Here are lessons learned from volunteers on 9/11

On Sept. 11, an unprecedented number of ED nurses volunteered their services. For readers who need information to revise disaster plans and plan for the future, here is what worked well and what didn't:

• Many nurses went directly to the disaster site. Scores of volunteers went directly to the site without contacting anyone first, reports Laura Giles, RN, nurse manager of the ED at Mount Sinai Medical Center in New York City. "It created a logistical nightmare," she adds, explaining that those in charge didn’t know who was there, and the volunteers had no idea who to report to or where they were needed. The day after the attacks, a nurse practitioner called Giles asking for supplies to set up a first-aid station at the site. "I spoke with my contacts who told me this was not authorized, and there were already too many people at the scene. So I did not provide any supplies," she says.

Going directly to the scene of a major disaster was a case of bad judgment on the part of many volunteers, says Suzanne Pugh, RN, ED nurse manager at Saint Vincents Hospital in New York City. "The site may not be safe, as was the case with the World Trade Center, and may be chaotic," she says. "In this case a volunteer can do more harm than good, and may very well become a casualty."

• Hundreds of nurses came to EDs ready to work. Off-duty nurses who lived nearby showed up at the ED almost immediately, and shortly behind them were agency and per diem nurses, and nurses who were unable to get to their regular jobs at area hospitals, says Pugh. "One helpful thing was that they all showed up in scrubs ready to work with minimal baggage," says Pugh. "So there was no need to find them something to wear or figure out what to do with coats and bags. It sounds like a small thing, but that morning it would have been just one more thing to worry about."

These volunteers were sent to the nursing office where a "manpower pool" was established, she says. Next, human resources staff obtained on-line license verifications, says Pugh. The ED was flooded with thousands of calls from volunteer nurses, and hundreds simply showed up. "There was truly a deluge. We had people driving in from Maryland and Pennsylvania," says Pugh. "The nursing command made every effort to answer phones and keep track of arrivals, but it became overwhelming."

Pugh says that volunteers should make every effort to find out where and what kind of help is needed by listening to the media and contacting colleagues. "It was difficult to get through to the hospital at times," she notes. "At one point, the nursing office phone number was given out on TV, and all bets were off from that point on."

By early afternoon, patients had stopped arriving because there were not many survivors. "Perhaps if we had continued to get patients as the night and days wore on, we would have been able to make use of the thousands of offers of help," notes Pugh. However, in the future, the ED will only rely on current staff and known volunteers, according to Pugh. "It was just too difficult and time-consuming to attempt to utilize foreign’ staff," she says.

• Some nurses became angry that they weren’t assigned to the ED. Many volunteer nurses expressed frustration that they weren’t being used "where the action is," says Pugh. "For a myriad of reasons, the ED is the last place that you would utilize unknown volunteers: knowledge, lack of orientation, liability issues to name a few," she adds.

Volunteers should be ready to help in any way needed, not just in ways that are exciting, argues Pugh. "Sometimes the most helpful thing is the most unassuming thing," she says. She gives the following example: About midnight on Sept. 11, Pugh was hungry and was directed to a box of peanut butter-and-jelly sandwiches. "Written on the wax bag was God bless you all, Jackie RN.’ I will never know who she was, but that was all the help I could have asked for after the first day," she says.

• Volunteer nurses helped in a variety of ways. Scores of nurses arrived expecting to care for victims, but instead helped in myriad other ways, says Pugh. "There are many areas that nurses can be helpful in that are not necessarily traditional,’" she says. Here are some examples:

  • Nurses provided support for rescue workers on ferryboats. "Nurses just stayed on the ferry, going back and forth in their floating first aid station," says Giles.
  • Nurses set up eyewashing and first-aid stations for rescue workers near Ground Zero.
  • Nurses sorted incoming donations.
  • Nurses set up a family assistance unit to help families and friends looking for loved ones, make phone calls, and provide transportation to people who needed to get home.

"It was a great service they did, and they were much more useful than those who went directly to the site," says Giles.

Sources

For more information on lessons learned about volunteering after the terrorist attacks, contact:

• Laura Giles, RN, Emergency Department, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029. Telephone: (212) 241-6273. Fax: (212) 427-2180. E-mail: laura.giles@mountsinai.org.

• Suzanne Pugh, RN, Emergency Department, Saint Vincents Manhattan, 153 W. 11th St., New York, NY 10011. Telephone: (212) 604-2513. Fax: (212) 604-2339. E-mail: spugh@saintvincentsnyc.org.