By James Coburn, staff writer
It’s all hands-on-deck at the INTEGRIS Health Paul Silverstein Burn Center.
Last year was the 50th anniversary of the center. The only certified burn center in Oklahoma accepts people of all ages.
“We try to get them back to a normal life, or a new normal life for them. And then we get to see them walk out,” said Victoria Fletcher, a registered nurse in the burn center’s ICU.
The burn center includes outpatient burn and wound care and an intensive care unit. Patients are admitted to the ICU when burns cover more than 15 percent of their bodies and certainly for burns covering more than 20 percent, Fletcher said. Med/surg hospital beds are designated for less serious or downgraded conditions.
Many patients are oil field workers or were injured in house fires. To save time, some patients are transported by helicopter to INTEGRIS Baptist Medical Center and are taken directly to the unit.
The doctor will come in to investigate the burn size. Patients are thoroughly cleaned before the family enters the room. Families are usually scared when entering the unit. The patient is understandably in acute pain.
“Pain control is kind of like our bread and butter in the nursing world as far as burns go,” Fletcher said. “Burns are one of the most painful things you can go through. We’re often giving pain medication. We’re trying to help them cope with pain in different avenues like listening to music or watching TV.”
Nurses recently began using nitrous oxide, used by dentists, as a safe and effective means of managing pain and anxiety. So far, they’ve seen a lot of success with that during dressing changes in addition to the typical intravenous pain medication given.
Fletcher’s approach is to speak calmly and be brutally honest when saying she must clean their burn wound. She may say, “I have to do these things. I don’t care what you have to do to cope with it. I’m going to give you pain medication. If you need to scream; we need to listen to music, you need to cry — I’m here for you no matter what.”
Fletcher never takes their reactions personally, she said. Quite simply, there is no better way to say it. Being brutally honest can help the patient break down a wall, and think, ‘She’s trying to prepare me for this’. And then, I usually encourage them afterwards. “You did so good,” she continued. “Let me know how that went. We’ll try to plan something a little bit better for next time.”
She will share with the burn team when a patient asks to clean the wound fast. The same applies when asked to clean the wound more slowly.
“So, I really try to advocate for the patient and pay attention to what they’re saying,” Fletcher said.
Afterall, Fletcher became a nurse to take care of people. She earned her Bachelor of Science in Nursing degree from Oklahoma Panhandle State University. While working toward her first degree in nutrition, Fletcher had always been fascinated with how nutrition plays a role in tissue and skin regrowth.
The burn center uses vitamin C resuscitation through a drip. Vitamin C is a free radical that goes in the body where it grabs the oxidizing tissues to help with the burn shock, Fletcher explained.
“Not every burn center uses that. It is something our medical director used at other burn centers. He brought it here and really likes it,” she said.
Her focus on healing, galvanizes her spirit to rise with best practices.
An oil field accident caused an extended ICU stay for an oil field worker. The day came when he would accomplish standing for the first time since his accident. Fletcher then told him that on the following day he would be helped to the door.
He said, ‘No, we’re doing it now.’ I said, ‘Hold on a second. This is the first time you’ve stood up in months. You’ve only been excavated for maybe a week.’”
The man replied, “No, we’re going to do it,” Fletcher said. After two or three steps she told him they would try again in an hour. She complimented his motivation.
“By the end of the shift, he was walking from his room to the ICU door,” she explained.
Today, when Fletcher is having a hard time at the gym, she tells herself she can do another repetition because of his motivation to walk.
“A lot of my motivation comes from my patients in the things they accomplish daily, in the things they had once thought as hopeless,” she added.
Her Christian faith is a huge part of who she is and how she lives.
Fletcher is passionate about a new support group with healing conversation. Survivors share that only a few people understand what they have endured.
“I think it will ultimately help them feel heard,” Fletcher said.
Fletcher encourages people interested in the support group to email [email protected], or call the INTEGRIS Health Paul Silverstein Burn Center at 405-949-3345.
