Provider Profile: Sarah Sweeney, BSN, RN, ACLS, ABLS

Editor’s note: Today’s Wound Clinic (TWC) recently interviewed the floor nurse on the burn ICU and medical ICU at Cabell Huntington (WV) Hospital to discuss her career in wound care and the industry in general and her role as a preceptor. To participate in a profile or nominate a staff member, please contact managing editor Joe Darrah at jdarrah@hmpcommunications.com.

TWC: What is your role as a wound care nurse on a burn unit and in the ICU?
Sarah Sweeney (SS): I collaborate with our physicians to decide which treatments, topicals, and dressings are best for each individual burn. It is also my responsibility to make sure that each patient is provided with adequate pain relief, is getting enough nutrition to ensure healing, and also that everyone is doing their physical therapy to help prevent decrease or loss of function. I act as a resource on the other units of the hospital, including the ICU. I consult with the other nurses and, after inspection of the patients’ wounds, give them my recommendations and provide education to unexperienced nurses on how to provide each patient’s wound care.

TWC: How and when were you introduced to the wound care industry?
SS: My first experience with wound care was in nursing school during my senior year in 2003. We did a rotation on the burn unit that I currently work in. I was able to assist during the patient’s hydrotherapy and dressing changes. I had yet to decide what type of nursing I wanted to do and after that day, I had no doubt that my specialty would be burns.

TWC: What are some exciting changes/improvements to medicine and wound care that have occurred during your time as a healthcare provider?
SS: One of my favorite improvements I’ve seen in healthcare has been the disinfecting port protectors that help decrease central-line infections and are huge time-savers. One of the newest developments in wound care is the GAMMEX® Burn Treatment Solution package (Ansell).

TWC: What do you enjoy most about caring for wound care patients?
SS: The best part of my job is that I have visual confirmation that what I am doing is helping the patient. I love seeing how each wound progresses daily and I enjoy seeing patients after discharge when their wounds are completely healed.

TWC: Please describe some of the conditions that your patients are experiencing on your units related to wounds and the challenges that come along with caring for this population.
SS: Some of the most challenging burns that we see come from our patients who are living with diabetes. Their decreased sensory perception makes it very easy for them to get a third- or fourth-degree burn without realizing it. Diabetes also causes decreased wound healing, which makes these patients especially challenging to care for. Another condition that can affect our burn population is compartment syndrome. Any area that is burned circumferentially can be affected. We monitor hourly pulses on affected areas and monitor bladder pressures and airway pressures when the trunk is burned circumferentially. Escharotomies are performed on areas that are showing signs of compartment syndrome to ensure that blood flow is not compromised and that damage to internal organs is not occurring.

TWC: Why and when did you decide to pursue your ACLS and ABLS certifications? How have these credentials impacted your practice as a wound care provider?
SS: I was certified in ACLS for the first time in 2004 and ABLS in 2006. Working in a burn ICU, it is required that I have both certifications. I use my ABLS every day for providing adequate fluid resuscitation. Unfortunately, many of our burn patients are extremely ill and there have been many times that I have needed to use my skills learned in ACLS to code patients. I also have found my ACLS very useful in dealing with heart and stroke patients in the ICU. With both certifications, I feel more prepared for whatever burn or situation I may come in contact with.

TWC: Please discuss your role as a preceptor and the impact you have on young/newly licensed clinicians who are caring for wound care patients. What value has this role brought to your career?
SS: Being a preceptor is a very rewarding part of my job. It is critical that I teach our new nurses how to provide the best care to our patients and how to handle themselves in any situation they may come across. I teach them how to care for all kinds of burns/wounds, including flash burns, chemical burns, electrical injuries, patients living with Stevens-Johnson syndrome, transcutaneous electrical nerve stimulation, necrotizing fasciitis, pressure sores, amputations, and any other wound our patients may be living with. Nurses learn how to wash and dress wounds, but more importantly how to visualize wounds and decide which topicals and dressings the patient needs. Even after I have finished training new staff members, I have developed a bond with our new nurses and act as a resource for them whenever they have questions. It is very rewarding for me to see these nurses flourish and become confident and empathetic caregivers. It’s also a learning experience for me. There is invariably something that they teach me that I take from them and use in my practice.

TWC: In the general sense, please discuss some of the products you use on burn patients that you believe hold the most promise for the treatment of wounds. Anything new in terms of products that are improving the care you’re providing on the unit?
SS: One of the newer products that we are using that I can see making a difference for our patients is the GAMMEX Silver Barrier Glove with adjustable closures. The new glove is used to prevent infection and reduce wound care for the patient. It goes on much faster than dressing each individual finger and has an outer-glove dressing that only requires that you change the outer glove when soiled. It also allows patients to use their smartphone/tablet as it is fully customizable, so compression can be tailored to the afflicted area and individual finger pieces of the glove can be removed to allow for more mobility. The product also uses Velcro straps, so that if someone wants to visualize the wound, the dressing can be taken apart and the individual area can be inspected without having to remove and reapply an entirely new glove. The glove both reduces pain and time of wound healing for the patients, allowing them to be sent home earlier. The glove has reduced wound care time on our unit and is great to send patients home in.

TWC: Looking ahead, how do you see the future of wound care progressing as it concerns burn patients? Any new modalities, etc. on the horizon that hold promise?
SS: In the future I hope to see more products that save nurses time and decrease pain for our patients. I think we also will see more dressings with extended wear times and also more that are glove or boot shaped. I would also love to see some changes in our topicals. It would be wonderful if some of our ointments could be sprayed on the patient instead of being rubbed on. That would be a huge time-saver and a definite plus when it comes to pain control.

TWC: For our readers who are working in the outpatient wound clinic setting, what should they know about caring for burn patients following hospitalization that they might not be aware of?
SS: They should be aware of just how much these patients have been through. It is absolutely amazing to see a third-degree burn patient who was burned over half of their body become a fully functioning individual again. Some patients have struggled for months and overcome many complications before they reach the outpatient setting. Sometimes a wound check can be more than an appointment for these patients. It is a milestone.