John Heaton, MD, chief anesthesiologist for Children’s Hospital, led a caravan of 40 cars, trucks, and SUVs to the interstate and onward to the airport. Staff members returned to the hospital despite worsening violence and health hazards in the city. Wednesday turned to the early hours of Thursday with only a few ICU patients remaining at Children’s.
At 4 a.m. a state trooper who came to support a chopper that was evacuating a patient recommended that staff prepare to evacuate at first light because of increasing danger due to flooding and looting in the city. Until then, Children’s had had very little contact with authorities, and basically made its decisions in isolation. One caravan of employees left with a police escort shortly thereafter. The remaining staff made their way unescorted when the last patient left for safety at 8 a.m., leaving a facility that had operated nobly despite Mother Nature’s wrath and security issues. When staff members left, Children’s Hospital had sustained only two broken windows.
Dr. Minkes praises the staff of every department, and indicates that leadership withstood this test. “The day after the hurricane, we were prepared to stay for two to six weeks,” he says.
When asked if he saw any skill used that surprised him in its utility, he hastens to say that they had power and water for most of the ordeal. He noted, however, that their chief of anesthesiology, an ardent fisher and hunter, calculated how high the waters would rise if the levies broke using a tool he retrieved from the Internet. He assured the staff that the water would not reach Children’s Hospital. It helped people’s spirits immensely.
After UTMB Galveston discharged and evacuated more than 425 patients in 12 hours as a category 4 Hurricane Rita was charging toward the island, Dr. Sexton called on the governor’s office to provide C130 military cargo planes to evacuate employees. About 130 UTMB employees chose to leave Galveston and were evacuated to Fort Worth.
Back to Jackson
Meanwhile, Dr. Otuseso was seeing an influx of patients in Jackson. With her, Lancy Clark, a registered nurse and Cogent Healthcare Program manager who liaises between St.Dominic-Jackson Memorial Hospital’s hospitalists and community physicians, was frankly shocked. The St.Dominic-Jackson facility staff—150 miles from Gulfport—had not thought that the devastation would reach them. It did.
With no electricity or water, St. Dominic-Jackson’s internal and external communication was in a shambles. Their backup: using the telephone, personal cell phones, and overhead page system. Although the county’s priority was to restore power and water to hospitals, its employees were working in the dark. And county-wide gas shortages meant that staff had difficulty reporting to work. Fortunately, the county gave healthcare providers head-of-the-line privileges for fuel.
“I was amazed at how fast people bounced up and worked,” says Clark. “We were all counselors. We often cried with patients as they told us their stories. We used all the resources we could to help emotionally and financially.”
In all of this, the healthcare providers, too, were victims; many have strong roots and family in the devastated communities.
As the adrenaline rush subsided and things started to be a little more normal, care providers began to feel the effects of the strain. All Clark wanted to do was sit in a chair and sink deep into it. Some experts call this compassion fatigue. It is a unique type of burnout experienced by people in fields that provide care for people under extreme circumstances, or the stress of caring for people who are scared, in pain, and/or suffering. Critical incident stress management and debriefing exercises are two ways to alleviate compassion fatigue. Clark indicates that Cogent Healthcare has plans to hold debriefings so they can apply what they learned.