Jackie Heinle's career is on fire.

"It's the burn patient that's been my life for 21 years, and I can't imagine not having them in it," said Heinle, RN. But then she's from a firefighting family: a father who, at age 12, was a burn victim and grew up to be a fire chief, and a husband and daughter who are firefighters.

Heinle, 45, is regarded throughout Iowa and nationally for innovation and advancing the care of burn patients as nurse manager of the University of Iowa's Burn Treatment Center in Iowa City.

What started as a small outreach has become a major focal point of a career that always will be filled with bedside care and mentoring. Heinle spends hundreds of hours a year traveling to rural hospitals and volunteer fire departments to teach firefighters, emergency medical technicians and, to some extent, industrial safety personnel how to improve burn victims' chances of survival.

Before patients' arrival at the University of Iowa, "There were a lot of things that weren't being done," Heinle said. So she developed a protocol for those who reach burn victims first: Give them oxygen, keep them warm, provide basic wound care, do some pain management and transfer them. "Granted, it's a lot more complicated than that, but those were the easy things. The information was there, it just wasn't being communicated," she said.

For 15 years, Heinle's protocol has featured the use of kitchen plastic wrap in the initial treatment of severe burns. The protocol is the result of evidence-based research, she said, that brought the university acclaim in the first national article to detail the use of plastic wrap.

"First of all, it keeps the patient warm. We know that one of the most important things that skin does is to keep you warm," Heinle said. "Patients that come in plastic wrap are much warmer than patients who don't. And if you don't have a warm patient, you'll have a dead patient.

"The other thing the plastic wrap does is it decreases pain stimulation," she said. "Your skin is occlusive. What it does is cover those injured nerves back up with an occlusive bandage. And, my gosh, it's cheap."

An overstatement, perhaps, but Heinle said she teaches that an ambulance or transport rig for a burn patient needs just three things: a box of plastic wrap, a box of freezer bags to isolate and seal off burned hands and a commercial hand-cleaning solvent "because we have a lot of tar and asphalt injuries here."

She said the careless use of flammable liquids-"You wouldn't believe the people that throw gas on things"-and explosions in the illegal manufacturing of methamphetamines account for many of the other 200 or so victims who pass through Heinle's unit each year.

The possibilities to expand her education role are numerous. For instance, last year she addressed the intimacy and sexuality of burn patients before the World Burn Congress. But direct care and seeing staff RNs through the long-term and often emotionally difficult situations remain first in her heart, Heinle said.

"When we are interviewing a new nurse for the burn center, I require them to come and spend a morning providing baths to our patients," she said, to gauge what she calls the nurse's "yuck factor."

What Heinle must determine is "Can you look at patients who have bad, bad burns? Can you inflict pain on them-children and adults-and know that these patients have altered body images for the rest of their lives? Can you provide that kind of care on a day-to-day basis? Because if you can't, it's not going to work for you to work here."

But for nurses who can do that, the rewards of burn care are lifelong and "fortunately, the happiness outweighs the sadness much more," Heinle said. "We had a wedding up here the other day. One of our burn patients was married on the unit and the nursing staff participated in that.

"I have a very simple philosophy. Burn injuries heal, but they never go away. We're part of those things that are never, ever going away," she said.

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