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Preparation key with Superstorm Sandy in Philadelphia region

Friday November 9, 2012
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With Superstorm Sandy bearing down on the Philadelphia Tri-State region, nurses knew they had a role to fill, and neither rain nor high winds nor power outages nor fallen trees would keep them from their appointed rounds. "I was out on the floor at shift change, around 7 p.m. Monday [Oct. 29], talking to a nurse who had a run-in with a downed tree," said Sue Speero, RN, BSN, CCRN, nurse manager at South Jersey Healthcareís Elmer (N.J.) Hospital. "Iím letting her tell her story, and all of a sudden weíre in total blackness. We were on generator power until about 10:30 a.m. Tuesday [Oct. 30]. It didnít really limit us because the generator kicked in right away."

The nurse, Melinda Pierce, RN, had been driving to work and, with surrounding lights out, didnít see the fallen tree until her headlights fell upon it. "She had a short reaction time, swerved and scraped her car," Speero said. "She didnít stop to look at damage; she just kept coming because she knew she was needed. Thatís pretty awesome."

Throughout the region, nurses kept staffing levels up, many beating the storm by coming to their hospitals early and staying overnight. They did their part in easing patient anxieties as hospitals made accommodations, which included discharging patients who could go home and postponing surgeries.

At Christiana Care Health System in Newark, Del., Diane Talarek, RN, MA, NE-BC, CNO, said the accommodations ensured space was available for injured patients if the emergency included fires, collapsed houses or other disasters. Likewise, Thomas Jefferson University Hospital in Philadelphia kept the census low in anticipation of the storm, said Eleanor Gates, RN, MSN, vice president of surgical trauma and director of the emergency management center.

"It does all come down to preplanning," Talarek said. "We do have emergency management meetings every two months, and you think, 'Gee, why are we doing this?í And the answer is — itís things like this. You hope that things that happened in New York never happen to you, but you never know. Itís being able to execute a plan that youíve talked about, and you practice it."

For nurses, thereís the added task of comforting patients and letting them know emergency preparations have been made.

"Nurses did a really good job reassuring the patients," said Cheryl Littlefield, RN, CHEP, emergency management coordinator at Beebe Medical Center in Lewes, Del. "Monday evening [Oct. 29] was our worst time. We lost power for a split second. One of the feeds to the hospital from the town failed, but we have another feed from another place as well as our own generator. The engineering folks were wonderful. We have backups for the backups."

Communication remained important throughout the storm, with hospitals setting up command centers to coordinate. Gates said Jefferson posted messages on its GetWellNetwork and on its website, while Littlefield said communication at Beebe included sending faxes between stations.

"We asked the nurses how communication was going and got really good feedback," Littlefield said. "One thing we did was to use our fax machines in-house to print information and post at the nursesí stations."

And, Littlefield pointed out, nurses and staff need reassurance, too. "It starts with nurses preparing their homes and families so they can come to work," she said. "You have to make sure kids, even teenagers, have food, water and know whatís happening. Then you can focus on your patients with a clear mind."

At Elmer and Kennedy Health Systemís Cherry Hill, N.J., campus, out-of-town families and patients needed a little special care.

Jonathan McCarthy, RN, MSN, MBA, NEA-BC, vice president of clinical services at the Cherry Hill campus, said a family from Singapore was in to visit their 89-year-old mother. "We didnít want them trying to get to a hotel," he said. "There were no taxis, no public transportation. The patient had a private room, and we were able to set the whole family up in there. They raved about how nice everything was."

McCarthy said Kennedy had a full staff of nurses on duty, even with significant call outs in other departments. Other facilities also were able to operate with full nursing staffs, something that came with planning. Littlefield said Beebe asked nurses to come prepared to stay overnight, and Speero said Elmerís nurse managers worked to ensure nurses who lived near the hospital were scheduled.

"We have nurses as far away as the shore areas," Speero said. "We didnít want to have them scheduled, or if they were scheduled, they could come in early and stay at the hospital, make a switch or we would make arrangements for them to switch."

Gates said Jefferson made sure nurses who stayed overnight had what they needed. "We provided sleeping accommodations here in our hospital," she said. "We have a disaster plan that provides for areas that we turn into sleeping areas. We have inflatable mattresses, sheets, pillows and blankets. We give them toiletries if they donít have them. We give them a meal ticket in our cafeteria, and we also give them a parking pass."

McCarthy said nurses maintained 100% staffing and stepped up outside the hospitals.

"From a commitment standpoint, nurses from all three of our facilities volunteered to staff local shelters," he said.

At Christiana, Talarek said, teamwork was essential.

"People really pulled together," she said. "They always do. On one ICU, you wouldnít even know weather was going on. They brought big suitcases, they ordered out — I donít know where it was from — and they were having their pizza together. It was like a slumber party."

While emergency preparation kicks into high gear when a storm is approaching, being ready is a year-round task, McCarthy said.

"We used the Hospital Incident Command System," he said. "Itís a [Federal Emergency Management Agency] thing, and I think all hospitals are on it. It does work. I think the one lesson that we learned from Irene that weíve been working on all year is for people to know their roles. It helps that all agencies are speaking the same language, have the same systems, have the same responsibilities across organizations.

"It really does work and the better you are at being able to deploy it, the better these things go."

John Grochowski is a copy editor.


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