"Emergency burns assessment unit - concerning"

I accomapanied my mother to an appointment with EBAC at QVH which she had been referred to by A&E at Tunbridve Wells hospital. She had a burn on her arm and hand which we were told at TW A&E was a partial thickness burn as it had blistered extensively and by the time we got to A&E theee was skin loss from almost the entirety of the burn - a not insignificant area of around 18x8cm. There was a startling difference between the excellent and empathetic treatment received at TW and the lack of empathy and concerningly poor assessment and ‘treatment’ at QVH EBAC. We were seen by a nurse who was not unpleasant but displayed no empathy and unfortunately was disinterested when we gently and politely voiced queries. I was very concerned that she assessed the burn as ‘superficial’ despite this being clearly incorrect. I’m a final year medical student and I’m familiar with burn grades and treatment. Superficial burns leave the skin surface intact and do not result in blistering and skin loss. She kept repeating that it was a superficial burn despite the skin loss. I was also concerned about her management, she refused to dress it properly, despite it still being raw and weeping, again based on her assessment of it as ‘superficial’ and she insisted despite our querying this that it only required moisturiser.

While this is what you do with a superficial burn with the skin intact or with a healed burn where the skin has reformed, this seems inappropriate with an open wound. When we queried this she said that the skin had healed, but it had not - she appeared to be referring to the dried layer of exudate which had dried due to the dressing being off and the delicate new granulation tissue that was just starting to form. She would only put a tiny adhesive dressing on one part of it that was bleeding the most - this not only left other areas open that were bleeding and weeping but also meant she had stuck the adhesive edges of the plaster onto raw wound tissue which is totally inappropriate and was very painful for my mum. The current evidence base shows burns shoulld be dressed with moist dressings to provide the best healing environment and prevent infection. I was also concerned by her method of cleaning the wound - a spectacle that left me incredulous as she donned non-sterile gloves and proceeded to wash her hands wearing the gloves and at each stage bringing over the water or soap on the gloves across the room from the sink to my mother - a distance of a good couple of meters - to rub them harshly over my mums wound. Not only did this not look like correct nursing technique to say the least, but it goes directly against guidelines (including NICE) to not rub the burn when washing to avoid causing further trauma and pain and swelling and disturbing new tissue. My mum was in a lot of pain during this and for some time after. oiQVH burns unit has an excellent reputation, but this experience has me concerned about the training of their EBAC staff