Along with their trauma and flight nursing colleagues, burn nurses are now privileged to demonstrate their expertise in burn care with the new Certified Burn Registered Nurse (CBRN) exam from the Board of Certification for Emergency Nursing (BCEN). Introduced in the fall of 2023, CBRN certification spans the entire burn care 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.
With this new certification, burn nurses are uniquely positioned to highlight the important role burn nurses play in the care of traditionally underserved communities. As burn injuries are often associated with several social determinants of health, including poverty (Patel, 2018), food insecurity (Elsey, 2016), and living in under-resourced neighborhoods (Alnabantah, 2016), burn nurses play a crucial role in caring for some of the patients most in need of care.
Burn nurses’ work is similar to that of critical care specialties like trauma and emergency nursing. However, burn nurses are also responsible for complex wound care, often requiring hours-long procedures in patient rooms. This affords burn nurses one-on-one time with their patients, allowing them prolonged individual time to assess individual socio-demographic risk factors better. This individual time also provides an expanded role for the burn nurse, often taking on the caretaker and trusted confidant role. In this role, burn nurses can better assess the needs of their patients post-discharge, anticipating potential problems like lack of transportation, living conditions without heat or electricity, or unstable food resources.
The ability of burn nurses to anticipate these needs post-discharge is such a crucial aspect of their role that it is a component of the CBRN exam. The CBRN exam tests burn nurses for diversity, equity, inclusion, community outreach, and interprofessional collaboration knowledge. In addition to acknowledging the unique role these nurses play in recognizing and intervening when necessary, the CBRN exam also acknowledges the difference in the presentation of both burn injuries and skin disorders like Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN). Given the recent acknowledgment of the lack of diversity in medical education training (Louie & Wilkes, 2018), it is vital for all nurses. However, burn nurses should know the differences in presentation for full-thickness burns and skin injuries in light versus dark-complected patients. In addition to including DEI as a testable item, CBRN item writers and exam construction review committee (ECRC) members made a concerted effort to include depictions of all skin tones to test this knowledge.
As a burn nurse of almost 13 years, I have seen the profound difference providing culturally sensitive care has made to patients in our burn center. When I started caring for patients with burns, for example, we used one type of shampoo and one type of lotion for all of our patients. While it seems like a small piece of care, providing products designed to work with the patient’s hair and skin demonstrates a commitment to culturally competent care. I profoundly hope that as we continue to make strides in educating burn nurses, we find new ways to provide the best care possible to all our patients.
REFERENCES
Louie P, Wilkes R. Representations of race and skin tone in medical textbook imagery. Soc Sci Med. 2018 Apr;202:38-42. doi: 10.1016/j.socscimed.2018.02.023. Epub 2018 Feb 23. PMID: 29501717.
Elsey H, Manandah S, Sah D, Khanal S, MacGuire F, King R, et al. (2016). Public Health Risks in Urban Slums: Findings of the Qualitative’‘Healthy Kitchens Healthy Cities’ Study in Kathmandu, Nepal. PLoS ONE 11(9): e0163798 Doi: 10.1371/journal.pone.0163798
Alnababtah K, Khan S, Ashford R. Socio-demographic Factors and the Prevalence of Burns in Children: An Overview of the Literature. Paediatrics and International Child Health (2016). 10.1179/2046905514Y.0000000157 [PubMed] [CrossRef] [Google Scholar]
Patel DD, Rosenberg M, Rosenberg L, Foncerrada G, Andersen CR, Capek KD, Leal J, Lee JO, Jimenez C, Branski L, Meyer WJ 3rd, Herndon DN. Poverty, population density, and the epidemiology of burns in young children from Mexico treated at a U.S. pediatric burn facility. Burns. 2018 Aug;44(5):1269-1278. doi: 10.1016/j.burns.2018.02.003. Epub 2018 Mar 7. PMID: 29551448; PMCID: PMC6453533.
Dorma Liz Davila (Lizzy) RN, BSN, CPN, EMT never expected a quick volunteer weekend as a camp nurse to provide a transformative experience, but it did. And now she wants other nurses to know how helping kids at Paul Newman’s The Hole in the Wall Gang Camp can breathe new life into their nursing careers.
The Hole in the Wall Gang Camp is an organization that provides what the organization calls “a different kind of healing” to thousands of seriously ill children and family members every year. The campers attend completely free of charge and are cared for by the skilled nurses who volunteer in the infirmary for a weekend, a week, or more.
Davila, who works as a pediatric critical care transport nurse, first volunteered last year when a colleague who works as a camp nurse there told her they needed nurses for the Spanish-speaking family weekend. Her colleague had talked about how much she enjoyed being a camp nurse there, so Davila decided to give it a try. But she didn’t really know what to expect.
The first day, Davila got a crash course in the facility, the campers and their conditions, the equipment she’d need, and that was before even meeting all the new campers. But it didn’t take long for her to feel something she didn’t expect. “The first time I went I just fell in love,” she says. “It is like no other job. It’s just completely different.” Davila’s feeling from that one weekend spurred a commitment to future work, and she will also participate as a camp nurse this summer. “I got hooked,” she says. “I said ‘I am your Spanish weekend nurse.'”
The biggest surprise for Davila was how joyful the camp experience is and how much fun she had personally. As a transport nurse, Davila sees patients at their worst, she says. So coming to the camp, she was able to see the kids just having fun, building relationships, and having some freedom, despite their illnesses. And she says it’s also different from working as a bedside nurse with the associated stress of potentially having too many patients or caring for patients in a rushed environment.
While Davila provides support and is there for medical emergencies, during the Spanish weekend, families come with their children and provide the usual medical care they provide at home. “I am there as a nurse, but I am also with them doing arts and crafts or meeting them at the tower for the zip line,” she says. “It’s almost like I am a camper. It’s not like I am on the sidelines.” And while she’s working with the children, she’s also working with the families who appreciate the support and camaraderie of the medical staff and the other families.
Davila didn’t attend camp as a child and was curious about what it would be like. What she found as an adult was an experience that struck a sensitive chord. The campers’ families and caregivers often talk about how the children are teased in school by other kids who don’t understand their medical needs or equipment they must use. At the camp, the feeling of pure acceptance is something Davila felt personally–and it affected her profoundly.
“To go to the camp and see these kids laughing and smiling and there are no kids picking on them,” she says. “At camp, no one puts anyone else down.” As a Latina nurse born and raised in Puerto Rico, Davila says feeling different or other, something that happens in the real world, was entirely absent at the Hole in the Wall Gang Camp. “I came home and said this was a fairy tale world within the real world,” she says. “It’s like a bubble.”
Davila encourages other nurses with pediatric backgrounds and training (particularly training in emergency medicine or urgent care (pediatric or adult), pediatric intensive care, pediatric hematology/oncology, pediatric metabolic/mitochondrial disease, and pediatric immunology) to consider working at the Hole in the Wall Gang Camp or one like it. As overwhelmingly positive as it is to see the campers truly bloom during the weekend, Davila says the staff are impacted as well.
“I wish I could have people experience this,” she says. “It was therapeutic for me too. I recommend this to all nurses.”
We nurses know lots of things. Our heads are filled with innumerable ideas, thoughts, concepts, theories, observations, and facts. We know so much about pathophysiology, anatomy, chemistry, pharmacology, communication, informatics, psychology, sociology, and countless other topics that we’re almost bursting at the proverbial seams.
But have you ever wondered if we sometimes know so much that our knowing can get in the way? What if our certainty and knowledge keep us from seeing something in an entirely new light or thinking outside of a box that we’ve more or less locked ourselves into based on our area(s) of expertise?
What would happen if we could break the mental calcification that our knowing can lead to and open our minds to new ways of thinking about a problem or challenge? Is this one of the places where inspiration and creativity are born?
The Inertia of Our Knowing
In some obscure corner of the internet, I recently heard someone say that we can “break the inertia of our knowing” by opening our minds to novel ways of looking at things. We can say plenty of positive things about the concept and experience of certainty. Still, we can also say that it can sometimes lock us into a frame of reference that prevents us from wearing a different lens at a moment when it could be helpful — or even revolutionary.
Did Einstein come up with his Theory of Relativity by only thinking thoughts he’d had before? Were Nightingale’s theories and concepts the products of a closed mind? Did Leonardo DaVinci devise sketches for flying devices and other fantastical machines by accepting commonly held beliefs about what was possible for 16th-century humans?
These groundbreaking innovators from different historical periods allowed themselves to break the inertia of their knowledge by opening their minds to what others in their time might have considered impossible or even crazy.
If your nursing career, your way of practicing, or any other aspect of who you are and what you do is stuck in the mud of stale thinking and close-mindedness, maybe it’s an excellent time to see how you might lift yourself into a new state of mind that transcends the boundaries of what you think you understand about the world around you.
“Maybe” and “Yes, And”
Every parent knows that the dreaded word “no” is dangerous when it comes from a two-year-old’s mouth, but it’s equally dangerous when it comes from a 22-year-old medical intern or a 52-year-old charge nurse.
The word no is like the castle gates crashing down to keep anything new from entering the kingdom. No, it isn’t about creativity or critical thinking — it’s about staying stuck in the inertia of your knowing.
When a problem or challenge is apparent, and someone offers a potential solution, saying “no” turns off the faucet of creativity. However, if you instead say “maybe,” the possibilities are now open for discussion. And if you want to take it even further, saying “Yes, and…” as described by medical improv expert Beth Boynton, RN, MSN, opens the door even more.
For example:
Nurse A: “This family and patient are so difficult — there’s just no way of getting through to them.”
Nurse B: “Yes, and there might be a way to get their clergy involved to help them feel safer and less ganged up on by the team.”
Nurse C: “Maybe if we bring the deacon or pastor in for the next meeting, they’ll feel like they have allies in the room.”
Nurse B: “Yes, and if they feel safer, they’ll be more likely to hear what we say and be open to our proposed solutions.”
If Nurse B or C had said “no, but” instead of “yes” or “maybe,” the conversation may not have been productive. However, more possibilities emerge when building upon one another with positivity and openness. This breaks the inertia of knowing and opens the door to creative solutions.
Sailing to New Horizons
The inertia of our knowing creates closed doors, whether in our careers, clinical practice, or even our personal lives. If Leonardo DaVinci had said to himself, “These are the things that I know, and nothing beyond that is possible,” so much of what he could have accomplished would have remained unrealized and unimagined.
If Florence Nightingale hadn’t allowed herself the luxury of thinking in new ways about hygiene, sanitation, and the emerging science of biostatistics, her breakthroughs would never have flourished in her mind and created new methods and strategies for improving the health of injured soldiers in the Crimea, not to mention patients around the world for hundreds of years to come.
If the inertia of your knowing is holding you back and keeping you from growing, then it’s up to you to short-circuit that inertia and think differently. Whether it’s your health and wellness, career growth, marriage, parenting, or any other aspect of your life, your certainty of how things “should” could stand in the way of a personal revolution.
So, the next time you feel stuck or somehow held back in life, ask yourself if the inertia of your knowing is the anchor that must be pulled up from the murky depths to allow your ship to sail to new horizons.
With unforeseen vistas and possibilities opening up in your mind’s eye, there’s no telling where you’ll go. This might seem like a scary proposition, but staying stuck in the inertia of your knowing might be even more terrifying.
Try this approach next time something new is called for, and see how breaking the inertia of your knowing can be the best decision you’ve ever made.
Wound, Ostomy, and Continence (WOC) Nurse Week runs from April 14-20 and brings attention to this nursing specialty and the expertise WOC nurses bring to patient care.
As a member of the Wound, Ostomy, and Continence Nurses Society™ (WOCN®) for 31 years and now its president, Vicky Pontieri-Lewis, MS, RN, ACNS-BC-CWOCN, says the field is exciting and ever changing. This kind of dynamic professional learning environment brings a career satisfaction that keeps her advocating for nurses in the specialty while also appreciating the continual work they must do to stay current of WOC developments.
Pontieri-Lewis shared some of her thoughts with Minority Nurse about the career path and the excitement of being in the broader field of WOC nursing.
How did your career as a WOC nurse begin and evolve? After graduating from nursing school in 1983, I had the opportunity to work on a surgical unit with patients who underwent cardiac surgery in addition to patients who also had abdominal surgery, with an ostomy. The unit had an Enterostomal Therapy (ET) nurse, now called a Wound, Ostomy, and Continence nurse, who consulted primarily to patients with an ostomy. I noticed when the charge nurse was making daily patient care assignments, none of my colleagues wanted to care for the patients with ostomies. So, I always volunteered to have the ostomy patients within my assignment.
I worked with the ET nurse at the time to ensure in her absence that I would provide the ostomy patients with the right education. Later that year, my grandmother who lived in a very small remote town in the mountains, was diagnosed with colon cancer. She underwent surgery and as a result had a colostomy. I went to visit her and was appalled by the lack of access she had to any type of ostomy pouching system. At one point she was using a plastic bag! I tried my best to get her access to what we used in the United States so she could have some quality of life.
When I returned, the ET nurse at the hospital announced that she would be leaving. After the experience with my grandmother, I knew I wanted to pursue the role of an ET nurse. I went to my administrator to inquire if the hospital could assist with the finances to attend ET school. After I wrote a proposal for financial funding, the hospital agreed to send me to ET school for 6 weeks, and in return I signed a contract that I would stay at the hospital for one year after becoming certified.
Thirty-eight years later I was still at the same facility, and it became a major academic university trauma medical center. I developed the full scope of the WOC nurse role at the facility and then the advanced practice role. I had no idea at the time how the roles would expand to consulting so many patients with ostomies, wounds of all types, and continence needs. Going to ET school was the best path I took in my nursing career. I have dedicated most of my nursing career to being a WOC nurse, and I absolutely love what I do!!
What attracted you to this specialty? As I shared above, I have a “love” for caring for patients with an ostomy. My grandmother was my inspiration and I always have the memory of her on my shoulder when caring for patients with an ostomy. Caring for patients with different types of wounds was ever-evolving as new technologies and products were being developed. It was almost like baby boomers, but “wound care boomers.” Each time I attended a conference there was something new and exciting being presented.
As the role of the WOC Nurse continued to grow and develop in healthcare systems, so did the WOCN®, the largest and most recognized professional nursing community dedicated to advancing the practice and delivery of expert healthcare to individuals with wound, ostomy, and continence care needs. The WOC nurse conferences began to include more evidenced-based lectures and presentations, more research was being done, and notably, products were being developed across the specialty.
What would inspire nursing students to consider this specialty as a career path? Nursing students across the country would be inspired to pursue a career path to be a WOC nurse by simply talking to and spending time with a WOC nurse. Nursing students today are thirsty for knowledge on how to manage wounds and skin integrity, and to educate patients with an ostomy.
Spending a day or two with a WOC nurse can provide a realistic insight into the scope of the role. Nursing students will undoubtedly be dazzled by the wealth of knowledge and expertise that WOC nurses possess, and the extent of how that knowledge and expertise contributes directly to patient care and quality outcomes. The role of the WOC nurse can be in an inpatient or outpatient setting, allowing one to work independently, and be innovative in the care delivered. Overall, the impact of the role is inspiring and rewarding and it can be a lifelong career filled with continuous learning and professional development.
What might surprise people about your role, all you do, and your connections with your patients? The role of the WOC nurse is very rewarding. WOC nurses can work with all members of the healthcare team to improve the outcomes of patients. Since the scope of practice is very specialized, WOC nurses are viewed as the experts and are consistently relied on not only by the healthcare team, but by patients as well.
I had the opportunity to form an in-depth connection with patients from providing support and guidance, to sometimes just lending an ear to listen to their concerns and healthcare needs. Overall, the in-depth connection, the breadth of education that is provided, and the ongoing support is the most satisfying—especially when you can see the impact that you have had on someone’s life.
Radiology Nurses Day, also known asRadiological and Imaging Nurses Day, is celebrated annually on April 12 and was established to recognize the work that nurses do in the specialties of radiologic and imaging nursing.
The work of radiologic and imaging nurses is not only important for an accurate assessment and diagnosis, but it is also a skill set increasingly in demand. As radiology and imaging services such as MRI, CT scans, and ultrasounds are required for more careful diagnosis, the expertise of a radiology nurse becomes critical to accuracy. And as the technology for such imaging become ever more advanced, radiologic and imaging nurses need to remain up-to-date on using the equipment and assessing the resulting data.
TheAssociation for Radiologic and Imaging Nursing (ARIN) leads the day honoring nurses in this specialty. Radiology nurses are an essential component of a holistic patient care team. Radiology nurses become skilled in preparing patients for and guiding them through radiology procedures. These tasks include explaining the procedure clearly, possibly administering an IV for medications or dyes, monitoring them and assisting them as they undergo a procedure. Some patients may need to ingest medications by mouth as well for monitoring digestion, for example.
Radiology nurses are able to keep patients informed of each step of a procedure and to let them know what is happening and why. For instance, an MRI’s loud banging noise and small space that can cause jitters. Because they can work with patients of all ages and with those who are coming for a routine screening or a serious illness, they need to be agile in navigating the details of medical conditions and the emotional stress patients might have.
As they use high-end, sensitive equipment, radiology nurses must develop highly specific skills to use the machines for the best results and in the safest manner for patients and team members. They have patient safety as a goal at all times, so must be aware of everything in their surroundings that could impact how an imaging procedure could go. For instance, the magnetic power of an MRI machine requires that no loose metal be nearby and that patients have removed all jewelry or metal. Radiology nurses will ensure that they ask patients all required questions to help ensure their safety. If they are working with a patient having a series of X-rays, they will need to position the patient properly while also ensuring they are protected from any unnecessary radiation.
To stay current, radiologic and imaging nurses will want to consider certification in their specialty. With certification, they will have the latest evidence-based practices to provide the best care possible. They can also read the Journal of Radiology Nursing and attend conferences to connect with other radiologic and imaging nurses and professionals.
Radiologic and imaging nursing is an exciting specialty and one that only promises to increase in complexity. If you are a radiologic or imaging nurse, celebrate today to honor your important work.
Whether you know it or not, you have a brand. Like it or not, YOU ARE THE BRAND! One way to check out your personal brand is to google yourself and see what pops up. You may be surprised. If you do not create your brand, it may develop on its own.
Research demonstrates that 94% of recruiters will search for a candidate online. Career Builder found that 70% of employers said they use social media to screen their candidates and are less likely to interview a candidate they cannot find online. There are many definitions of a brand. However, the simplest explanation is how people perceive you. To sum it all up in one word, brand is your “reputation.”
What do you want to be known for? And why should you care?
Nurses should prioritize personal branding as it allows them to distinguish themselves in a competitive job market, enhancing their visibility and desirability to employers. A strong personal brand communicates professionalism, expertise, and dedication to patient care. The reality is a brand can assist nurses in attracting rewarding career opportunities and advancement prospects.
Nurses can cultivate trust among patients, colleagues, and healthcare organizations by strategically shaping a personal brand. Personal branding can lead to greater career fulfillment and success in the dynamic nursing field. Are you ready to learn how you can shape your brand?
Here are 5 Steps to Create a Standout Personal Brand for Nurses
1. Define Your Unique Value Proposition
What sets you apart from other nurses?
Reflect on your strengths, skills, experiences, and passion in nursing.
Determine what makes you unique as a nurse.
What attributes do you want to be known for? (empathy, communication skills, clinical expertise, or leadership abilities)
]What is your purpose?
2. Create a Professional Online Presence
Establish a strong presence on professional on LinkedIn!!
Optimize your profile with a professional photo, compelling headline, and detailed summary highlighting your expertise and achievements.
Engage with other healthcare professionals and join relevant groups to expand your network.
3. Develop a Consistent Brand Image:
Ensure consistency in how you present yourself both online and offline.
Dress to impress or at least have a stand-out style
Be yourself as much as possible so people will be able to recognize you in person when they meet you and remember YOU!
4. Showcase Your Expertise Through Content Creation
Demonstrate your expertise and thought leadership by creating content related to nursing topics.
Write articles/blog posts, record educational videos, or host webinars on topics that align with your expertise and interests.
Establish yourself as a trusted authority in your field.
Just Start! Do not worry about the equipment or lighting! Get out of your head!!
5. Seek Opportunities for Professional Development/Recognition
Invest in professional development by pursuing advanced certifications and attending conferences/ workshops.
Showcase your expertise, such as speaking engagements at conferences, guest lectures at nursing schools, or writing articles for publications.
Seeking recognition and advancement within the nursing profession, you can further enhance your brand and position yourself as a leader in the field.
