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The year isn’t half over, and already floods and tornadoes have devastated various communities, creating unique challenges for home care professionals. No area is safe, it would seem, from nature’s wrath.
The Ohio River soaked a big chunk of Jeffersonville, IN, when it flooded over its banks in March. The area’s worst flood in a generation created some unique experiences for Southern Home Care, which is located in the river town of Jeffersonville. The hospital-based agency serves eight counties in southern Indiana.
One neighboring small town of Utica was completely underwater during the river’s worst flooding. And Southern Home Care’s nurses were asked by the American Red Cross to help give flood victims and relief volunteers tetanus shots to ward off infections from the muddy, contaminated waters, says Lorraine Waters, RN, BSN, MA, director of Southern Home Care. Waters also has a certification in community health.
A few of the agency’s staff missed work because their homes were flooded, and some patients were difficult to reach because of closed roads and bridges. This interrupted the agency’s normal routine for about a week. But fortunately, few patients were moved out of their homes, Waters says.
Home care educators say there are plenty of ways to teach staff how to prepare for a natural disaster, but those who have survived catastrophes say the experience has taught them lessons they otherwise might not have learned.
The education manager at Lincolnland Visiting Nurse Association in Mattoon, IL, knows how a disaster can hit any agency at any time — often without warning.
Everyone still had cookies to bake, gifts to wrap, and a few had miles to travel on that chilly Friday before the snowy Christmas of 1996 in Illinois. Lincolnland Visiting Nurse employees scurried around during the last few days before the holiday season with the usual urgency to finish work at the office before rushing home.
Little did they know that would be the last time they would see their office building.
A fire that might have been caused by a faulty furnace consumed the agency’s headquarters Dec. 21, 1996, and nothing survived the flames.
Worst of all, the agency had been preparing for a July survey by the Joint Commission on Accreditation of Healthcare Organizations. And the fire destroyed all of its documentation.
"We were just in the process of changing to a computer system where everything would be backed up off site," says Liz Newton, RN, staff development coordinator of the nonprofit full- service agency that serves 15 counties in south central Illinois.
Newton says Lincolnland’s staff learned several painful lessons because of that experience.
The most important lesson was that education managers should have backups of everything at another location. The documentation wasn’t the only casualty of the fire. Newton also lost most of her educational materials.
"I lost my master book for orientation, but I called the two people who had been through orientation most recently, and I had them bring their books in so I could copy those," she says.
"Also, I’ve lost some of the training records, but we just decided we’re going to go forward with what we have," Newton adds.
Lower Cape Fear Hospice, based in Wilmington, NC, also faced a disaster last year. Hurricane Fran struck the North Carolina coastline in September, smashing homes, flooding neighborhoods, and disrupting power and business. But the agency was well prepared for Fran’s 150-mile-per-hour winds because they had been through a scary trial run during Tropical Storm Bertha six weeks earlier.
"From the minute there was any possibility that Fran was heading in this direction, we began to do education with patients and families," says Ellen Cameron, MSW, CCSW, director of regional operations and director of family counseling services for the hospice that covers all of southeastern North Carolina.
Lower Cape Fear Hospice’s staff contacted all patients to find out where they would be and how they could be reached by telephone when they evacuated their homes. "We also reminded patients of emergency radio stations that would give information about hurricanes," Cameron adds. (See Tips on what to do when disaster strikes, p. 47.)
Fortunately, the hospice’s buildings were unharmed by the storm, but it did force the staff to take an unplanned break from preparing for a Joint Commission survey, which was scheduled for two weeks after Fran’s landfall.
"They did call to see if we wanted to delay it, but we went ahead with our survey, and we got the accreditation," recalls Joanne Paulin, Lower Cape Fear Hospice’s director of human resources.
Several weeks later, the hospice held an all-day staff retreat at which the management gave employees certificates called "survival awards," in honor of their "surviving the incredible stress of the Joint Commission and Hurricane Fran," Paulin says.
Hurricane disasters might offer the best opportunity for planning because areas usually have several days of warnings, but one disaster that can never be predicted — an earthquake — rocked a San Jose agency’s service area in 1989.
"Most of our patients were fine, but the ones who lived near the Santa Cruz mountains were the most affected by the last earthquake," says Jane Hoffmann, RN, MS, education coordinator of Columbia Homecare and Hospice of San Jose, CA, a full-service agency that covers several counties in the South Bay area near San Francisco.
"Some patients had to move and stay with relatives," she adds.
Hoffmann says she routinely teaches staff about earthquake safety and how they can make a patient safe. "We tell the staff to make sure the patient is all right, and then they should go home, and as soon as communication is available, they should call the office."
The agency identifies patients who would need service immediately or within 24 hours, patients who can wait up to 72 hours, and patients who are relatively stable and can wait until their next regularly scheduled visit. This way the agency knows exactly which patients to call first when the earthquake hits.
"After the last big earthquake, by the next day, the phone service was restored to almost every area, and we just called all our patients to identify their needs," Hoffmann recounts.