The Calm Before the Storm
by Wendy L. Bonifazi, RN, APR, CLS
Even as Florida was handling its
post-Katrina consequences, other states were gearing up. Some were activating their
volunteer nurse networks and nurse emergency response teams.
“We’re contacting and tabulating the
Alabama-licensed nurses we’ve been recruiting, screening, and training through the
state health department for the past two-and-a-half years,” said Jessica Hardy, RN,
MPH, director of the office of women’s health for the Alabama Department of Health.
Available nurses, she said, would be mobilized to care for local patients and out-of-state
evacuees.
On Saturday night, days before the storm struck, all the
country’s 117 Disaster Management Assistance Teams were on standby alert, and teams
in Louisiana’s capital, as well as Alabama, Tennessee, and Texas, were ready to roll,
said Buddy Bell, program manager with the National Emergency Medical System.
“We won’t put a team in New Orleans until
it’s out of harm’s way — or they’d become victims, too,” said
Bell. Nurses, who participate in the recovery teams for people and animals, are a key
component of each 35-member DMAT, equipped to provide treatment at existing facilities and
special shelters.
By 2 AM Aug. 31, the VA Medical Center of New Orleans had
settled in for the storm, sheltering an unusually full house under its roof.
“We don’t function as a shelter, but once [the
storm] occurs, streets are impassible,” said Clinical Coordinator Jim Wayman, RN,
BSN. “We brought in patients receiving home-based care because they’ll need
oxygen, air-conditioning, and other comforts of home, and we brought their caregivers. Our
staff will be working 12-hour rotations, so one group is already sleeping here.
Two hundred miles away, in Shreveport, La., Knox Andress,
RN, emergency preparedness coordinator for the CHRISTUS Schumpert Health System and
designated regional coordinator for HRSA-Louisiana Hospitals, Region 7, and his colleagues
were in the Emergency Operations Center (EOC) they set up Aug. 27. Andress immediately
initiated twice-daily conference calls and e-mails to his group of area hospitals to track
the storm and their role in response. They reported available beds and equipment in
designated categories, including adult and pediatric ventilation, preparing for evacuees.
Everything went smoothly. Until it didn’t.
Waves of disaster
After hitting Florida, Katrina bombarded Louisiana,
Mississippi, and Alabama, knocking out homes, health care, and communities, stranding
survivors with a flood of filthy water, sewage, corpses, contamination, mosquitoes, and
devastation.
Rescuers initiated evacuation efforts to rescue those
trapped in high buildings, rooftops, and high ground. More critically, they undertook a
massive effort: To evacuate and relocate patients, many already critical or fragile, from
hospitals and nursing homes, including the New Orleans Veterans Hospital and Superdome; to
transfer frail people from special needs and medical needs shelters; and to provide care
to those injured in the flood, or suffering from the extreme heat and the loss of water,
food, medications (particularly insulin), and health equipment.
Mid-morning Monday at the Shreveport EOC, online access
slowed intermittently, then stopped, so the staff evacuated and reopened in another office
equipped with multiple phones, cable TV, and functional Internet service. Ironically, the
EOC’s Internet servers were based in New Orleans, and they had been flooded, just
like much of the city.
The results were grim: Massive damage. Mass casualties. Mass evacuations.
“We have rooms and beds and nurses awaiting patients,
but it’s not going the way we want it to go,” said Andress, noting problems,
including the Office of Homeland Security’s continuing loss of Internet service.
“You have to move on the disaster’s schedule, and you have to be flexible. In
New Orleans, they have to triage and stage patients, ferrying them in boats to helicopters
and planes. They may send six instead of four. … It’s a less controlled
environment than usual. It’s a more austere and chaotic hand-off.”
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