Becoming a burn nurse meant learning to find strength in chaos and humanity in pain.
The first thing that hits you when you cross the threshold of the burn unit is the smell. It’s an assault on the senses, a clashing blend of burnt flesh, antiseptic chemicals, and dressings. I remember thinking that while I didn’t yet know how I felt about being a nurse in the burn unit, I certainly knew how I felt about that smell.
My first shift as a burn nurse
When I walked into the break room to clock in for my first shift, I could feel the other nurses’ attention turn toward me. I was clearly new. My scrubs were bright and new, and my nervous smile hadn’t yet been replaced by the fatigue that comes from consecutive 12-hour shifts. I was a newly graduated nurse, a “baby nurse,” and naivety all but radiated from me.
At 6:53 a.m., the nurses and CNAs lined up to clock in. This unit held a group report each morning before individual patient assignments were made, a routine not common in all units, but essential here.
We reviewed each patient’s wound care requirements and discussed support needs. As I listened, feeling utterly overwhelmed, terms like Silvadene, seven-layer dressing, wet-to-dry, and tank room were casually tossed around. I wondered how I would ever master not just the language but the complex care behind it.
Building more confidence
My 12-week orientation began on the step-down unit, where I cared for patients with large burns or surgical wounds. Slowly but steadily, I learned the fundamentals every nurse needs: time management, prioritization, interdisciplinary communication, and adaptability.
As I gained confidence with routine patient care, I also honed the specialized skills burn care demands, such as admitting fresh burn patients, calculating total body surface area (TBSA), and initiating fluid resuscitation protocols. However, the emotional skills came slower.
The day it all became real
I stood beside the medical isolation cart, suited up in a gown, mask, protective glasses, shoe covers, and a hair net. This would be my first “big burn” patient in the hydrotherapy room, which we called the tank room.
Before we started, I confided my fear to my charge nurse, a seasoned burn nurse with decades of experience.
“It’s just like giving a big bath,” she said calmly.
Sure, if bathing skinless, intubated people was normal, I thought.
Earlier, we’d heard that a young man was in route via helicopter with burns covering over 90% of his body. All day, the thought of his arrival weighed on my mind.
When the unit’s double doors slammed open, a type of organized chaos ensued. The smell of gasoline was overwhelming. On the stretcher lay a young man, barely out of his teens, lying in a puddle of fuel. All his skin was nearly gone. He’d been intubated in the field. The only intact skin left was on the palms of his hands and a narrow strip down his spine. We later learned he survived a suicide attempt.
That day, I learned to compartmentalize, an emotional skill I couldn’t afford to develop slowly. If I were going to be present and provide care in this impossible situation, I had to focus.
The road to recovery
The patient’s procedure lasted for hours. We flushed gasoline from his stomach, attempted to place IVs and an arterial line, debrided his burns, and drained blistering wounds. Several nurses had to be treated in the ER for fume inhalation. We rotated in and out of the 95-degree tank room to avoid overheating, a critical environmental setting for burn patients who can no longer regulate their own temperature. It was brutal.
I remember wheeling him to his room. I remember holding his hand and praying. The prognosis was grim. Multisystem organ failure was expected if the burns didn’t claim him first.
I cried all the way home. I never expected him to survive the night.
But he did. And then the next night. And the next.
He became a fixture in our unit. He endured multiple surgeries, infections, and setbacks. He stayed with us for over six months before being discharged to rehab.
Over those months, I became more confident, not only in his wound care but in caring for all the patients we admitted. I began to feel proficient. But most important of all, I discovered something else: a deep, unshakable passion for trauma nursing.
Lessons learned and knowledge gained as a burn nurse
The knowledge I obtained was invaluable, but what stayed with me more than any protocol or procedure was the resilience of the human spirit. That young man who had arrived, barely alive, became the moment I stopped being afraid. The moment I stopped wondering if I could do this job, I started knowing that I could.
His survival wasn’t just a triumph over injury. It was proof that healing is possible even in the darkest, most hopeless circumstances.
For him, that meant skin grafts, surgeries, and the long, painful journey back to life. For me, it meant learning to find hope in heartbreak, strength in chaos, and purpose in pain. It was the beginning of a fulfilling and challenging career filled with trials, challenges, and healing. It was the beginning of becoming a nurse.
Now, when the double doors burst open and that familiar smell hits me, I don’t flinch. I take a breath, put on my gown, and step forward, not with naivety, but with confidence. Because behind every devastating wound is a human being — fragile, resilient, and worth every ounce of care. And I know I am exactly where I’m meant to be.
