I am interestered in hearing stories of nurses who assisted in disaster relief

itsmejuli · May 16, 2012

sounds like a homework question to me

SN15671 · May 16, 2012

No, not homework. No longer in school.

BostonTerrierLover, BSN, RN · May 17, 2012

I wasn't trained for it, I wish I had been. It was a disaster to me, but many had it much worse.

Monday August, 26 2005-to the following Monday. Hurricane Katrina.

I was ER Coordinator in a small Critical Access Hospital in Central Mississippi. We had many volunteers, Red Cross Vehicle Team, UNICEF, and Mississippi State Department of Health Workers making a base out of 14 Trailers the Government had sent down, and we were supposed to be in a "Safe Zone," as Hurricane Camille in 196O's (also a Cat 5) came through our area with relatively no damage, minor flooding.

It was amazing, I have never seen so many helicopters bringing Vent patients in to a crippled hospital. We had a Generator, but always ran on borrowed diesel. We ran 1-2 Jugs ahead at the most the whole time. The average daily highs were well over 100 degrees Fahrenheit, and the private rooms all contained two patients. We had taken in everyone who needed electricity such as Asthma and COPD patients, Vent patients, etc. We had several storm injuries that were "local," and we field triaged for 2 days straight everything from Dysentary, to dehydration, to injuries. I spent several days in the hospital sleeping 4 hours between 16-22 hour shifts, finally collapsing from exhaustion mentally, physically, and spiritually on day 4. It was a nightmare.

Mississippi Hospitals have since been prepared for disaster MUCH better than 2005, although we had only 3 actual casualties, 54 bodies were brought to us. There was a nursing home in Central Mississippi where a Generator was placed in a basement killing 12 residents, and 2 staff members. Much education is needed to prep Nurses who have any chance of being involved in Disaster Response. You can't imagine the weight placed on your shoulders in such an event as terrified people look to you for guidance, care, and sometimes lifesaving aid that you may or may not be prepared for training wise, or ability wise in needed instruments, space requirements, and devices needed.

We had 3 emergency lifesaving surgeries done under brutal conditions, after air conditioning, electricity (main), and plumbing had went out. I worked there 2 more years after Hurricane Katrina, and amazingly we never talked about what happened during it ever again. Life just went back to some form of normality, and we embraced it. We tried to block out the images of people begging for clean water, ice, and food. The national guard with automatic weapons overseeing the gas lines until they ran out completely, and water/ice lines that often ran out with panic stricken mothers of infants begging for water for formula. Or begging for formula,- I remember one women screaming for breast milk, or clean water.

That said, I have seen many normal average human beings turn into animals, but I saw many more rise to the ranks of heros and super heroes that week. There will always be overwhelming selfishness, and amazing sacrifice in times like these. I thank all those who sacrificed. I know who many of you are!

:redbeatheBoston

GitanoRN, BSN, MSN, RN · May 17, 2012

i'm rushing out the door to a meeting i'll get back to you on this subject...aloha~

pockunit, ADN, RN · May 17, 2012

American Red Cross offers disaster training. Go sign up!

GitanoRN, BSN, MSN, RN · May 17, 2012

i must confess that this is an issue dear and close to my heart, and one that i shall never forget. after completing the four primary disaster classes several of my colleagues me included, continued to volunteer in order to keep an active member of the current dat team, totally oblivious to the fact that we were going to be utilizing what we just learned in an actual disaster. needless to say, local disaster response experience is required for the membership in the dshr system. admittedly, at the time of receiving the call to assist in the disaster of the devastating hurricane katrina, i lived in atlanta georgia. assuredly, we got the call and there was no thinking it twice, our facility gathered all medical personnel that was involved in the disaster team. first of all, we implemented a chart with all information on how to triage by colors and separate each pt. to the correct team color. for example, red team handled trauma pts. and this pts. would have a red tag, green team less severed patients, yellow handled those pts. that were ambulatory and were transported to shelters, and the elderly were place in nursing homes & hospices throughout, an so on. needless to say, as i look back and reflect on how calm we handled this horrific rescued it amazes me on how we nurses truly came together, working with one purpose to attend to those in need. however, there were horrible cases that will be embedded in my mind for as long as i live, not to mentioned the awful smell coming from the bodies that lay everywhere. furthermore, a female pt. that lost her husband, and her 3 children and while she waited to receive assistance she was raped several times; i will never forget the state of shock she was in and how scared she was to see a man trying to help her. unquestionably, i'm certain that we all learned a lesson once it was done and over with, never to waste any time in responding to any disaster. at this level, i can't continue with all that we experienced while trying to make sense and assist those in such chaos and devastation. obviously, i would like to take this opportunity to thank all of those that were involved in assisting the katrina disaster. it only goes to show how fragile we truly are.

sauconyrunner · May 17, 2012

I worked overseas for several years (I was in Liberia managing the ICU/Peds/MS floors when Katrina occurred) I gotta admit that everything I learned there doesn't really apply to here.

canesdukegirl, BSN, RN · May 18, 2012

I went down to Katrina with the NC disaster team. After reading the posts of those who were also there, it brings back harsh memories of desperation, helplessness and confusion experienced by the residents affected by this debilitating disaster.

I worked in a mobile disaster hospital equipped with an OR-which is where my primary work took place, but I was also working in the triage tent. Everyone was briefed during the flight in, and we were briefed again by the staff members at the mobile hospital when we landed. There were long lines of patients seeking care for cuts that had become infected, people that had been the victims of violence, open tibia fxs, and lots of people needing care as the result of dehydration/malnutrition. We also treated pts who had lost all of their medications-diabetics, asthmatics, pediatric pts..the list was endless.

As we worked in our mobile hospital, the waft of rotting trash, decomposing bodies (human and animal) and stagnant water routinely assaulted our senses. Helicopters landed every hour. The heat was close to unbearable, but it was difficult to complain about the heat when faced with pts who had lost everything they had, including their family members. Several of our staff members succumbed to the heat because they were so focused on pt care that they neglected their own needs, and they became pts themselves.

We were protected 24/7 by the SWAT team, and we were warned not to leave the confines of the hospital without force protection. A psychologist accompanied my team during my deployment, and he and I went on 3 mile walks to the coast just to clear our heads and talk about what we had seen. I think that man saved my very sanity; during my 7 day deployment, I slept only 6-8 hours. It was hard to choke down food in that kind of heat, so my caloric intake averaged about 400-500/d. It was brutal. After triaging pts, doing emergency surgeries and pitching in with logistics for 16+ hours, as soon as I laid my head down on my cot, I was being radioed to the OR for another case. But I still couldn't find it within me to complain.

If you want to join a disaster team, find out if your state has a state medical response team. These teams are broken into regions, and you will be able to sign up on a state roster for your region.

Feel free to PM me if you need more info.

SeaH20RN, BSN · May 18, 2012

i’m anrn in south fl and i know no one wants a disaster to happen but it will, somewhere,sometime. i used to live in california with earthquakes and i know californiais not prepared for the "big one" like it should be.

i wouldlove to work for samaritan’s purse or the red cross someday. im currentlyplanning on going to nigeria for a while to work in a small hospital. i waslooking for some sort of degree in emergency preparedness/ humanitarian. ithink i found something you can take on online from univ.of denver co. let me know if you find anything out on howto be on call. good luck!

anotherone, BSN, RN · May 18, 2012

These posts are so inspiring and seem pretty traumatic, I am in awe of you:boston, canesdukegirl and gitano! .

BostonTerrierLover, BSN, RN · May 18, 2012

When Hurricane Katrina passed, and all the mold dried up and died, and all the trees were pulled away from the highways- I knew everything in my life up until that moment of my county's Disaster Director saying over the Bearcat Scanner- 23 minutes before total white noise-

"MEMA Station # (Blah Blah Blah), We are crippled here, we have catastrophic loss to the fundamental structures of our facility, we have 3 Major Injuries to vital staff members, and it's no longer viable to maint, . . . .Folks, to cut the crap, it's real bad here. We have to leave base to find more sustainable shelter. The water seems to be rising at an alarming rate. It's already went from my knee to belt talking to you guys. We will regain communication when possible. Winds were clocking 130mph gusts before we lost our Makkar 23, and we are not even in the worst of it yet. We lost contact with State Officials in Meridian, MS over on hour ago (just 45 minutes after landfall, city over 150 miles inland). Our best advice is Field Triage when possible, NO GOING OUT FOR RESCUE, and we have suspended answering any 911 calls, use the Shortwave for ALL vital communications, We're out!"

No one from that command post survived. Shortwave Radio was lost shortly after. Communications were dead between hospitals, Aid Stations, MEMA Bases, and State Officials, and would remain down for over 72 hours.

There was no way even after the storm to tell them we couldn't take ANY more VENT patients, they kept coming. We couldn't tell them we were out of Morphine, Hydromorphone, and only had 1 20 vial box of Nubain, and 13 vials of Demerol 100mg. 25 minutes after we used the last vial of Demerol, and had 3 Nubains left, a Helicopter landed with a "FieldKitPrep." It was like Christmas as the Pharmacist signed in endless supplies of Medications, including IV antibiotics commonly used, Saline Bags of all types, and the much needed Analgesics, and Anti-Convulsant/Anti-Anxiety drugs.

Something many people forget is that Addicts/Alcoholics are at an EXTREME risk of Withdrawal related symptomologies during the aftermath of a catastrophe secondary to no access to drugs/alcohol. Seizing feild triage patients were RAMPANT. And, any other Chronic Disease that was left untreated were exacerbating like overwhelming crazy! Diabetics were coming in, in ARF and severly dehydrated with extreme hyperglycemia, and all that comes with it. Nephrology patients dropped like flies across southern MS, and Southeastern LA unable to recieve dialysis for over a week. I could go on, and on, and on. But, a disaster class introduces each issue, and how to assess, plan, prepare available resources, and respond to a crisis.

I could tell you some really WILD stories that occured during this time. But, What I will never forget is 2 things that still keep me up at night in a daze of overwheming anger, frustration, and resentment.

1. There were totally stocked pharmacies, and hospitals, that recieved little to no impact even within an hour of the affected areas, but Red Tape, Beaurocracy, and Policies and Procedure prevented so much needed help. Blood was an EXTREME need as well, and some VERY hard decisions were made there. We completely ran out of Oxygen, Medications, Beds/Stretchers, Space, Staff, Food, Water, Dressings, Alcohol Pads, Tape, IV initiation Sets, Bed Pans, BSCs, IV Pumps (haha never enough anyway in these small hospitals.) I won't even get into what was hung by gravity under EXTREME low staffing levels. I did get 40 pumps from a rental company brought in by fixed wing aircraft on day 2. When the generator first kicked on it broke down an hour later, and several had to be bagged, fractioning available staff. We pulled Diesel Fuel from stalled 18 wheelers from the blocked highways. A farmer lended us a large poultry farm generator that saved us, along with 3 days worth of diesel he wouldn't take pay or recognition for.

2. No Intervention was done following the incident to Psychologically Debrief the staff, and help them cope. We saw amazing things, and horrible things all in the stretch of a week. I don't blame the disaster totally, but my inability to cope led me to a Chemical Dependency that nearly killed me. I TAKE FULL RESPONSIBILITY. I do feel I would have had a better chance if the Hospital would have just "helped" those that helped with all they could do. The guilt I feel from that week still haunts me, What could I have done different? Can I live with some of the decisions we had to make? I have been clean since 2006, and I didn't divert- I had a frivolous MD,(note I take full responsibility- I know what I signed up for). I just simply wish that people exposed to those kind of conditions could get some counseling following a disaster of that proportion. It's something to not have the time to be a fellow storm victim, put away the fact that your home is under 5.5 ft of water, and that you have lost family members- you have a job to do, then you can worry about all "that" stuff. Although, there never was time, we hit the ground running to catch up after Katrina, and I guess we were supposed to just "Deal with it!" I was not the only Nurse SEVERLY affected by the events of 2005. I still have nightmares that wake me up to being drinched in sweat, shivering, crying, gasping for air, and feeling that "sence of impending doom."

I hope Nurses are prepared for disasters as much as possible with all the available resources, manpower, space, and algorithims they need, however it is my desperate prayer that none of you reading this post EVER have to experience a Regional/Local Catastrophie/Crisis/Disaster. I still feel just as damaged as the next week sometimes, but I try to remind myself, all I can do is prepare for the "Next" one, using what I have learned from the "Last" one.

I have learned, don't let a severely costly decision JUST rest on you. I know everyone is busy running around, and I did find out every Nurse at the Hospital would have made one of the same decisions I had to make- but when it's put to a vote, you KNOW you are doing the "Right" thing, and the consequences of that decision won't follow you the rest of your life. I now know what it must feel like to live in a 3rd world country devoid of any "services," support, or coordination of resources in a total devastating/crippling disaster. We lived it for a week. I just hope I didn't sell my soul to get through that Hell Month!

It took me 25 months and refresher residency to regain my "ability/confidence" to practice as a NP in the ER again. When I "asked" for help, 6 months after the disaster, one part of my treatment was a "Medical Ethics" course after Detox, and Rehabilitation for 120 days. That class reinforced every devastating decision we made. I then sat down with a Board of Nursing Invesigator to speek about that weeks occurences (I was that desperate for closure on the decisions I made sleep deprived, terrified, nervous, and overwhelmed. I always tried to think, "How would a prudent, and compiant nurse deal with this situation," and then on to the next horrilble case, and decisions.

I am so sorry that this post is so breathy, but this subject is embedded in my being.

:redbeatheBoston