Value of disaster drills emerges during hurricane
ICU staff manage to stay afloat
The destructive path cut by Hurricane Floyd on Sept. 16 flooded roads, ruined homes, and uprooted thousands of residents in more than one mid-Atlantic state. But for ICU nurses at Heritage Hospital in the small town of Tarboro, NC, the event was a near-textbook case in emergency planning.
Twenty inches of rain that fell in one day and 120-miles-per-hour gale force winds hit the hospital and surrounding communities with unrelenting fury. Despite fears of massive flooding, hundreds of injury cases, and loss of power and vital services, the hospital got through the worst of Floyd largely unscathed.
And for everyone, the storm helped confirm one important fact, says ICU Manager Ginger Gay, RN. "You can’t have too many disaster planning drills."
In fact, Gay, who also runs the hospital’s emergency department, thanks the importance placed by hospital administration on disaster planning for getting the 350 employees and dozens of patients housed in the facility at the time through the frightening ordeal.
Hospital is sole provider
The 127-bed rural provider is the only hospital in town and was one of the hardest hit in the state as Floyd rolled through dozens of small towns and hamlets in eastern North Carolina.
The hurricane’s fury was so intense that Prince-ville, the town adjacent to Tarboro, had to be evacuated. In addition, about 64 of the Heritage staff lost their homes.
"Dozens of homebound patients crowded into the ED asking for medications and oxygen refills. Several others needed dialysis treatment. The whole thing was an emotional roller coaster from the start," she says.
In the ICU, the fear was of shattered glass and windows, Gay recalls. Four of the five patients in the seven-bed ICU were relocated to areas of the floor closer to the center of the building and away from windows.
The four were hooked up to mechanical ventilators that had to be connected to portable generators in case of a power outage. Although there was never a real fear of power loss to the hospital due to backup generator service, the ICU staff was not taking any chances, Gay says.
The biggest concern was really about staffing and transportation, recalls Karen Andrus, Heritage’s director of occupational health. With roads flooded and impassable, getting employees — including physicians — to work was a problem.
In anticipation, department heads, including Gay, called in staff for a planned 24-hour shift.
"We asked the night shift to come in early, and had the morning shift in at the same time, and bring two days’ worth of clothing and personal articles," Gay adds.
The bunker scenario worked. Staff slept wherever there was space in patient rooms with low census or in the empty same-day surgery suite. "We could not have asked for a more willing and dedicated staff," Gay says.
A couple of nurses couldn’t make it in due to the flooding, but arrived later. And fortunately, two RNs from another hospital who were cut off by the same flooding came in with the Heritage nurses, says Gay.
As a result, the ICU managed to maintain its usual patient-to-nurse ratio of 2-to-1 without any interruption in service, the hospital says.
What did the staff learn from the experience? Plan ahead, but make changes as the need arises, says Gay. And don’t minimize the vital importance of disaster drills. "Until you go through something like this, you never appreciate just what the drills are all about."
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