Over Christmas break, I had the chance of getting to job-shadow Dr. Butts in the Burn Clinic for the Holidays. He gave me many options of dates I could come see him work, so I thought the Burn Clinic would be something interesting to see. I had the opportunity to go twice in one week. Thank you Dr. Butts for making this happen!
On day one, I was able to walk all around the clinic with him. I started off the early morning in the conference room as he gets up to date with patients and how they are healing and other medical data. I watched as he met with many patients that are completely healed from their burns from up to six months ago. A few had healed skin grafts that needed quick checkups and a view medicine changes in brands and doses. When some burns would itch and be irritated, he would advise compression sleeves and minimal products used. After those few patients in the clinic, he charted other patients he had to see. Once we walked over to the actual hospital, we saw more recently admitted patients that have suffered new burns. There were a large amount of grease burns that caused many severe injuries that required scheduled skin grafts. I walked around with one of his nurse practitioners to watch her give eye exams to a patient who had grease burns over his eye socket. I saw many recent skin grafts that are in the process of healing. Many patients are eager to go home for the holidays, but they have to be cleared under conditions that require no IV medication and healthy grafts/healed burns. Wound care is very important and many patients had to make sure they were regularly getting the care done. I got to see the process of checking in and discharging the patients, which was something I didn't think I would get to see. Dr. Butts allowed me to apply silver nitrate to a patient's healed skin graft after they complained of a few places that needed cutting off. Along with grease, there were burns from fireworks, electrical mishaps, and many more. Something really interesting that I got to see was how translations happen in the hospital. A Spanish speaking woman with wounds all over her body had to listen to a translator on an iPad to understand Doctor Butts. He remained very calm and made the woman feel safe. I feel that the paper I wrote was super beneficial as I heard a lot of terminology that I wrote about. For example, I heard Lovenox be referenced, which is an anti-coagulant that I wrote about. There were many scheduled amputations and skingraft surgeries the day after I left.
Dr. Butts asked if I wanted to return later that week and watch whatever surgeries he had planned for the day. I arrived at 7:30 where we rushed to see a trauma patient that arrived just 20 minutes before from a car crash. He generally sees trauma patients that have been injured from car wrecks, gunshots, and more. He only had 25 minutes of sleep after operating on a gunshot victim over night. I watched the trauma patient receive an MRI, which showed nothing severe. This victim did have an open fracture on her shin. After that, he took some calls and completed some charts before heading into his first operation of the day. I had the chance to go into the operating room to watch a skin graft be placed on a woman's right forearm/hand and her foot/ankle. After all the protocols of scrubbing in and addressing the team, they began to operate. Dr. Butts and his resident removed thick layers of the burn to allow full recovery for the skin graft. Removing the burns means cutting the skin deep enough where there was none left. This allows blood flow to be in the area receiving the graft. They used this interesting looking machine to remove a perfectly rectangular thin piece of skin that was put through a cutting machine that turns the slab of skin into mesh. The mesh was placed on the cut area and then stapled and spread. The mesh allows for optimum healing. It also leaves an awesome scar! They were very particular on measurements and documentation throughout the whole process. The operation went smoothly and I enjoyed the process the whole time. I enjoy being in the operating room more than anything! His team worked so well together and you could see the highest respect they all had for eachother. Dr. Butts created a fun and upbeat environment that everyone could laugh and work in.
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