Excruciating pain, enduring suffering, and searing burns: The culture of care in burn units of hospital in Iran

Abstract

Burn injuries are among the significant threats to population health, with distinct characteristics, and caring for these injuries is of paramount importance. Along with the painful sensations, burns bring about profound grief and enduring suffering that encompass not only patients but also their families and communities. This ethnographic study, conducted in 2021-2022 focused on the pain and suffering resulting from burns and their management in the Iranian context. The primary objective of this ethnography is to explore cultural meanings and experiences of 32 nurses, 13 patients, and 3 physicians using various methods, including observation, fieldnotes, 48 ethnographic interviews, and informal conversations (overall, 356 hours). Inspired by Arthur Kleinman's approach to care and illness, we discuss the potential for "being" based on ethnographic findings from a referral burn center in Iran. This allows us to understand the human experience and its existence within an embedded context, providing a structured direction towards the future. From the perspective of our participants, there is a close relationship between the culture of burn care and Iranian culture regarding pain and suffering. Hence, the experience and narrative of burns are closely associated with sadness, as in the context of Iranian historical culture, people had restricted opportunities (life chance) in everyday life to encounter joy. The intrinsic fear that an untreated burn could lead to catastrophic consequences for the present and for the future. This study also demonstrates that burn care nurses, despite the considerable challenges, dilemmas, and pressures they face, sacrifice their lives to light the candles of hope in the hearts of burn victims. Indeed, they sustain the flame of hope amidst the darkness of the pain and suffering experienced by burn patients. The profound insight and understanding that these nurses possess enable them to exert a significant socio-emotional influence on their patients and resumption of their everyday lives.