September 11, 2005
A Small Hospital Takes on a Big Job
Tim Bush, RN, is Administrative
Supervisor, St. Elizabeth Hospital, Gonzales, Louisiana.
I can not begin to document the events of the days after hurricane Katrina made land fall in southeast Louisiana. I was reminded of recent medical mission trips to impoverished countries abroad, mainly because of the enormous need and the same unselfish acts I witnessed by those working beside me.
St. Elizabeth Hospital is a small hospital just west of New Orleans, with an average inpatient census of 35. On Tuesday morning after the hurricane we were the closest fully functional hospital outside the city. We began receiving patients almost immediately. An ER that usually sees about 1600 patients a month saw over a 1000 in a few days! Our inpatient census more than doubled.
Several adjustments were made in an effort to accommodate the influx. Triage stations were set up in our auditorium and PACU, and clinical and nonclinical team members were used where ever there was a need. Storage areas were converted into patient rooms and beds were borrowed from other less acute facilities. Available supplies quickly ran low, but we began receiving shipments from outside facilities and vendors within a couple of days. We had enough supplies to help supply law enforcement, military units, and other portable medical units that set up in the area.
We had very little to no notification when patients were coming. They came by ground and air and they kept on coming. Sometimes there were 1 to 2 patients and sometimes there were 8 to 10 at a time. At first people came directly from the city and then from shelters and surrounding areas that were evacuating. Patients presented with an assortment of ailments. These included a 60-year-old who broke both ankles while trying to get in a rescue craft, a bus full of evacuated nursing home patients who had not received care in several days (the driver stopped because one had died on the way), a patient on the back of a military truck who had been there for several days because she was too large to move by conventional means, people with numerous infections from unsanitary conditions, and the list goes on and on. We even cared for 40 swat team members involved in a chemical explosion who needed decontaminating. We put our decontamination tent up and had them all wet and naked in less than an hour. We were seeing every type of injury and illness you can imagine.
Our leadership team was phenomenal. They held several planning meetings per day in an effort to anticipate needs and solve existing challenges. In the days since the storm I have not heard one of our team members complain. Many have been displaced themselves, but all of them pulled together and did whatever needed to care for those that continue to come. The effort has been enormous.
There have been challenges, as one could imagine. Transportation was a big issue. We would treat and then try to send the less acute patients to the smaller outlying facilities to make room, but ran into trouble trying to get them transportation. Some patients would be treated and discharged but refused to go to a shelter. Several shelters sprang up. Some were set up in local churches, schools, large public buildings, and individual homes. There remain several thousand refugees in our area. Aid is being sent from several places, but the enormity of this is unbelievable. These people, several thousand of them, have nowhere to go. They are toe-to-toe in the shelters under difficult conditions and their medical needs are only going to grow. In the northern parishes there are thousands who still can not leave from their homes. Many, and I mean many, have lost every worldly possession they have. The fortunate have family to stay with or have found residence in the surrounding areas. The populations of some local cities have grown by 40 to 50% overnight.
We have been witness to the best and the worst of human kind during these past days. Healthcare workers, fireman, law enforcement of every kind, the military, volunteers, and many others have given much in an effort to help. There is much to be done. This tragedy will affect us for years to come. I thank God for His mercy and pray for the strength to continue helping these people in the days to come. I would ask that you do the same.
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