The care of the burn patient is performed through a team effort. During the course of burn recovery you will have the opportunity to work with physicians, nurses, physical therapists, occupational therapists, dietitians, social workers, respiratory therapists, chaplains, burn technicians, clerical workers and volunteers. The team members, who include the patient and family, work together to help the patient both physically and emotionally to return home.
The physician, as leader of the team, is skilled in all aspects of burn care. Specialists include plastic and reconstructive surgeons, general surgeons, pulmonary specialists and internists.
During the early stages of burn treatment, the patient is dependent upon the nursing staff and other members of the team for total care. As healing progresses and grafting is near completion, the patient becomes more independent. Patient motivation is important during rehabilitation to enable the other team members to do their job more effectively. The team encourages independence from the day the patient is admitted and asks that patients feed themselves, take care of their own grooming and hygiene needs and be out of bed as much as possible.
The patient’s family is a very important member of the team as they can help provide motivation and emotional support to the patient. They will be informed how to handle various situations that will be encountered in the burn center and at home, and are encouraged to ask questions to the staff and physicians.
This service includes registered nurses, licensed practical nurses and nursing assistants. The burn center nurses are specially trained in burn care and will do everything possible to help the patient achieve total rehabilitation. The nurse’s job will be facilitated by the cooperation of the patient and family. Physical therapists and burn technicians work closely with the nurses and assist patients with many of their needs especially related to dressing care.
The physical therapist’s goal is the preservation of functional burned extremities and joints. The physical therapist’s primary responsibilities include wound care, exercises, positioning, assisting with splints and developing individualized home exercise programs. The preservation of function of burned arms, legs, hands and feet depends on the cooperation of the patient with education from the physical therapist.
The goals of the occupational therapist are focused on preventing deformity, increasing independence in daily living and work skills, helping both the physical and emotional adjustment to any residual disfigurement or loss of function, and restoring the patient to his or her maximum capability for independent functioning.
The occupational therapist assesses the need for splints to decrease edema and maintain burned areas in the position of function to prevent contracture. The occupational therapist’s responsibilities include range of motion exercise, splinting and treatment to ensure maximum function in self-care.
The dietitian promotes a normal level of nutritional welfare to minimize weight loss and to promote wound healing. The patients are instructed concerning the necessity of maintaining a high calorie and protein intake (3000 to 5000 calories a day). This is further achieved by supplemental feedings, as indicated. The dietitian is available to meet with families regarding any special food considerations and diet modifications of the patient.
The social worker provides emotional support and rehabilitation counseling to the patient, obtains a history of the patient, performs family counseling at the time of crisis, and facilitates family group sessions for education and emotional support. The social worker provides information about community resources and makes appropriate community referrals to help the patient return as a productive member of his or her family and community and assists other team members in the goals of rehabilitation and discharge planning.
The respiratory therapist administers oxygen or other assistance for patients who may be in acute or severe respiratory distress due to inhalation of noxious agents, fumes or pneumonia. In more severe circumstances, patients may need additional assistance in breathing with the aid of a respirator.
The chaplain serves the immediate spiritual and pastoral needs of patients and families in the burn center. The chaplain helps the patient discover the significance of his or her faith during the recovery process. The chaplain is available on 24-hour call for these services.