gretchen Carrougher and Katie Hollowed, in particular) was so exciting. To think that we could work together with burn experts from all over the country to help on our path to certification was life-changing.

How does the committee’s work serve as a roadmap for nurses who sit for the CBRN exam?

In our work, we helped define what the burn nurse does, which helped define the parameters of the CBRN exam.

-Do you have anything else to add for Burn Awareness Week?

This year’s theme is preventing flammable liquid injuries, so I encourage people to check out the resources available at ameriburn.org to ensure they are following all appropriate safety measures!

World’s First Burn Nursing Specialty Certification Now Available

World’s First Burn Nursing Specialty Certification Now Available

The Board of Certification for Emergency Nursing (BCEN)  launched the world’s first Certified Burn Registered Nurse (CBRN) burn nursing specialty certification. To earn the CBRN credential, eligible RNs and APRNs must pass a rigorous national exam spanning the burn nursing continuum, including prehospital care and initial management, acute and critical care, post-acute rehabilitation, outpatient and community care, and aftercare and reintegration, as well as injury prevention, education, and psychosocial patient and family support.

“At last, tremendously skilled and compassionate burn nurses worldwide have the opportunity to have their advanced clinical and professional knowledge and expertise validated through board certification,” says CEO Janie Schumaker, MBA, BSN, RN, CEN, CENP, CPHQ, FABC. “The best possible thing a burn patient could have is a CBRN-certified nurse taking care of them.”

Nurses play critical roles in every aspect of burn care and recovery, and research links burn care specialty expertise to improved outcomes in patients with burn injuries.

In a new burn nursing video, burn nurse experts and American Burn Association (ABA) leadership comment on the development and future impact of BCEN’s CBRN certification program.

Burn injuries significantly cause disability and death, affecting all ages.

  • In the U.S., over 400,000 seek medical treatment for burn injuries annually, with 40,000 hospitalizations, including 30,000 at hospital burn centers, and over 3,800 deaths.
  • Worldwide, there are approximately 11 million burn cases and 180,000 deaths annually.
  • Learn more about burn injuries, care, and burn nursing in Burn Nursing Excellence: The CBRN.

Eligible nurses with a U.S. RN or APRN, or equivalent, may apply to sit for the CBRN exam here. Nurses educated or licensed outside the U.S., Canada, or Australia must first go through BCEN’s international credential evaluation process. BCEN offers exam discounts to ABA members, U.S. military active-duty service members, reservists, and veterans. Volume discounts are available through the BCEN Voucher Program. A CBRN practice exam and interactive burn nursing CE courses are available on the award-winning BCEN Learn professional development platform.

BCEN Announces Burn Nursing Specialty Certification for 2023

BCEN Announces Burn Nursing Specialty Certification for 2023

The Board of Certification for Emergency Nursing (BCEN),  the benchmark for specialty certification across the emergency nursing spectrum, today announced it is developing a burn nursing specialty certification. The new professional credential will be called the Certified Burn Registered Nurse (CBRN). After collaborating with the American Burn Association (ABA) on the initial development of the CBRN, BCEN will own and maintain the CBRN certification program.

“Following years of extraordinary advocacy by the American Burn Association and the burn nursing community to set the stage for a burn nursing-specific professional credential, and knowing the impact specialty certification has on ensuring optimal patient safety and outcomes as well as nurse success and satisfaction, BCEN is honored to take on this important endeavor,” said BCEN CEO Janie Schumaker, MBA, BSN, RN, CEN, CENP, CPHQ, FABC.

“The CBRN will advance our specialty by promoting the knowledge, skills and abilities needed to care for those impacted by burn injury, thus encouraging quality nursing care and best patient outcomes,” said Gretchen J. Carrougher, MN, RN, Research Nurse Supervisor, Department of Surgery, UW Medicine Regional Burn Center at Harborview Medical Center, Seattle, Washington. “I have been impressed by the dedication by many in our specialty and appreciative of the support by the ABA and BCEN in this long-standing effort.” Carrougher chairs the American Burn Association’s nursing certification committee.

BCEN Burn Nursing Certification Milestones (as of March 2022)

Among the ABA-led accomplishments leading up to the development of a burn nursing specialty certification was the formal recognition of burn nursing as a nursing specialty by the American Nurses Association in August 2020 and the publication of Burn Nursing: Scope and Standards of Practice. The latest updates on BCEN burn certification can be found at https://bcen.org/burn-nursing-specialty-certification/.

March/April 2022:

BCEN nursing specialty certification experts, American Burn Association (ABA) burn nursing subject matter experts, and BCEN test development partner PSI Services conduct the initial burn nursing role delineation study (RDS) to define the burn nursing scope of practice and body of knowledge.

Burn nurses participating in the RDS nurse survey play a very important role in defining and validating burn nurse roles, responsibilities and competencies (knowledge, skills and abilities). The results of the survey will help determine the content of the CBRN exam and be the basis for the detailed exam content outline.

SPECIAL NOTE: The burn nursing survey will be open until April 15. Burn nurses wishing to participate may contact Amy Grand at [email protected].

Fall/Winter 2021:

Subject matter experts are selected for a burn nursing role delineation study (RDS), which then gets underway in early 2022.

The ABA continues drafting a core curriculum titled Burn Nursing: From Injury Prevention to Rehabilitation, which will be one of the primary resources for the creation of exam content.

Summer 2021:

BCEN enters into a partnership with ABA to develop a burn nursing specialty certification program. BCEN will solely own the certification program and maintain the exam.

September 2020:

Burn Nursing: Scope and Standards of Practice publishes. Created by a diverse committee of experienced burn nurses, this reference provides the official scope and standards of practice for burn nursing and was critical to burn nursing being recognized as a nursing specialty.

August 2020:

The American Nurses Association formally recognizes burn nursing as a nursing specialty, approves the scope of practice, and acknowledges the standards of practice.

________________________________________________________________________________________________________

Please direct any questions or inquiries about the burn nursing RDS and burn certification program to BCEN Director of Certification and Accreditation Amy Grand, MSN, RN, at [email protected] For more details and future updates about the CBRN, please visit BCEN’s CBRN burn nursing certification page.

After 235 Days in Burn Center, Grateful Survivor is “Thinking About Being a Nurse”

After 235 Days in Burn Center, Grateful Survivor is “Thinking About Being a Nurse”

Having a patient say they want to do what YOU do, or receiving Facebook friend invitations from their family are among the happiest side effects of nursing excellence. The first-hand experience of making a real difference in peoples’ lives is one of the main reasons bedside nurses love their incredibly hard — and profoundly important job.

The nurses and other staff at University of California Davis Health Burn Institute Regional Burn Center will remember a recent patient and his loved ones long after the 92 thank-you cards are stored away (though as you can see, the cards are awesome too!). And when their former patient, Mexican truckdriver J. Guadalupe Romo Fonseca says he wishes he was a nurse—after spending some 8 months fighting through third-degree burns, a stroke, and the loss of his leg—it is evident that he had some truly inspiring caregivers.

 

“He pulled through so many times…”

Stethoscope in heart shape.During any other holiday season, truck driver J. Guadalupe Romo Fonseca would be traveling Northern California roadways, hauling heavy loads alongside FedEx, Amazon, and UPS drivers.

But this year, he’s off the road and thankful to be alive.

“For me, I was dead. I don’t remember nothing for six months,” Fonseca recalled.

That was his reality in November 2020 after a propane stove tank explosion tossed him outside his mobile home in Chico. The Guanajuato, Mexico native was making local hauls before his planned return to family in Mexico for Christmas.

Instead, he spent the holidays — and 235 days total — in the Firefighter’s Burn Institute Regional Burn Center at UC Davis Health. His wife, Berta, and their sons Silvestre and Jesus flew in and remained by his side. Alicia and Carlos, his daughter and other son, were not able to be there in person, but their minds and hearts were with their father.

“When my dad’s boss called and told us about dad’s serious burns on his body, we were just like, ‘Oh my God! Maybe it’s not that bad,’” said Silvestre Romo Llamas. “He is the strongest man I ever met. For me, seeing him like that was hard. It was heartbreaking.”

For the next six months, Fonseca drifted in and out of consciousness while recovering from third-degree burns over 60% of his body. He suffered a stroke, lost his right leg, experienced multiple bouts of sepsis, and underwent more than 10 surgeries.

“Twice I told the family to say their goodbyes. At times, it looked really bad. And then he pulled through. He pulled through so many times,” said Marianne MacLachlan, RN, one of Fonseca’s nurses.

 

“They were taking care of my dad, but also taking care of us.”

While Fonseca fought for his life, his family found support in MacLachlan and the team of nurses, therapists, and support staff in the Burn Center.

“It was so much love they were showing to my dad. They had great teamwork,” Llamas explained. “They were taking care of my dad but also taking care of us. They were angels for us.”

The Burn Center team consists of more than 25 experts: physicians, nurses, researchers, and administrative personnel who support patients and families in the largest burn treatment center in Northern California.

While it’s their job to care for those with serious burn injuries, doctors and nurses believe their role extends beyond the patient. Tina Palmieri, chief burn surgeon, says that “Patients and families spend many days in the hospital, with multiple operations, dressing changes, and physical therapy sessions. We work with them to envision what the patient can become and then help them get there. Our goal goes beyond survival: it is about helping the patient live a quality life.”

“It’s amazing what you can do for people when they trust you.

In 20 years, I’ll remember them. These are the people who stick with you.”

Marianne MacLachlan, RN, UC Davis Health 

“When you have a patient who’s very sick and not interactive with you, you do all you can to care for them, but you’re also caring for the family. They become the patient, too,” added MacLachlan.

MacLachlan added that of the many patients she has tended to over the years, this family was special.

“I’ve never seen such a beautiful connection with a family. Regardless of whether you speak the same language or not, compassion and love are the same,” she said.

 

It took a village—of 92 nurses, therapists, and physicians. And his son thanked each one of them with a personal card.

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As the only nurse on the unit fluent in Spanish, Adrian Montano, RN bonded with the family and helped them navigate every challenge they faced.

“Everything that could have gone wrong did. But they stood by him and were there every day and very appreciative of staff,” Montano said. “You don’t see families like this very often, not to that extent. Every day they took the time to interact with everyone and get to know everyone.”

Once Fonseca was out of the woods and his discharge was imminent, his family surprised those who had cared for them with an unexpected thanks — handmade cards, created by Jesus Romo Llamas, for the 92 nurses, therapists, physicians and various other staff who tended to their needs.

“The cards were just a little token of appreciation for all the intensive work I saw happening in the ICU.

Staff there gives everything they have so patients and family have another opportunity to be together. I wish I could give more than cards back.”

—Jesus Fonseca, son of J. Guadalupe

“Every so often we’ll get something from a family. But it’s very unusual for them to go out of their way to make something individual for everyone,” Montano said.

“It’s amazing what you can do for people when they trust you,” added MacLachlan. “In 20 years, I’ll remember them. These are the people who stick with you.”

 

“I’ve never liked hospitals to be honest, but now I’m thinking about being a nurse”

The compassion and care from UC Davis Health nurses not only paved the way for Fonseca’s recovery, they made an indelible impression on Silvestre Romo Llamas and his future.

“I’ve never liked hospitals to be honest, but now I’m thinking about being a nurse,” he said. “It’s incredible how you feel in this situation in such vulnerable moments. I want to help people.”

More than a year after that fateful day when an explosion rocked this family’s world, Silvestre Romo Llamas is taking a home health aide course and Fonseca is learning everything again.

“Since I got out of the hospital, everything was new for me again,” Fonseca said. “I’m doing a lot better. I got my prosthesis and I’m taking my first steps.”

Fonseca says his future, most likely, will not include driving a big rig. He hopes it includes a return home. But for now, gratitude: “This Christmas has special meaning, to be thankful of everything that’s happened through the year.”

Now they look forward to next year when they can return home to Mexico. And they stay in touch through Facebook with the team who healed them.