Mandatory Hurricane Evacuation - Can I be Forced to Work?

[Lorie Brown RN, MN, JD]

Is it legal to make nursing staff stay at a hospital that was ordered by the Governor to evacuate for hurricane Florence . This hospital just was recently rated for only a category 2 hurricane and this hurricane is a Cat 4. This hospital is prone to flood, low lying area at the coast. They divided the nursing staff into 2 teams (A & B) and are requiring all of team A come in prior to hurricane and staying at this hospital even though the patients have been evacuated, they have a few patient that are supposedly not able to move. They have a sister hospital, also under mandatory evacuation , this hospital is rated up to a Cat 3 hurricane. They have transferred some of the patients from the hospital that is rated to withstand a Cat 2 to there sister hospital ( under mandatory evacuation )... waiver was denied to stay per Governor. I have no problem staying and working if I am provided a safe place

Great question. This is such a difficult situation. Fortunately hurricanes are predictable. Hospitals are open 24/7 making it difficult to deal with these situations. Hospitals are faced with the decision to take the extreme action of closing and transferring their patients which is costly and potentially risky to the patient or to stay open and "weather the storm". Each hospital should have a disaster preparedness plan usually approved by their accrediting body. It is recommended that there be an A team and a B team both of equal competence. Team A for during the storm and team B for the aftermath. Your hospital's policies and procedures and your employee handbook should provide you with what is expected and if you are required to stay. This will supercede any advisements to evacuate the area. I am glad you are willing to stay and help your patients. You can also look to the hospital's policies and procedures on how they will keep the staff safe too. Preparation in these emergencies is the key. Hopefully it won't be that bad.

[Kooky Korky, BSN, RN]

By "predictable" I meant we know she's a'comin'. I know the path and strength can change, as Flo is doing.

But we know she's been on the way for a long time and that it's been possible to see where she is probably going to hit the hardest, as predicted by meteorologists and other professionals whose job is to figure this out.

Thus it seems likely to me that evacuations could be planned and carried out well in advance of the worst of these disasters. Just my 2 cents.

And I still don't see how an employer's orders (advisement, counsel) can top a Governor's Mandatory Evac Order. Yes, I'm sure they can fire you if they want to, no matter what.

Thanks to all the brave nurses and best wishes to all.

[rgo2018]

I don't see how a policy or employee handbook can supercede mandatory evacuation orders from the Governor.

How can a civilian employer force its staff to risk, literally, life and limb when this extremely dangerous Hurricane Florence has been known about for quite some time, sufficient time to evacuate all patients?

It's bad enough that police, fire fighters, paramedics must stay. But hospital or nursing home staff?

What is the difference between advisements and mandatory evacuation orders?

Well if all the hospitals shut down and bail, where will the paramedics going to deliver their patients?

[rgo2018]

I agree. I don't understand how an employer's policy can supersede an ordered evacuation. I have lived in Florida for a long time. Hurricanes are not predictable. They change paths and they sometimes worsen. You get days, if not weeks to prepare, so why don't they follow the advisory and evacuate? I think most nurses would be happy to work as long as they are truly safe. It is assuring to know that if I do have to work a hurricane, I can take my family and even pets to the hospital with me, but for my family, patients and for myself, I think it is more prudent to evacuate to a safe area. As nurses are we not expected to make choices that any "prudent and cautious person" would make? Why aren't healthcare facilities held to that standard?

I recommend you read this paper - "Decision Processes and Determinants of Hospital

Evacuation and Shelter-in-Place During

Hurricane Sandy". The decision to evacuate is not taken lightly and is influenced by various factors.

[tnbutterfly - Mary, BSN]

I recommend you read this paper - "Decision Processes and Determinants of Hospital

Evacuation and Shelter-in-Place During

Hurricane Sandy"

. The decision to evacuate is not taken lightly and is influenced by various factors.

Excellent reference. I added the link to that paper.

[rgo2018]

Excellent reference. I added the link to that paper.

Thank you! Here is a free copy from Center for Health and Security

[broughden]

I agree. I don't understand how an employer's policy can supersede an ordered evacuation. I have lived in Florida for a long time. Hurricanes are not predictable. They change paths and they sometimes worsen. You get days, if not weeks to prepare, so why don't they follow the advisory and evacuate? I think most nurses would be happy to work as long as they are truly safe. It is assuring to know that if I do have to work a hurricane, I can take my family and even pets to the hospital with me, but for my family, patients and for myself, I think it is more prudent to evacuate to a safe area. As nurses are we not expected to make choices that any "prudent and cautious person" would make? Why aren't healthcare facilities held to that standard?

Pretty simple. Nothing in government is ever black and white.

The SC "mandatory" evacuation orders provided exceptions for hospitals or medical facilities who needed to stay open.

[bgxyrnf, MSN, RN]

If not us, then who? I am not saying everyone should abide by this philosophy, but I am saying it is MY philosophy.

I agree...

Kinda like the attitude that caused me to volunteer to be the first nurse contacting a possible Ebola case and then joining the later-created Ebola team.

We are part of emergency services and, like the cops and firefighters and National Guard, don't get a pass when things get dicey.

If push came to shove and I were concerned about the facility's preparedness - or lack thereof - I might choose to go but I would expect that I might be sanctioned or terminated for said decision.

Nobody ever said that nursing is risk-free. Cops run toward the gun shots, firefighters run into burning buildings, and nurses care for the sick and injured - even in risky circumstances. In all these cases, the level of acceptable risk ultimately up to the individual but if it deviates from the assessment of the employer, the government, or the public, there may be unpleasant consequences.

[Kooky Korky, BSN, RN]

Well if all the hospitals shut down and bail, where will the paramedics going to deliver their patients?

People should not be there to need paramedics, as people have been ordered to get out. I know some do not go, but that is their choice. As the news people have been saying, people will be on their own if they stay because first responders will not be responding before it is safe for them to do so.

That said, I guess they will have to go to a facility that is open, wherever that might be.

Perhaps governors and other government officials can answer this query.

I wish there weren't so many newspeople in the storm areas. I think it encourages other people to not leave, interesting though it is to follow the news information.

I saw a woman and 3 small kids - one really small - in the ocean playing in some very rough waves. I think she is an idiot. She can endanger herself if she wants, I suppose, irresponsible though it is because she apparently has these young children. But she ought to be examined by child welfare for taking those kids out there.

[Kooky Korky, BSN, RN]

Pretty simple. Nothing in government is ever black and white.

The SC "mandatory" evacuation orders provided exceptions for hospitals or medical facilities who needed to stay open.

Needed? Please explain.

Or do you mean they are needed by government to be open because they are needed to receive expected casualties among first responders?

I wonder if buses or other means of evacuating have been provided so no one really has an excuse to be in areas that are mandated to evacuate. I know it's a pain in the neck to leave hearth and home, but if it's that or doomsday, I guess we should get out.

[Kooky Korky, BSN, RN]

Pretty simple. Nothing in government is ever black and white.

The SC "mandatory" evacuation orders provided exceptions for hospitals or medical facilities who needed to stay open.

Were there other exceptions?

[broughden]

Were there other exceptions?

Exceptions were made for hospitals who stayed open to support emergency responders and in the case of doctors/medical directors who had patients they didnt think could be moved without killing them.

[Have Nurse, ADN, RN]

Fortunately, Hurricane Florence has been downgraded to a 1 this morning. She hit shore today.