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Near ground zero on Sept. 11, dedication overcame fear. Health care workers heard rumors of further attacks, of other buildings collapsing, of a bomb in the hospital. They coughed and squinted from dust. But they kept working.
The staff at New York University (NYU) Downtown Hospital and Saint Vincents Hospital in New York City have been among those who provided inspiration in the aftermath of the terrorist attack on the World Trade Center. The hospitals, in turn, mobilized in the weeks after to support their staff and address their emotional needs.
"Not only are these health care workers, not only have they helped the victims, but they were really also victims," says William Lee, vice president of human resources at NYU Downtown Hospital, which is only four blocks from the site. "Almost all of our staff saw the buildings burn, the towers collapse, people jump. They were covered in dust. Everybody was hit by the cloud [of dust and debris when the towers collapsed].
"Some employees thought it was a nuclear attack," he says. "Some thought it was a bioterrorism attack. All kinds of things went through our staff’s minds."
The 150-bed hospital treated about 500 victims within a couple of hours of the attack. Staff began triaging patients in the hospital’s courtyard when the towers collapsed and the enormous black cloud engulfed the area. They quickly moved patients indoors. Even there, some dust came in through loose windows. "Many of our employees had corneal abrasions and breathing difficulties," Lee says. "All of the employees were given vials of eye drops to help alleviate the symptoms of dust blowing in their eyes."
Meanwhile, the hospital lost phone service and electrical power. Staff used a generator and received a swift donation of a CT scan with its own power source from General Electric Corp. In the following days, employees continued to show their determination to work. When food service and housekeeping employees were turned away from police checkpoints as "nonessential" employees, they found other routes to the hospital. "These employees knew they were essential to make sure the place was clean and the employees were fed," says Lee.
Two miles away, the 600-bed Saint Vincents hospital set up secondary emergency rooms in the rehabilitation center and endoscopy suite. Ruth E. Smith, MD, MBA, director of personnel health services for Saint Vincents Catholic Medical Centers, switched from treating employees to treating victims of the attack.
Mobilizing its disaster preparedness plan, the hospital was prepared to treat waves of rescued victims after the first onslaught of patients. Sadly, there were no further patients. About a week after the event, both hospitals began offering emotional support services to employees. "Employees can’t sleep," Lee says. "Employees’ children are very afraid that their parents are coming back to work." The hospital provided educational sessions and information sheets, and set up small support groups that encouraged employees to talk about what they saw and experienced.
The Local 1199 New York Health and Human Service Union (SEIU) arranged for counselors to come from Kaiser Permanente in California. Other counselors came from Thomas Jefferson University in Philadelphia and New York sites. The hospital offered individual counseling, and shared their resources with the local community.
Saint Vincents advised managers to be alert for symptoms of acute stress reaction and, using hospital resources, offered educational sessions and counseling for employees. Saint Vincents is one of the few hospitals in the country that maintains an emergency response plan and conducts regular drills. Still, Smith says, the hospital is reviewing what additional steps it should take to be prepared for potential chemical or biological terrorism.
In those events, hospitals would need to do even more to protect health care workers. "I think we need to have a careful plan thought out," she says. "I don’t think any of us have a full-blown plan to handle employees who are secondary casualties [of an attack]."