Staffing during hurricanes?

Nurses General Nursing

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Hey all, just wondering what your hospital does in regards to staffing during a hurricane.

Do they increase staffing, maintain staffing, or decrease staffing?

How about immediately after a hurricane or storm?

Thanks!

I've been thru many of them, in Florida and Alabama, at several different hospitals. During each, we were told to come and bring clothes and your own food. They did not provide food or drink for the employees, only the patients. We slept on the floor, or on army mats. We also were not allowed to bring any of our kids or family members. The doctor's families were given a patient room to sleep in, but not the other staff. The doctors could bring in their kids, but we could not. I vividly remember being there for several days already, and finally crashed in a hospital bed that was not occupied. Just as soon as I closed my eyes and drifted to sleep, someone came in my room and said get out, a doctor's wife was coming and would need that bed. We slept in the hallway on army cots.

That's not right. What makes the doctor's families any more special than the nurses? As for the food-they SHOULD provide it for free.

We weathered hurricane Gustav at the LTC I worked at last year. Nobody was forced to come in to work during that time, but they provided sleeping arrangements and food for those who did. I came in one night, but couldn't stay because my hubby had to be at his job (prison) almost around the clock and I had nobody to watch our two year old. My aunt is an ER nurse, and she was actually upset that she wasn't scheduled to work during the storm, because those who did make time and a half.

To answer the OP's question: I haven't ridden out any storms at the hospital, but I've lived in a hurricane affected area all my life. There's really no reason to increase staffing during a hurricane, except in order to allow for call-ins if staying is optional. People don't really flock to the hospital in droves before, during or after a storm. Most people want to stay put.

They would have had to have physically removed my fat *** from that bed.
Specializes in Critical Care, Education.

My organization has several facilities in hurricane country. Here's what we do . .

Side note: Remember that hurricanes are never 'sudden'.. there's always a few days to prepare as we track that sucker wobbling towards us in the Gulf. We have a lot of advance information about storm surge, approximate day/time when the roads will become impassible due to storm surge, etc. Note: our emergency generators & fuel are elevated above flood levels, window glass is reinforced, building structures 'hardened' to withstand most wind damage. We know what areas will flood and which ones won't.

We begin by preparing to decrease census as much as possible. Discharges are expedited when possible. If that is not possible, we try to transfer them to other facilities in 'safe zones'. The most unstable patients are usually not transferable, so we have to have core staff to care for them. When it's 'time', they are moved to the most secure/appropriate locations in the facility.

We have employee 'teams' already identified. The 'stayers' are all volunteers and expected to stay and care for patients throughout the storm (when transportation and roads are impassable). We also provide food & shelter to their immediate families and (in most cases) can even accommodate their pets. We have physicians and all other clinical disciplines on the 'stay' teams. We also have essential departments staffed appropriately (pharmacy, dietary, CS, etc). Maintenance guys are essential... on-the-spot repairs, hauling water, etc.

Admin determines the timelines for preparation based on storm progress... The Stay team is in place prior to transportation shut-down. Potable & utility water supplies are stored on every floor... generally, water pressure goes out very quickly after the power grid is shut down. "Alternate" patient hygiene protocols go into effect if/when running water is unavailable. When power goes out and generators kick in, electrical conservation methods go into effect. Our facilities are prepared to be self-sufficient for 4 days.

Generally, the actual "storm" lasts 12-24 hours. As ground transport becomes available, the relief staff start coming in and the Stayers can leave when that happens.

The most exasperating problems are those associated with the aftermath:

Lack of ATM/banking.... no power means no ATM transactions & banks are not open - AWK. Our HR folks have had to hand deliver cash money to employees because we can't accomplish the automatic deposits for payday.

Scarcity of gasoline - again, no power = no gas pumps. Evacuees have used up all the available gas... tanker trucks are delayed due to road closures/damage. Most people who live in hurricane country have generators, but they also require gas to keep them running. There are some very interesting stories about getting employees to and from work. Some involve airboats, ATVs or horses - LOL!

Not enough Blue Tarps!!! Needed as emergency cover for roof damage, siding damage, etc. These get scarce really fast. Our organization maintains a stockpile & provides them to employees who have house damage.

Specializes in Pedi.

I live in New England and don't work in the hospital anymore. We rarely get hurricanes so when we do, people kind of panic. My city basically shut down during hurricanes Irene and Sandy and neither hit here with hurricane strength. During Hurricane Irene, Boston completely shut down public transportation. The hospitals begged them to keep it open through the morning commute so their staff could get IN. Note that they had no concern with their staff getting home. I wasn't working that day but wouldn't have had a way to get in if I were, since I relied on public transportation.

By the time Sandy came around, I'd left the hospital. Schools were closed and my office allowed everyone to go home at 11am. It was barely raining and there was a little wind when I went home. Hospitals expect those scheduled to work to show up and certainly (at least here) don't beef up staff.

We also had several LARGE snow storms this past year, including one that led the Governor to ban car travel. Essential employees were still expected to be on the road and get to work.

Having lived in hurricane country, earthquake country and tornado alley....I'd go for hurricanes any day...at least you see it coming a week in advance and have plenty of time to prepare. Earthquakes and tornados give no such notice.

Specializes in ICU / PCU / Telemetry / Oncology.

I was stuck at the hospital during Superstorm Sandy and they took very good care of the staff, assuring everyone regardless of rank that they will have somewhere to sleep. And we got vouchers for the cafeteria, which had plenty of food. During the huge Northeast blizzard last February, staff at the hospital were mandated to stay, while everyone else was called in and/or rescued as appropriate to travel to the hospital to relieve the mandated. The nice part about this event was that the hospital paid out overtime to nursing staff that were forced to sleep at the hospital between shifts. I stayed at the hospital for 3 days so was paid 12 hours between shifts x 2. Paid to sleep! How about that? :D

Specializes in Med/surg, Quality & Risk.

The last time someone asked a question related to this it became a 20+ page thread of people who wanted to tell everyone what great parents they were because they would abandon their patients, refuse to stay, refuse to come in, etc. because there was just no one else on earth who could look after their children under threat of severe weather. I expect this thread to take the same turn.

During Katrina a nurse wrote extensively on her LiveJournal about her experience staying at her hospital through all of it, complete with pictures etc. I wish I could find it. It was horrifying and inspirational at the same time.

Our hospital has only been threatened with tornadoes in recent history, but they just do core staffing as near as I can tell. Some of the more fabulous managers probably seek extra people to come in just in case; most don't. We have a form we fill out yearly asking about our kids and pets and how much time we would need to make arrangements to care for them in order to come in, how long it would take us to get to work in the event of an emergency, emergency #'s etc. I imagine they filed those away and use them against the people who would refuse to work in these circumstances.

If you are curious about your own hospital, you could always seek out your policies on "severe weather" or "emergency preparedness."

At my hospital. There are certain teams. A B and C. Team C leaves immediately when the mandatory evac is ordered. Team B leaves 24 hrs after the evac is ordered, they also help with the massive discharge and transfer (to other hospitals) of every pt that we can. Team A stays in the hospital during the storm (My hospital can withstand a Category 3 storm).

You have no choice what team you're on really...pregnant employees, those with serious health problems, or tiny children are allowed to be on Team C. The rest of us are up the creak without a damn paddle if we want to keep our jobs.

AND get this---shifts for Team A can be 16 hours long. You are only paid for the time you're clocked in, and no family can stay with you at the hospital.

Damn I need a union.

Did I mention no extra pay other than the time and a half they legally have to pay out?

Specializes in LTC.

I work in LTC, and for Sandy, I had to evacuate with my assigned residents. I had to pack them all up, and we went to another facility. The company put us up in a hotel with the assisted living people. It was crazy, he residents were falling left and right ( i work on the dementia hall). AS far as pay, we got paid our regular time plus 6 hrs of PTO for each shift.

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Specializes in Aged care, disability, community.

I work in aged care and During Cyclone Yasi, we had staff volunteer to stay at the evac center for the duration of the cyclone and the impending storm surge, my facility was evacuated and I assisted with that, but once we got the facility empty, I was sent home and still paid through a thing called disaster leave, Staff were able to stay at the evac center along with their families and were also fed, I was exempt from coming in even though I was rostered on as I was breastfeeding a baby. They had all hands on deck though at the center and I've seen photos of not just care staff doing care on residents, we had people on strict 2nd hourly pressure care who came out of sleeping on the floor with no new pressure areas. All of management were there and all staff were helping out where appropriate, including things like the head of hospitality services holding up sheets around residents so their cares could be attended to. We practice every year and do a small evac at the beginning of cyclone season to the evac centers so we keep our skills up.

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