Nursing in the StormNatural or man-made, disasters can be frightening, chaotic, and tragic events.  In these events, nurses play a fundamental role in response and patient care. In our series, “Nursing and Disasters”, prominent voices in the field give voice to ensure that all nurses are personally and professionally prepared for a disaster.

Before we could begin writing Nursing in the Storm: Voices from Hurricane Katrina, we needed to find nurses to interview. However, in a post-disaster landscape, finding nurses was a challenge.  According to Census Bureau Statistics, the population of Orleans Parish, where we used to work, had decreased from 437,186 (July 1, 2005) to 158,305 (January 1, 2006). In a period of six months, the population in Orleans Parish had decreased by over 60%.Within the seven parishes that comprise the New Orleans metropolitan area, the population dropped by 29 percent. Our place of employment was one of the eight closed hospitals in the area.  Katrina destroyed 1,847,181 housing units, 18,700 businesses and resulted in 139,930 unemployment claims.

We had success in reaching a few nurses.  They reached out to colleagues and from there, our network grew. We followed the same question format for everyone we interviewed.  We asked about their background, experience with emergencies and disasters and hurricane preparation. We also inquired about what they experienced during Katrina and during their return to work, as well as what lessons they could share from these experiences.  In his forward, Lieutenant General Russel L. Honoré wrote, “These nurses adapted to, and overcame, near-wartime conditions with the courage of Clara Barton and the grace of Mother Teresa.”  As they shared their personal stories with us, that courage and grace was palpable.

There was one interview that underscored the power of sharing the experience.  We had finished the interview with a seasoned nurse.  As she rose to leave, she paused, turned to us and shared that it was the first time in three years that she had spoken to anyone about what she went through with Katrina. She said thank you and left.

Usually after a disaster, a hospital has a staff debriefing for assessments of systems and protocols. But since these nurses left their flooded hospitals, uncertain if they would have a place of work when they returned, they did not have the post-storm review with their colleagues.  Their work place had been obliterated.  Many had lost their homes and their communities. Taking the time to reflect on what had happened wasn’t necessarily a possibility when surrounded by so much instability and uncertainty.

In a post-disaster environment, it is important to have accessible employee assistance programs and counseling services. Displaced families and residents should be provided with housing assistance, on or off-site for employees and families during the transition; work-site access to donations of uniforms; and food and other basic commodities.  Hospitals should facilitate a way for staff to reunite, especially if the facility is damaged or destroyed.  Timely communication of essential information is critical, and if possible, nurses and employees should be offered the opportunity for a debriefing. Talking about the experience helps to reach closure.