Young Kim/NurseWeek	More NurseWeek Features   Smoke-Free Zone   Nurses and patients tackle nicotine addiction   Bloodless Survival     Surgical techniques to use when transfusion drops out of the equation
At Maricopa Medical Center's Arizona Burn Center, patients are supported by physicians and nurses, physical and occupational therapists, social workers, psychologists, nutrition and pharmacy consultants, respiratory therapists, chaplains and volunteers.

There comes in every nurse's career a most unforgettable patient. Jason Schechterle is such a man. The Phoenix police officer came to the Arizona Burn Center on an ambulance gurney, more dead than alive. His arrival was announced by wailing sirens and flashing lights.

Schechterle had been buckled into his patrol car, responding to a call of unknown trouble the night of March 26, 2001, when his cruiser was slammed from behind by a speeding taxicab. The patrol car exploded into a ball of fire.

Providentially, a fire truck was at the same intersection, en route to the same call. But in the minutes it took firefighters and police officers to cut Schechterle from behind the wheel of his cruiser and pull him through the window, he had suffered fourth-degree burns to his neck, head and hands. His torso, arms and legs were seared, too.

Surgeons, who by published accounts doubted the wisdom of what they were doing, spent hours removing Schechterle's charred, dead skin. Layer by layer in the initial surgeries, they cut away his face in search of living tissue. No more eyelids, no cheeks, no nose, only a rough semblance of ears. In operation after operation, their scalpels and skin-grafting skills addressed burns over 40 percent of Schechterle's body. He ultimately would lose several fingers to the burns.

Schechterle has no memory of what happened, the crash or the fire, which he said is a good thing.

The biggest question

For more than 10 weeks, he lay in a drug-induced coma. The biggest question, as with all sedated burn patients, was, "When is he going to wake up?" said Kevin Marugaki, RN, of the burn center's intensive care unit. Schechterle's wife, Suzie, wanted an answer, and so did a brotherhood of worried police officers.

"You kind of have to remind them that this is very normal and reassure them that things are progressing the way they should when they are," Marugaki said.

Schechterle was a "one-on-one" in the early going in intensive care. He was Marugaki's only patient in shifts of repeated head-to-toe assessments, constant monitoring of systems function and pain management. Dressing changes typically ran upward of two hours and sometimes three. Bed turns required all of Marugaki's muscle.

"The Jason I had was unresponsive, so I never had a chance to hear his voice or get a view of his personality," Marugaki said.

But it was evident that the officer was not a typical patient in the hearts and minds of Phoenix residents.

"This guy was on the news, sometimes daily. He got a lot of publicity here," Marugaki said. "You've just got to shut that out and stick to what's going on in the room. He can't tell you when he's in pain, so you have to use your nursing judgment," gauging physical distress by variations in blood pressure, heart rate and respiratory status.

"The acuity just kind of comes with burn," said Marugaki, 29, who plans to strengthen his cardiac experience, but considers burn treatment to be his specialty. Integral to his practice is supporting and educating families with "Just the facts: What they need to know, what they can expect and possibilities. I don't deceive them in any way," he said.

Next Page