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Residents of Louisiana, who had to flee their homes because of Hurricane Katrina, are inside the Houston Astrodome and being helped by the Red Cross and other health care workers.
PHOTO BY ED EDAHL/FEMA
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A Clinic, and
Much More
Houston facility serving hurricane evacuees finds itself addressing a host of needs.
by Scott Williams
Air Force flight nurses, most of them seasoned from bringing combat-wounded service members out of Iraq, helped evacuate some of the sickest survivors of Hurricane Katrina who had sought shelter at the Louis Armstrong New Orleans International Airport.
The clinic at Reliant Arena in Houston, treating residents forced from their homes by Hurricane Katrina, could become a model to prepare for future disasters, according to a nurse involved in setting up the clinic.
Barbara Reece, RN, MS, CNAA, BC, chief nursing officer at Lyndon B. Johnson General Hospital in Houston, said the clinic could more accurately be described as a miniature hospital offering a wide range of medical, social, and mental health services. She said those responsible for organizing the clinic have already begun discussing ways to document how they went about setting it up in case the federal government requests it.
Reece said the clinic at Reliant Arena, serving evacuees housed at the Reliant Astrodome and Reliant Center, has treated as many as 50 people per hour for all sorts of acute and chronic problems including congestive heart failure, HIV infection, drug addiction, intestinal viruses, and diabetes. Patients range from newborns to elderly people suffering from dementia and Alzheimer’s disease, Reece said.
On its first day, the clinic saw 2,000 patients in a 24-hour period, she said. As of late last week, the clinic was seeing about 700 to 750 patients a day.
“Everything that has come through here we have done our best to accommodate,” she said, “and if it’s health care services that we are not able to provide, then we are sending [the patients] out to the hospital setting.
“The demand is unending. We initially set up to take care of their health care needs, but all the other things are coming with it.” Those needs include mental health counseling, eyeglasses, child care, clothing, and food.
Reece said the clinic has taken over the entire 350,000-square-foot arena and is staffed by nurses, physicians, volunteers, pharmacists, radiologists, lab technicians, and others, such as clerks, nursing assistants, phlebotomists, and ECG technicians. Besides staff and physicians, the clinic had put to work more than 400 volunteer medical professionals in its first week, she said.
Elizabeth Madrid, RN, MSN, CNAA, CNOR, director of operative services at LBJ General Hospital, said she and Reece were charged with setting up a staffing center to make sure the clinic has qualified health care professionals available at all times “so we [don’t] have 100 people on the day shift and no one on the night shift.”
Madrid said Reece called her on Aug. 31, and told her that the Harris County Hospital District, which owns and operates the LBJ hospital along with Houston’s Ben Taub Hospital and other facilities, had been charged with setting up a staffing center. The hospital district’s department of nursing, in collaboration with physicians at the University of Texas at Houston Medical School and Baylor College of Medicine, set up the clinic.
Reliant Arena, Reliant Center, and the Reliant Astrodome are part of a complex of convention, meeting, and event facilities known as Reliant Park. The park is near downtown Houston and the Texas Medical Center, home to the world’s largest concentration of medical schools, hospitals, and other medical facilities.
Nurses and physicians — set up at various places in the two shelters to screen patients seeking care — treat those with minor problems and send the others, via shuttle, to Reliant Arena, where they’re interviewed, triaged, and sent to the appropriate treatment areas, Reece said.
She said nurses are also moving throughout the Astrodome and Reliant
Center to make sure everyone who needs care receives it. That’s especially important for the elderly, she said, who may not be able to get their own food and water, and may need supervision to make sure that they are taking prescribed medications.
Patients who come to the clinic are met by a nurse and registrar who collect basic demographic and health information, Reece said. Based on their needs, they are then directed to the appropriate caregiver, be it medical, social, psychiatric, or pediatric. The clinic includes X-ray facilities, a pharmacy, individual treatment areas, and a lab. Tests that can’t be handled at the clinic are sent by van to a nearby lab, and patients who need to be hospitalized are sent to one of the Harris County Hospital District facilities. The hospital district also has set up an information technology department to create electronic medical records for each patient.
Child Protective Services staff are on hand to make sure children are receiving the care they need and placing those who have been separated from their parents into foster homes. Physicians, psychiatrists, counselors, social workers, and nurses who specialize in psychiatry are offering assistance to patients with mental health problems, Reece said. “Some of them had those problems before Katrina, and so it’s just escalated that,” she said. Many are expected to suffer from posttraumatic stress disorder, while others just need someone to talk to.
Spiritual needs are being met by members of the clergy, Reece said, and the drugstore chain CVS has set up a pharmacy in the Reliant Arena parking lot to provide medication. The clinic also includes a food court, sleeping area, temporary showers, and isolation areas for people with intestinal viruses. Trucks and ambulances come and go throughout the day and night.
Many evacuees are receiving tetanus and other immunizations, Reece said, and many are suffering from intestinal viruses that cause vomiting and diarrhea. They’re being kept separate from others to prevent the spread of illness.
“We do not want them to go back into the main dome area, and so we are housing those individuals,” she said.
Madrid said she has never experienced anything like this, and she can’t help wondering whether she, as a resident of a town near the Gulf of Mexico, might someday find herself in a similar position as the evacuees.
“You keep thinking this could be me,” she said. “If a hurricane hit Houston, this could be me getting off a bus and going to a shelter.”
Madrid said the atmosphere at Reliant Park has been both thrilling and gratifying. She wonders, though, how long the philanthropic spirit will prevail and what will happen to people whose lives have been uprooted.
“Will they be forgotten?” Madrid asks. “Or will we follow through in helping them establish their lives?”
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