Trauma Burn Critical Care at The MetroHealth System

Trauma Burn Critical Care Team

Trauma Burn Critical Care at The MetroHealth System

The MetroHealth System
Cleveland, Ohio
United States
Theresa Hannu, RN; Barb Church, RN; Darci Robinson, RN; Denise Davis-Mauldy, RN; Sharon Quallich, RN Jessica Maalouf, RN; Denise Murtz, RN; Suzann Minano, RN; Nicole Blaha, RN; Andrew Needing, RN; Tyler Heck, RN; Christina Rozman, RN; Chelsie Huntington, RN; Brandy Kulak, RN; Mary Barnes, RN; Jason Woodyard, RN

Working at a Level 1 trauma and burn center means being prepared for any emergency, 24 hours a day 7 days a week, even on a holiday. That is what we do at The MetroHealth System every day. But there are times when disaster strikes, and we not only do what we do every day, but we take it up a notch.

The burn unit is a small unit with highly specialized training in burn care. In addition, the spectrum of care is wide, they run a 24-hour burn clinic in addition to acute and critical care patients, meaning they maintain competency to care for low acuity patients in the clinic, moderate acuity patients in floor status and high acuity patients in the critical care area. They also maintain competencies in pediatric through adult care.

A team has been defined as, "A group of people with a full set of complementary skills required to complete a task/job/project working together with a strong sense of mutual commitment thus generating performance greater than the sum of an individual member." This amazing group of people did just that.

It truly takes a village when emergency and disaster strike and the burn unit lives to that motto every day, on this November day, their village became a city.

One evening we were notified of a structure fire in Geuaga County with an unknown number burn patients, adult and pediatric, coming to MetroHealth by air. Within a very short time, all six trauma bays were flooded with critically burned children and their mother. This is what we would consider a burn disaster.

While a disaster is happening, normal operations must also continue. The AOC Kevin Ortner notified the ACNO who reached out to her team. The nursing supervisors Barb and Darci, along with the Director of Nursing, Denise, quickly facilitated transfers out of the burn unit so that that the burn unit could focus on admitting and treating the new burn patients. They also managed the flow of patients out of the ED into the ICU beds to assist the ED staff who were also managing patients in their 6 trauma bays.

The burn attending physicians, Drs. Brandt and Khandelwal quickly triaged and assessed patients. They were instrumental in writing orders, triaging patients, managing fluids, scheduling ORs, and performing procedures.

The burn unit received 5 intubated patients, 4 of whom were children. This is how our village became a city:

The ED staff knocked it out of the park, while the trauma bays filled up, they continued to care for 65 patients and 2 code strokes in the ED.

Sharon the burn NP came in from home to assist in the trauma bay, on the treatment tables, and with bedside care until the wee hours of a holiday morning.

The nurses scheduled on the burn unit that night were Jessica Maalouf, Denise Murtz, and Suzann Minano; did an amazing job but couldn't do this alone, they had help. As it rolled into night shift, the no-float holiday rule came into effect. Nicole Blaha, a new grad RN from 3E, graciously, without hesitation floated to the burn unit. Not only was it the first float of her nursing career but it was to the burn unit.

Andrew Needing, a burn nurse, was in rapid response (RRT) and stayed past his shift, well into the night to assist with transfers of patients out of the burn unit to the ICUs, burn patients from the ED to the burn unit, and assisted with treatment table transfers. He came back for his 0700 shift to care for patients on the burn unit.

Tyler Heck (former burn nurse) relieved Andrew as RRT and stayed on the burn unit all night helping Nicole (float nurse) and all team members in any way that was needed.

Dominque Dar-Issa (CCP) and Trang Nguyen (CCP) stayed well past her shift into the night to ensure the only child not intubated was tended to, informed and not alone.

Suzanne Minano went down to the ED, out of her element, to wash and debride burned skin and apply dressings.

Christina Rozman and Chelsie Huntington, former burn nurses were working in the OR/PACU. After hearing the trauma/burn page, they went to the burn unit, gowned up and worked. Neither were asked nor was this an expectation.

Brandy Kulak, the new Nurse Manager came in and worked all night side by side with her staff to show support. A true leader. Mary Barnes the former nurse manager provided guidance over the phone while traveling out of town.

Jason Woodard, Nursing Supervisor was not scheduled to work but came in and stayed on the burn unit all night to facilitate any needs the staff had. He ran for pumps and equipment, was another set of hands, and assisted in any way needed. This also allowed the nursing supervisor who was scheduled to continue with normal operations.

In addition to the nursing staff the entire MH team stepped up:

Social workers Emily Mally and Mariam Biskiy worked tirelessly with the families gathering and communicating information. They assisted well into the holiday.

Although spread thin, Respiratory Therapy continued to manage the entire hospital while admitting 5 intubated, smoke inhalation, and facially burned patients; 4 of which were children. This was accomplished calmly, without sacrificing care in other areas (Aaron Davis, Vicky Davis, Dustin Holloway, Biz Baden, Cathy Baumgartner, Aiden Munar, Robin Underation, Heidi Pease, Desiree Gerstenberger, Gina Legarth, Zach Norton).

None of this could have been accomplished without our EVS team. They quickly turned over 5 rooms in the burn unit on an evening shift, with a full hospital. Thank you, Jeane Moore, Nan Malkay, and Tammatha Glover.

The AMO Dr. Talbott was instrumental in writing transfer orders, coming to the burn unit, and assisting where needed.

Through this burn disaster, the MH team pulled together and gave outstanding, compassionate patient care without impacting care in any other area of the hospital. Some question and say, "isn't this what we do?" the answer is yes, it is what we do, but many went above and beyond. Staff stayed late into the night to help. Staff came in on their day off, on a holiday to aid. A new graduate nurse who had never floated and had never worked burns, floated on a no-float holiday. Two nurses working in other departments, went to the burn unit to help as they had burn experience. It was not a hospital emergency or disaster, but it was for this small unit. This group of people with complementary skills, pulled together with a strong sense of mutual commitment and gave awesome care to our patients and their families. They are truly a DAISY Team.