Will you meet the needs of ED nurses during disasters?
Will you meet the needs of ED nurses during disasters?
Working days without sleeping or eating, and worried about the safety of their own children and family members. These were the horrific conditions ED nurses faced during Hurricane Katrina.
During any disaster, ED nurses may be working short-staffed under dire, chaotic circumstances with inadequate supplies and staff. But what if nurses also haven’t eaten or slept in far too long?
"You have to take care of your staff so they can take care of the patients," says Rachelle Zahniser, RN, regional manager of the ED at Coral Springs (FL) Medical Center.
This doesn’t happen by accident. It needs to be part of your disaster plan, says Anne Byerly, RN, nurse manager of the ED at Candler Hospital in Savannah, GA. It is obvious from the stories from Hurricane Katrina that ED managers must review policies and discuss all aspects of them, she says.
"As the interim manager of the ED, it is my responsibility to make sure all the needs of the emergency nurses are being met," she says. "This is when administration has to put on those scrubs and join the ED staff."
To ensure that needs of ED nurses are met during disasters, do the following:
• Make sure nurses get adequate rest.
Before Hurricane Katrina hit, staff were given designated sleep areas and meal times, says Zahniser. "Staff members that were assigned sleeping times during scheduling meetings were excused and would get up-dates when they were on duty," she says.
"Wake-up call" rounds were done to ensure a smooth transition between shifts by giving staff time to shower and eat beforehand.
"We know when everybody is sleeping and who is responsible for waking them up," says Zahniser. Rest may be limited, but staff aren’t working 40 hours without sleep, she says. "That does nobody any good, and you will have a worst-case scenario," she points out.
When Savannah was evacuated during 1999’s Hurricane Floyd, nurses who worked in Candler’s ED during the storm brought clothing and personal supplies from home and stayed for several days, says Byerly. Several treatment rooms and the day surgery area were used for sleeping and showers, and nurses brought their own food and drinks.
"We slept, ate, and bathed in the hospital," she says.
• Bring supplies as needed.
At Memorial Health in Savannah, GA, nurses are asked to bring the following items to the ED during disasters: Flashlight with extra batteries, bottled water, snacks, pillows, sleeping bags, clean clothing, personal hygiene items, and personal medications.
Although the hospital has enough supplies for staff and patients for 72 hours, additional patients may be picked up after the storm when search and rescue begins, says Debra O’Connor, RN, senior nurse for the ED.
"The staff may want some snacks, and the supplies don’t allow for food to be left out and wasted," O’Connor says. "The other suggested personal supplies are a good backup if there is a delay in relief arriving."
• Decide whether to allow family members.
During Katrina, many ED managers allowed staff to bring in family members and even pets. "Allowing family members might prove to be a burden to the ED," says Zahniser. "Ideally, you want the least number of people in the hospital. Otherwise, you become inundated."
The ED asks nurses to complete forms requesting to bring family members in during disasters, and cases are individually reviewed, she explains.
Staff are advised to make plans for their family in the event of an evacuation or disaster, taking into consideration special needs such as age or disabilities. The "B" team is released from the hospital 18 hours prior to the storm arrival. Candler’s updated policy states that the hospital cannot accommodate family members, so staff must make provisions for family prior to evacuation.
However, during Hurricane Floyd, families were allowed to accompany staff at Candler’s ED, but they had to provide their own food and drinks. "In fact, you often saw family members helping to deliver food to the floors," says Byerly. "They also assisted staff to feed and accommodate citizens with special needs who were being boarded in the hospital."
Sources
For more information on the needs of ED nurses during disasters, contact:
- Anne Byerly, RN, Nurse Manager, Emergency Department, Candler Hospital,5353 Reynolds St., Savannah, GA. Telephone: (912) 819-8224. E-mail: [email protected].
- Debra O’Connor, RN, Senior Nurse, Emergency Department, Memorial Health, 4700 Waters Ave., Savannah, GA 31404. Telephone: (912) 350-9748. E-mail: [email protected].
- Rachelle Zahniser, RN, Regional Manager, Emergency Department, Coral Springs Medical Center, 3000 Coral Hills Drive, Coral Springs, FL 33065. Telephone: (954) 344-3017. E-mail: [email protected].
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