Weathering the Storm: Healthcare Providers and Disaster

Weathering the Storm: Healthcare Providers and Disaster

Hurricanes, earthquakes and other disasters have monopolized our attention lately. Though I was far outside of the paths of Hurricanes Harvey and Irma, I monitored their progress. With each update, I considered how ill prepared I would be for a local emergency.

It wasn’t always this way. In 2005 I was living and working in south Florida. It was a busy hurricane season. There were 28 named storms in the Atlantic, seven of which were classified as category 3 or stronger. It was the year of Hurricanes Katrina and Wilma. The season started early (the first storm occurred in early June), and ended late—not until January 6.

By the end of the 2005 season, I was a pro. My house was stocked with food and water. There was extra gas stored for the generator, my car’s gas tank was always at least half full and I held on to a wad of cash for the days that the power was out and ATMs were out of service. My locker at work held a change of clothes or two, a few bottles of water and a small headlamp. I figured I was ready for anything.

I had my plan, we had a family disaster plan. My hospital had plans for staffing, backup power, bedding, food and supplies that would get us through a hurricane and its immediate aftermath. We were ready for two to three days of working under emergency conditions. In 2005, when Hurricane Katrina struck, the people and hospitals of New Orleans were at least as well prepared.

As I read Nursing in the Storm, I was enthralled and enlightened by the stories of the experiences of the New Orleans nurses who worked during Hurricane Katrina’s unimaginable flooding and resultant consequences. What they endured was a situation for which no one was prepared. Their stories made me reconsider my (very meager) preparations for disaster. I might be able to ride out a storm with a flashlight, a deck of cards, a bottle of wine and some comfort foods. My preparations and resources are inadequate to withstand the intensity or duration of a true disaster, and I am not alone.

During disaster preparation, especially in hospitals, we focus on tangible things—things that can be figured out. In the heat of the moment, even without pre-emergency planning, you could arrange the horizontal evacuation of patients without working elevators. You could ration food and supplies. You could implement backup charting and ordering systems. Nurses who worked through Hurricane Katrina and other disasters did all of that and more.

Their stories reflect an emotional resilience that most of us don’t realize we have. For most of us, our endurance and skills have not been put to such an ultimate test. How many of us have experienced third world–like working conditions? Who knows how they would function under the combined stressors of prolonged fatigue, weather extremes and uncertainty? Who knows how they would focus if the safety of their home and family were unknown?

When an emergency passes, the media will focus on the next big story. Few will be interested in how you made heart-wrenching choices, like deciding to welcome—or to turn away—an influx of people when you were already beyond capacity. No one wants to think about how they would live with themselves after making decisions in no-win situations.

Not many institutions, communities or individuals in the United States are prepared for a prolonged power failure, severed lines of communication and other crippled infrastructure. Individual, family and institutional emergency plans are essential, but even the best logistical planning will not be perfect. There will be unconsidered variables unique to each situation. The stories of the New Orleans nurses repeatedly convey the importance of realizing and accepting this. By and large, their stories told, they got through by letting go of the things they could not control and focusing on what they did have power over—taking the best possible care of themselves, one another, and their patients, until help arrived.