When Hurricane Katrina’s Category 4 winds blew into the Gulf Coast, their effect was catastrophic. Days after the winds dispersed, the damage was still expanding. Breaks in the storm-stressed levee system caused flooding in New Orleans. And a backwash of consequences breached regional health care services set up to stop the tide of disaster.

“Everyone’s doing everything they can, but we haven’t seen the bottom yet,” said one northern Louisiana Health Resources and Services Administration safety and security officer, who asked us to withhold his name. “We’re ready to take patients here, but with communication out, we don’t know what’s left and what’s coming. It’s not only evacuations from hospitals and patients needing insulin, oxygen, and dialysis. It’s the entire New Orleans population that’s been displaced.”

And the Big Easy isn’t alone. The storm spread misery along the Gulf Coast, killing hundreds if not thousands and destroying an estimated 90% of buildings in some coastal areas.

With roads flooded, power out, and communication lines and towers down, experts struggled to assess the damage and evacuate patients and residents to regions with water, electricity, and staff.

Relocating hundreds of thousands of people — who abruptly lost their homes, jobs, and health providers for the foreseeable future — might require a national response unprecedented in its scope and size, some said.

At an August 31 press conference, U.S. Health and Human Services Secretary Michael Leavitt announced that the department had identified 2,600 beds available in a 12-state area, with 40,000 nationwide. How many would be needed was unknown.

“We’ll have fewer [transfers] to care for as the days go by because of deaths,” said Knox Andress, RN, the day before. Andress is the emergency preparedness coordinator for the Christus Schumpert Health System, Shreveport, La., and designated regional coordinator for HRSA-Louisiana Hospitals, Region 7.

“It’s the third day without power, food, water, or dialysis, and some [patients] have to be manually bagged,” said Andress. “These are incredibly austere conditions.”

Be part of the solution

Nurses are desperately needed, and in the states directly and indirectly affected, and state boards of nursing are fielding inquiries, determining how to expedite temporary licensure, and directing volunteers to organizations matching skills and needs. Some nurses are displaced themselves, and the influx of patients puts great pressure on nurses elsewhere who are caring for patients traumatized by their experience and transfer.

Nurses willing to volunteer hands-on care can find themselves in over their heads, even in areas that aren’t 20 feet under water.

“It’s worse than a jungle,” said Andress, listing insects, sewage-filled streets, snakes seeking dry ground, daytime temperatures in the 90s, humidity above 80%, hotels filled past capacity, and looters. “People feel compelled to respond, but they get in the way and run out of gas.”

Volunteers can avoid becoming part of the problem by serving with established organizations, such as the Red Cross.

As Katrina’s consequences increase, nurses can do something far better than hand-wringing over the crisis — and perhaps more important than hands-on care.

“We’d like to see more nurses involved in disaster preparation, asking questions and finding answers,” says Andress. “This is the kind of thing that makes that happen.”

American Red Cross

Salvation Army

National Volunteer Organizations Active in Disaster

USA Freedom Corps

Department of Health and Human Services