They witness firsthand the pain, suffering and despair of those who have lost everything, including their loved ones.
They are the volunteer American Red Cross nurses throughout the U.S. who visit next of kin after fatal single or mass casualties. As members of the organizations condolence program, they may travel across country and spend weeks or months helping families in need.
“The greatest service that we offer is our ability to listen and hear what family members have to say,” said Red Cross Health Service Manager Rita M. Grady, RN, BN, BVE, MSHCA, who traveled from California to the New York/New Jersey region during Superstorm Sandy. “They realize that their story is being heard, and the more they tell, the better they may feel.”
Along with a nurse, a Red Cross case worker, a mental health professional and/or a chaplain are part of the integrated care team in the condolence program.
They help families in the worst of times, often in the midst of death and destruction. Some nurses have accompanied family members to identify the remains of loved ones after 9/11, and others offered family support at a Buffalo, N.Y., airplane crash site in 2009.
“Despite the extremely difficult realities, we let them know that people of the U.S. care, and that they are not alone,” Grady said.
Meet the needs
Providing emotional support to family members is crucial to the Red Cross condolence program, but there is even more the team accomplishes during the visits.
“We look at the familys disaster-related unmet needs and problems and work to resolve them,” said Disaster Health Services Manager Mary Casey-Lockyer, RN, BSN, MHS, CCRN, who works with a team in Washington, D.C., to provide central support to those involved in casualty care. “The public often hears about the Red Cross services in mass casualties, but many times the work of the condolence program is centered around single fatal fire fatalities.”
Each member of the team assesses and takes care of the needs of families from their own professional background, said Susan B. Hassmiller, RN, PhD, FAAN, senior adviser for nursing, Robert Wood Johnson Foundation, and director, Future of Nursing: Campaign for Action.
“When a disaster strikes, it is always up to the generosity of the public and their donations as to how much help can be given to victims, and we always provide shelter and food,” said Hassmiller, who served as a Red Cross nurse in the condolence program during the Alabama tornadoes in 2011.
Besides food and shelter, the team can help injured family members obtain needed medical care and replace lost prescription medications, eyeglasses and durable medical equipment, such as wheelchairs, hospital beds and walkers. The program volunteers may assist the family with funeral expenses and identify mental health and other community services. For displaced victims, the program can assist them in finding new living arrangements or long-term care, where needed. The volunteers also work closely with community partners to fill the many needs of affected individuals, which may include clothing, furniture and other essential items.
Making initial contact with the next of kin isnt always easy. During Superstorm Sandy, a Red Cross condolence team spent the initial hours and days trying to confirm who had died because of the storm. Verification lists were protected because of the Health Insurance Portability and Accountability Act. Phone and Internet services were down. Many family members were displaced from their homes, and medical examiners were difficult to reach because of interrupted phone service.
Once the deaths were confirmed as disaster-related and family members were contacted, some declined the Red Cross condolence visits.
“Families may be in shock or feel overwhelmed, be bombarded by the media or dont realize that we were there to help them,” said Red Cross volunteer Kelly Ausbun, LPN, who traveled from Arizona during Superstorm Sandy and stayed for eight weeks.
The work of the condolence program takes a toll on its team members.
Grady was concerned about the team suffering from compassion fatigue during the days after Superstorm Sandy. She made sure they had enough sleep, ate properly and exercised. She said she knew it was critical that they also expressed their feelings and experiences with one another.
Because of the intense feelings of grief, shock and hopelessness family members experience, the condolence team always works together to debrief and support one another after the visits, Hassmiller said.
Arline Cookingham, RN, disaster health services lead in New York state, is looking at ways to improve Red Cross services post-Superstorm Sandy.
“Its a challenge servicing those people with expensive medical needs during a disaster, and we are hoping to facilitate ongoing agreements with medical supply companies who are willing to donate items like hospital beds and motorized wheelchairs,” said Cookingham, who lives in Rochester, N.Y., and has worked with the Red Cross for seven years. Shed also like to work with state legislators to secure overrides from insurance companies, so medications can be replaced before the scheduled date and copayments can be waived.
Best in nursing
Every person, family and situation is unique, each presenting with different healthcare challenges and special cultural needs, said Ausbun, who has been deployed eight times during the past three years. She has offered assistance after tornadoes in Georgia and Alabama, Hurricanes Irene and Isaac, and Superstorm Sandy.
“Some families are all business, while others want to talk for hours about what has happened to them,” said Ausbun, who is pursuing her BSN degree. “The main thing is that we help as much as we can during our visits, without overstaying or understaying.”
In one special case, the Red Cross provided financial support to a family who wanted a loved ones body transported overseas to their home country. In another situation, they offered assistance to next-of-kin who needed to return to the U.S. after Superstorm Sandy.
“This program brings out the best in nursing, because we are true advocates for others and within the Red Cross guidelines and standards, we can function independently and interdependently with our team,” Grady said.
Janice Petrella Lynch, RN, MSN, is a regional nurse executive.