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Carolinas MED-1 is a mobile hospital unit designed to supplement hospitals that are damaged by disasters. Inside the truck are four ICU beds and a surgical suite. Carolinas MED-1 traveled to Gulfport, Miss., and set up shop in a shopping center parking lot to help take care of Hurricane Katrina victims.
PHOTO BY TERRI PENNINGTON, RN |
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A Truckload
of Help
Nurses, physicians, and other health care professionals take their mobile hospital to Mississippi to aid Katrina victims.
by Debra Anscombe Wood, RN
A multidisciplinary team of 90 health care professionals from across North Carolina left home September 2 for a mission of medical mercy. Their 16-vehicle convey went to the hurricane-stricken Gulf Coast with Carolinas MED-1, a one-of-a-kind mobile hospital from Charlotte’s Carolinas Medical Center that has the capacity to serve as a level-one trauma center and a field hospital to care for patients with lesser injuries and illnesses.
“As we were coming into Gulfport [Miss.], a lady drove up beside us in a car,” says Terri Pennington, RN, an ED and critical care transport nurse at Carolinas Medical Center. “She was crying and saying: ‘Thank you for coming. Thank you for coming.’ It was so fulfilling to be there and know you were helping somebody.”
The team set up in a Waveland, Miss., shopping center parking lot and found unspeakable devastation. The air reeked of death, with bodies still atop store roofs. But it was the living the North Carolina nurses came to care for — they heard the medical teams were there and walked for miles to obtain health services.
“The first three days were surreal; it felt like we were the only people on the planet,” says Jennifer Kettle, RN, an ED staff nurse at Carolinas Medical Center. “A church group set up food service. A few locals were there. By the end of the week, it was quite an organization.”
Taking quality care on the road
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A team of nurses, physicians, pharmacists, and technicians from North Carolina has provided care to thousands of Hurricane Katrina survivors in Mississippi.
PHOTO BY ALAN TAYLOR
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Nurses from North Carolina State Medical Assistance Teams (SMAT) triage new arrivals 24 hours a day and treat 300 patients daily. People who need medications or who have minor health problems, such as rashes and lacerations, receive care in the 75-bed field hospital. Survivors who have more serious complaints, about 10% of those triaged, board Carolinas MED-1.
At one point, three patients with myocardial infarctions showed up within an hour of one another. The physicians set fractures, stabilized a 12-year-old boy with a severe head injury, and monitored a pregnant woman in premature labor before airlifting all of them out of the region.
Carolinas MED-1 comes complete with an operating suite, diagnostic services, and a four-bed ICU in two standard-sized semitrailers. A team of Carolinas Medical Center nurses and physicians designed the unit to augment a damaged hospital during a natural or manmade disaster. In this case, the crippled facility was the Hancock Medical Center in Bay St. Louis, Miss.
Carolinas Medical Center received two $2 million grants from the Department of Homeland Security to develop and outfit the prototype facility. Pennington, Kettle, and the Carolinas HealthCare System team trained with Tom Blackwell, MD, FACEP, incident commander for the medical team, for two years in preparation for taking the unit out to a catastrophic event. Nurses learned how to take X-rays and perform laboratory studies. Being on the MED-1 team has its benefits — Kettle found herself working much more independently than in a traditional ED.
Intense work
People receiving care expressed gratitude for everything, even little things, like being given a Motrin, and were patient when health care workers asked them to come back the next day for a tetanus shot, says Michele Rudisill, RN, BSN, a University of North Carolina Hospitals, Chapel Hill, trauma outreach coordinator and the MidCarolina Trauma Regional Advisory Committee (RAC) coordinator.
“Being in the field [and] taking care of patients was exhilarating,” Rudisill says. “Helping those people was one of the best things I have ever done in my entire life.”
Most of the patients the team treated had lost everything except the clothes they were wearing. They no cars, no homes, no money, and some even had family members who had died. Although these patients grieved, they weren’t hostile or bitter toward the health workers.
“They needed someone to listen,” says Patricia Fields, RN, assistant chief of emergency medical services at New Hanover Health Network, Wilmington, N.C. “Each person had a story. They wanted to share that story. It was part of the healing process to get it out. Sometimes the burden got heavy and the triage nurses would come out, get away from the area, and go back refreshed. It was very intense.”
Jimmy D. Taylor, RN, CEN, EMT-P, a regional disaster planner with Wake Forest University Baptist Medical Center, Winston-Salem, and the Triad RAC, found working at the field hospital incredibly painful; he still cannot talk about some of the details.
“A bigger purpose”
Hurricane Katrina offered the first opportunity for Carolinas MED-1 and the SMAT teams to fulfill their disaster-response mission. Nurses from multiple specialties and physicians from all over answered the call. Although many of these people had never met, they pulled together to work as a well-honed team. Fields says the entire operation functioned as if it were one big hospital, except for the Super Kmart sign.
“It grounded you and made you [think] back to why you went into nursing,” Fields says. “You’d go and sit and talk to the patients and do what was necessary [and] provide the care they needed — medical and emotional. It just flowed. It was absolutely wonderful.”
Nurses worked eight- or 12-hour shifts, but many often stayed late or came in early.
“I worked 20-hour days for several days,” Taylor says. “I’d sleep for a few hours and get up. If I was awake, I knew there was work to do. I might as well do it.”
Team members slept in tents, in Carolinas MED-1’s empty supply trucks, or in the backseat of their cars. They ate at the food-service tents with the evacuees and showered at a forestry base camp several miles away. They had e-mail access, but cellular telephone service was spotty.
“Doing without was a minor inconvenience,” Kettle says. “We had a bigger purpose.”
All the nurses Nursing Spectrum spoke with say they found the experience rewarding and are ready to go back. In the meantime, additional nurses are receiving training. Teams will rotate in and out on a weekly basis for two months or longer, depending on when Hancock Medical Center resumes operations.
Katrina has demonstrated a great need for more nurses trained in disaster relief, and Taylor emphasizes the value of preparing and responding through an organized system. However, as much as the North Carolina teams readied to provide relief, the nurses still were in awe of the devastation and the resilience of the people they treated.
“It gives you a whole new perspective on life and your profession, Taylor says. “It was easily the most incredible thing I’ve ever been involved in. ... It was an awesome thing and once in a lifetime, which is fine with me.”
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