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After the Storm

During Hurricane Sandy and its aftermath, nurses rise to the challenge

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Sandy. It is a gentle-sounding name. However, add the word "hurricane" to the mix and you get something altogether different. Hurricane Sandy was the anything-but-gentle hurricane that galloped through the Northeast. Everything in Sandy's path - schools, businesses and hospitals - was subject to her impact starting Oct. 29, and in the days and weeks to follow.

A number of hospitals in New York and New Jersey were hit hard by Hurricane Sandy's rain and wind. The affected facilities implemented their existing emergency preparedness plans in conjunction with creating strategies specific to the impending storm.

"We stuck to our emergency preparedness plans and also moved quickly on areas we knew would be important for this storm," said Susan Green-Lorenzen, RN, senior vice president of operations at Montefiore Medical Center in the Bronx, NY. "Our team of engineers coordinated activities such as expedited deliveries of medical supplies in advance of the storm. We also increased food and water deliveries to ensure we were stocked up and ready to go."

Typically, emergencies do not offer a 24-hour notice the way that Sandy did. Since this tempest was forecasted, facilities were able to predict problems and correct them in advance.

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East Coast healthcare organizations have a lot to say about what happened before, during and after Sandy rolled through the region.

"Fuel tanks were topped off and buildings were prepared for the heavy rain and high winds. It was a coordinated and efficient effort to ensure Montefiore was prepared for Sandy's arrival," Green-Lorenzen said.

Tending to the Details

Despite the anticipated nature of the storm, planning for an emergency on the scale of Sandy required hospitals to predict problems long before they occurred.

"Our emergency preparedness plan was in place and we knew the storm was coming," said Sheryl Slonim, DNP, RN-BC, NEA-BC, executive vice president of patient care services and chief nursing officer at Holy Name Medical Center in Teaneck, NJ. "On Sunday , several members of our senior management team came in to prepare some specifics for the storm. We worked to find places for staff to sleep and we decided to evacuate a freestanding hospice building located 12 miles away from our main facility."

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SANDY BABY: While out on patient visits in Newark, NJ, during Sandy's aftermath, Mavis Doozie, RN, of VNA Health Group saw a man driving erratically, going the wrong way down a one-way street. He got out of the car and began shouting for "someone to help." She stopped and asked what was the matter, and the man yelled, "Please help me, my wife is having a baby." Without hesitation, Doozie moved quickly to the car to assist the mother in the successful delivery of a healthy 9-pound baby boy. Upon delivery, Doozie wrapped the newborn in her coat and directed the father to Newark Beth Israel Hospital. At one point, Doozie had to step outside the car with the newborn in her arms and direct the traffic to let the car by. "I was just fortunate to be in the right place at the right time," Doozie said. "As a nurse, we do whatever we have to do, that baby wasn't waiting to get to the hospital and mom and I knew it." Courtesy VNA Health Group

Slonim and the rest of the staff at Holy Name were very pleased to see their emergency preparedness plan went without a hitch. In particular, the hospital's electronic health records (EHR) were maintained without a problem.

"We have an emergency outlet system attached to our hospital's generators," said Deborah Zayas, MPA, RN, vice president of nursing at Holy Name Medical Center. "Part of our preparedness preparations had us checking the functioning of our 'red outlet' emergency power outlets. Checks were done ahead of time and we did not have to go to a pencil and paper system. We build our systems; we do not buy them."

Montefiore Medical Center did not lose power, so its EHR emergency plan did not have to go into action. However, an EHR contingency plan was in place if needed.

"As part of our emergency preparedness response, our IT department ensured that in the unlikely event our systems failed, we could rapidly convert to a paper record. Our system is designed to print critical medical records, such as documentation and medication administration records, in the event that our EMR goes offline," Green-Lorenzen said.

Unpredicted Surprise

A surprise storm always seems to elicit surprising stories of heroic efforts. Hurricane Sandy did not disappoint in that regard.

"Montefiore had committed to accept four babies needing to be evacuated from NYU Langone; however, six babies arrived at our hospital. Our team quickly took action and made room for the additional babies. But to take the care one step further, our nurses also made sure the babies' parents were OK - giving them food, orange juice and a room to rest after what was surely a traumatic experience," Green-Lorenzen said.

Not only did the storm produce unexpected patients, it also produced some unexpectedly long shifts for nurses; many hospitals in the region had to call in extra staff with some facilities even providing gasoline for doctors and nurses. In New Jersey, Holy Name Medical Center pumped 6,500 gallons of gas for staff free of charge. In New York, Montefiore shuttled staff from home to the hospital, making over 650 trips in the process.

"As I walked in on Monday, I was so moved to see our staff walking in with duffle bags in hand. They knew that their role as nurses was to care for their patients even if it meant staying here overnight. We had to find additional places for our nurses to stay," Slonim said.

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'Nurses Were Amazing'

Hurricane Sandy made a mess of New York and New Jersey. Yet, in the midst of that mess, nurses were clearly shown to be among the most passionate and influential of healthcare providers.

"Our nurses were amazing, as they always are, and really made an impact in the excellent care provided to our patients, but also to their families and loved ones. Concern was shown to everyone within Montefiore's walls, and our nurses were the ones leading that charge," said Green-Lorenzen.

Faster than the floodwaters, nurses rose to the occasion to perform their duties. As the floodwaters receded, hospitals were looking to care for their nurses in their time of need. "While they were here caring for patients, some of our staff had their houses devastated by the storm. We are in the process of finding out which of our people need assistance and how we can help them," Slonim said. 

A. Trevor Sutton is a frequent contributor to ADVANCE.

Three NYC Hospitals Remain Closed

Three weeks ago, facilities throughout the Northeast were battered by Hurricane Sandy, but among the hardest hit were those in and around New York City, including NYU Langone Medical Center in Manhattan and Health and Hospitals Corp.'s (HHC) Bellevue and Coney Island hospitals, both in Brooklyn.

At press time, inpatient services, including emergency departments, at all three facilities remained closed. On Nov. 5, outpatient services were reopened at NYU Langone and new patients were being accepted.

Bellevue's outpatient facilities are set to reopen Nov. 19, and its ED is expected to be operational by the end of the month pending state approval. Coney Island, a 371-bed facility, is offering limited outpatient primary care services 24/7 for New Yorkers. Some specialty services are available from 8 a.m. to 8 p.m.

NYU Langone was forced to evacuate approximately 300 patients to other hospitals, including Mount Sinai Hospital and Beth Israel Medical Center, during the storm that knocked out its emergency power. Bellevue, a 778-bed hospital, evacuated 726, and Coney Island, about 200.

While still being assessed, NYU officials estimate damages at NYU Langone alone could cost upwards of a billion dollars to repair. Cleanup, rebuilding, lost revenue and research, as well as employee salaries during the closure, are included in the estimate.

Mayor Michael R. Bloomberg recently announced a $500 million emergency plan to help make the necessary repairs for public schools and hospitals. If passed, the plan would allocate $300 million to HHC for damaged facilities. Necessary repairs include structural restorations, new boilers, new electrical systems, roofs repairs, flood remediation and more.

"The serious storm-related damage to several facilities within our public hospitals system is unprecedented," said HHC President Alan D. Aviles. "We have an army of personnel working around the clock to restore services as soon as possible so we can continue to meet the healthcare needs of New Yorkers."

- Catlin Nalley




     

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