(Photo courtesy Lenox Hill Hospital)
"We didnít know how many patients we were receiving, nor did we know what disciplines they would be in," said Phyllis Yezzo, RN, BSN, MS, nurse executive at Lenox Hill.
What they did know was that more than 300 physicians would need to be issued "disaster privileges" and what would eventually be 800 nurses would need verification and a quick orientation to start work.
Lenox Hill quickly opened up four previously shuttered med/surg nursing units.
At first "we were admitting about one patient every three minutes," Yezzo said. Because NYUís medical center is completely electronic and it had lost EHR capability, nurses were triaging with only verbal handoffs, she said.
"All the drills that weíve done Ö they really paid off," Yezzo said. "Everyone knew exactly what to do."
While patientsí health and safety was the top priority, part of that meant attention to regulatory details.
"You have to worry about the regulatory agencies, that any time they could come in and audit," said Donna Tanzi, RN, MPS, NE-BC.
First, Lenox Hill had to validate the nurses with a photo ID, validate their professional licenses online, and check to see whether there were disciplinary measures against the license.
They had to train nurses quickly in corporate compliance and patient safety and how to use equipment that worked differently at Lenox Hill. For instance, the IV pumps were primed and used differently than they were at NYU.
Herminia Castaneda, RN, a labor and delivery nurse at Lenox Hill, was paired with an NYU nurse and said the most difficult part of the training was teaching the basics of the computer system and getting passwords set up. Total orientation took about two days before the NYU nurses became actively involved in patient care, she said.
The addition of NYU nurses was critical as the number of deliveries at Lenox Hill doubled in the first weeks after the storm, Castaneda said. "We had only nine to 10 nurses and we needed at least 14 per shift," she said.
Training started with only the basics.
"What this forced us to do was to look at the mandatory and the must-dos as opposed to the nice-to-dos," Tanzi said. "The nice-to-do parts we had to do on the fly."
NYU nurses also had to go from the electronic documentation they were familiar with, to the paper documentation Lenox Hill used.
"Once youíre used to electronic medical charting, itís very hard to go back," Tanzi said.
While in crisis mode, supervisors had to watch for nurses who had worked too many hours, as the patient load spiked.
Yezzo said leadership from both hospitals kept a constant check on how the nurses were holding up. Lunches, sleeping accommodations and shower facilities were provided as the hospital also became a hotel for staff.
When the NYU nurses came in, "one of our first questions to them was 'How long have you been up?í" Tanzi said. If they had worked 16 hours, they were sent home. That went for Lenox Hill staff as well.
Baby came early
One of those nurses who lost sight of her own needs while treating others was Lenox Hill orthopedic surgery nurse Heather Stansbury, RN. She came in to help the NYU nurses transition even though she was two weeks from giving birth.
Her water broke six hours into her shift on Oct. 30, a day after the storm reached the region. Twenty-three hours later, son Logan Stansbury was born.
"I probably was in labor when I went in and didnít know it," Stansbury said.
As of mid-December, nurse leaders were working on an exit plan for the NYU nurses.
When they do return to NYU, they will leave a strong impression at Lenox Hill.
"Some of them had been carrying patients down 15 flights of stairs," Tanzi said. "They carried them through dark hallways with flashlights. Then they came in (to Lenox Hill) and they stood by their side. It just really showed that this is what nursing is. This is what we do."
If something could have been done differently, it would be to make sure hospitals have a Plan C — a plan if the contingency plan doesnít work, Yezzo said.
"Not only do you need a disaster plan. You need a dark disaster plan," Yezzo said. "What do you do if your generators donít go on?"
Marcia Frellick is a freelance writer.
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