November 10, 2005

Thoughts on Serving: Two Weeks as a Post-Hurricane Volunteer

It is Tuesday, October 4, 2005 at 4:00 pm.  As is a normal day at home, I am juggling homework with my children, attempting to make something edible for dinner, balance the PTO checkbook for the next meeting, and get ready for a night at work. Naturally, the phone begins to ring.

I reluctantly answer, while thinking up an excuse for what seems like the 10th telemarketer that day.  To my surprise it is Lieutenant Commander Pellen, with the Office of the Surgeon General!  Can I still help with a medical relief mission being organized for the Gulf Coast?

Never in a million years did I think they would actually call, after so many people stepped forward to volunteer.

Well, 36 hours later, I am on a flight headed to
Louisiana, home to the devastating aftermath of Hurricanes Katrina and Rita.  Though I am traveling alone and a little (okay, a lot), frightened by what I have signed myself up for this time, I am also excited to be participating in this effort.

After processing my paperwork, and a night of sleeping on a cot in a tent with 100 other volunteers at "tent city," in Baton Rouge, I find myself being sent not to a hospital or medical center like I had originally thought, but to a special needs shelter for evacuees.  What do I know about "special needs"?  I'm a cardiology nurse with a 4 or 5:1 ratio, not 40:1 in a large gym!!! 

Well, I quickly realize that living and working in a disaster shelter, everything I had done for years under hospital regulations was history.  In these situations and time of need you work with what you have and pray for the best.  There are no sinks in every room, but strategically placed hand sanitizer amongst rows of cots where people are "living."  No charts, but alphabetized folders placed in an egg crate.  No pyxis or med cart, but a makeshift pharmacy in a storage closet, and your patient's meds are kept in a plastic bag, then stored in a Craftsman toolbox. (Yikes!) Flexibility and team work become your motto.

What helped me through those two weeks was not only the amazing attitudes of the evacuees, so positive and thankful, but for the many other volunteers I was lucky enough to meet and work with.  Forty seven states across the country were represented while I was there, with volunteers from all different medical areas and expertise, from clergy, fire fighters, paramedics, National Guardsman, Red Cross workers, Public Health Service officers, to many, many more.  What an incredible group of individuals.

Helping the evacuees with their medical needs, finding family members or friends to take them in, or just listening when they needed to talk, whether about the uncertain future or their stories of survival, is an experience I will never forget.

After an emotionally and physically exhausting two weeks of sleeping on a cot myself, using outdoor bathrooms and showers, and eating less than appetizing food on most days, I was glad to be headed back to the comforts of home and family.

I would never wish for another catastrophe such as this to happen, but I encourage everyone to experience this life-changing journey if ever given the chance.  It is true what they say about not appreciating what you have until it's gone. Never again will I take for granted the things in my life.  Not just monetary things like a home, car, a good job, but especially my family and friends here, and the ones I left behind in Louisiana.

I feel truly blessed to have each and every one in my life, and extremely fortunate to have been a part of an amazing experience of nursing in the face of disaster.

Melissa Bless, RN


November 10, 2005 in Hurricane Katrina: Nurses and NPs Help | Permalink | Comments (3)

September 22, 2005

Health Professionals and Hurricane Rita -- Tell Us Your Stories

With Hurricane  Rita now moving toward  Texas,  we are concerned that there will again be  a need for health professionals to  step forward and provide relief efforts and/or to care for large numbers of displaced people.   If you are a health professional (physician, nurse, NP, PA, pharmacist) living and working in the Gulf Coast,  do let us know what is happening. How is your workplace preparing for this storm? Are patients being evacuated from hospitals and nursing homes? What unusual experiences have you had?  How difficult is it to tend to your own life and family and to your professional responsibilities as well? Click here to  write us with your first-person accounts;  photos are also welcome. Please include your permission for us to consider posting your story or photos  on the blog.

September 22, 2005 in Hurricane Katrina: Nurses and NPs Help | Permalink | Comments (1)

Midwives, Blankets, and Babies

Baby72x921Don't miss this press release from the American College of Nurse Midwives about their "Blankets for Babies " campaign. Thousands of blankets and baby clothes, donated to the Texas Health Care Nurse-Midwives of Fort Worth, Texas, will be distributed to women and babies displaced by Hurricane Katrina. Check out this link for more information.

Nurse-Midwives Help Hurricane Katrina Evacuees; Displaced women, babies receive donations

September 22, 2005 in Hurricane Katrina: Nurses and NPs Help | Permalink | Comments (0)

September 16, 2005

Psychiatric/Mental Health and Gerontology Registered Nurses

Certified Psychiatric/Mental Health and Gerontology Registered Nurses Needed for Katrina Response and Recovery Effort

In response to a request from the Substance Abuse and Mental Health Services Administration (SAMHSA), the American Nurses Association (ANA) and the American Nurses Credentialing Center (ANCC) are recruiting approximately 100 certified psychiatric and mental health and gerontology nurses to work in Louisiana.

Selected registered nurses will be deployed as part of a multi-disciplinary team that includes psychiatrists, psychologists, social workers, substance abuse counselors, and pastoral counselors. The assignments will be for two weeks and there will be four deployment cycles starting on September 18 with the last two-week deployment cycle starting on November 1, 2005. Expenses related to travel, housing and meals will be covered. Selected participants will also receive a $200 per day honorarium. Applicants must hold a current active RN license; be certified by ANCC in psychiatric/mental health OR gerontological nursing; and have professional liability insurance. In addition, applicants must be able to withstand the rigors of working in a disaster response area for a continuous two week period.

Information and Application


September 16, 2005 in Hurricane Katrina: Nurses and NPs Help | Permalink | Comments (0)

September 13, 2005

A Rewarding Experience

Debra Hunt, ARNP, is from Clermont, Florida and she has just returned from volunteering in Ocean Springs, Mississippi.

I am trying to process the magnitude of the destruction from Katrina.  I was part of a mobilization organized by the Florida Health Department of over 100 medical personnel, the majority of us nurses.  My particular team consisted of 2 other nurse practitioners and an ED nurse.  We helped establish a primary and special needs clinic in an abandoned restaurant in a mall. 

Each day we treated nearly 100 patients with a variety of rashes and respiratory illnesses associated with the contaminated flood waters, as well as abscesses, lacerations, and puncture wounds.  That was the easy part.  Listening to the horror stories from our patients was heartbreaking.  So many people were stranded in their homes in sea water contaminated with sewage, dead bodies, and oil.  One 5-year-old little boy sat on my lap as he told me about his roof being in the next yard with all his toys, clothes, and many other belongings. What could I say to this innocent little child as we looked into each others eyes and talked about such horror?

We also went on several "house calls" and the violence of Katrina was so dramatic.  People are living with dead fish and sewage in their yards.  The black mold has taken over the inside of their homes so they live in the yard in pup tents.

In spite of the sadness and destruction I can say that, without a doubt, this was the most rewarding experience of my personal and professional life.  The people I met were some the kindest, warmest individuals I have ever had the honor of meeting.  We experienced no violence or hatred, just thanks and heartfelt gratitude for any little thing we did for them. I feel blessed and honored to have helped our neighbors in Mississippi and I thank them for allowing me into their lives.  I received so much from them, perhaps more than we gave.  I have a new appreciation for my family and my colleagues because of this experience.


September 13, 2005 in Hurricane Katrina: Nurses and NPs Help | Permalink | Comments (0)

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.



September 11, 2005 in Hurricane Katrina: Nurses and NPs Help | Permalink | Comments (0)

September 07, 2005

Paramedics and Firemen: The Caregivers Suffer as Well

We heard from Thomas Lahut, PA, MS, in a previous dispatch. He just returned home to upstate New York today, but before he left Baton Rouge, he provided Medscape with this report.

On Monday, September 5, 2005 I was summoned (“Please come now!”) at noon from the chapel. That’s where sleeping accommodations have been made (darkened windows, cots) for medical workers who are working late night shifts at the P-MAC (Pete Maravich Assembly Center at LSU), the temporary medical evaluation area in Baton Rouge for Katrina evacuees.

New Orleans paramedics and firemen, who have essentially worked 24/7 since the storm hit and the levees broke were finally being relieved. Firefighters from Houston are now able to replace these men and women, who have given so much, and who still remain victims themselves.

The paramedics and firemen have been bussed out in large groups from New Orleans and they need to decompress. As an urgent perk, the City of New Orleans has solicited charter airflights, accommodations, and stipends to allow these rescuers to take their families out of the area, and out to Las Vegas or Atlanta for a 5-day furlough.

They were first sent to Baton Rouge and brought to a formerly grand and now-seedy hotel “in the bad end of town,” as an initial staging point. 

These workers needed an initial medical/psychiatric evaluation -- urgently. As a physician's assistant, I worked with 4 docs and 3 nurses and we were accompanied by dozen psychiatric liaison staff physicians, social workers, and nurse practitioners.

Also included were offerings of warm food and clean clothes. As a separate (screwed up) offering, FEMA was supposed to be present to offer coordination of low-cost loans and initiation of housing assistance for these people who gave so much. After multiple requests, with one of our docs getting quite agitated in a cell phone call to HQ, FEMA finally came, but very, very late, after many firemen had left to seek out their displaced families.

Firemen and paramedics are tough folk. They prepare for the worst, they offer excellent medical care, but they were in rough shape. They were tired, anxious, apprehensive, and dry at this time. They maintained the facade of normalcy, but when questioned directly, they made frustrated references to the Superdome; they saw death and a lot of people too ill to save. The psychiatric liaison staff was excellent.

A paramedic who had surgery days before the hurricane, and who had worked above and beyond any description for the past week, was ill appearing. She was anorexic, looked pale, BP 90/30, tachy, pale conjunctiva. She was shipped out STAT to a local hospital, and went directly to the operating room.

A fireman, carrying a puppy with big ears, was a magnet for the attention of the support staff. The pup was named “Ernie,” for the place he was rescued from: the Ernest N. Morial Convention Center -- the Superdome.

Psychiatric issues of depression, substance abuse, memory problems, difficulty sleeping, and feeling estranged could only be transiently and superficially addressed. The burden of that work will be passed to future clinicians.

The clinic broke for the evening; tomorrow, another bolus of rescuers will present again.

September 7, 2005 in Hurricane Katrina: Nurses and NPs Help | Permalink | Comments (0)

Atlanta's Incoming Survivors

Marilyn Ringstaff is an advanced practice nurse from Rome, Georgia. She is working with the Georgia Public Health relief effort, caring for Katrina survivors at Dobbins AFB in Atlanta, Georgia.

September 7, 2005: I was with Georgia   public health for our second day of emergency relief meeting the incoming Katrina survivors at Dobbins AFB in Atlanta yesterday. Sunday we saw the most appreciative folks, but yesterday we were seeing a lot of angry people. These are the ones who said they were forced from their homes at gunpoint who didn't want to leave, or had been waiting on their roofs for rescue for several days, or who had been separated from their families. I learned that in the three days we were there, around 1500 people were screened and transported either to shelters, hospitals, or nursing homes. They were exhausted, disoriented, and many still in denial; mental health workers were present to talk with everyone.

I was there with several other nurse practitioners (NPs), but we were so handicapped by Georgia's antiquated prescriptive authority laws.  Georgia is the last state in the country that refuses to allow NPs to sign our names to a prescription. So here we were, with a building full of people we were trying to process out quickly before the next flight. We couldn't call needed prescriptions to a pharmacy because we didn't know where the patients were going; they needed a slip of paper to carry with them and also to document for the pharmacy to fill it without charge. So, we had to run around a congested air force base hanger to look for a physician to sign a prescription. I wanted to scream for FEMA to divert these patients to a more progressive state.

My first family was a family of 10 people, one of the little girls was named Katrina and when I asked her name to start the paperwork she came up and whispered it to me so no one would hear her. Five of the family members had been on their roof since Tuesday, 5 days; they ran out of food and water. They saw the helicopters going back and forth past their house, they were waving t-shirts and anything they could find 'but they just kept going on by.' We taped Pampers on the toddler's feet because the Red Cross had run out of shoes and she loved it.

Another woman, Toni, didn't know where she was. I said something like "Welcome to Atlanta," and she started crying and said "I was supposed to be in Houston." She was separated from her 17-year-old daughter; she refused food or water until she talked with her daughter in the Astrodome. Toni had heard the reports of rapes and violence in the domes and her daughter was unattended. We couldn't get through to any phones there but the Red Cross will keep trying. Contact information was put into databases as soon as available and many families were able to immediately locate each other, but we had to put Toni on a bus to a shelter without getting in contact with her daughter.

A family of 7 people arrived who had been sleeping on the bridge after reaching it by boat, and they finally decided to leave their home after the water started turning black from the bodies. They had a 3-week-old pit bull puppy with them -- they were feeding "Lady" with a dropper. Lady probably has Parvo and animal control took her to an Emergency Vet, no word yet on her condition. But I'll keep checking.

It's good to come home and see that our hometowns have so many relief efforts in place. All of these families are going to need long term support.


September 7, 2005 in Hurricane Katrina: Nurses and NPs Help | Permalink | Comments (0)

September 06, 2005

3 Days in Louisiana: A PA Reports

Thomas Lahut, PA, MS, usually works at St. Peter's Hospital Emergency Department, in Albany, NY. But for the last few days he has worked in Baton Rouge, LA, at the Temporary Medical Operations Staging Areas for the evacuees from New Orleans.

Monday, September 5, 2005: Some of the patients, seen at the Temporary Medical Operations Staging Area at the P-MAC in  Baton  Rouge    are described here. Most had reluctantly been evacuated from New Orleans now that martial law has been established by a growing 40-state National Guard contingent:

- 48 yo female, SOB, dehydrated, schizophrenic, no meds, ETOH 1hr PTA

- 21 yo male, hypothermic, in water for 3 hours attempting to get to a rescue boat for family with autistic member, succeeds, then struck by helicopter landing gear exiting with wind gust. Gash without fracture; now shaking with audible wheezes.

- 55 yo female, substernal chest pain, anxious, improves with psych liaison

- 64 yo male, prior TBI, BMI >40, Code Brown rehydrated, sent for NH placement

- 42 yo male, uremic, no HD x 7 days, FSG 42, improves to 127mg/dl with Gatorade and sugar

- 55 yo female, BP 210/108 after EMS placed foley and IV Lasix 40mg; greatly improved with NTG and Lisinopril, pharmacy fills a week of meds to go.

- 36 yo female, ‘trench foot’ after punctures and multiple immersions for 3 days, IV Abx with return in AM planned.

- 45 yo male, IDDM, tarry feet & puncture, (no shoes); Rx insulin and Keflex

- 91 yo female, SDAT, HTN, never uses meds per daughter, now combative and mute; rehydrated after U/A and labs

It goes on. The patient/family interactions are a great source of satisfaction, as well as the wonderful professional contacts.


Sunday, September 4, 2005: Deeply troubling to see the extent of devastation - the lives of people here, after the Hurricane Katrina. The stories of victims, as well as those stories of the extremely generous people here, are very moving.

Tragedy brings out extremes. But I cannot commend highly enough the churches, university, local police, and the whole of the community her, for opening up their lives to the difficulties in the New Orleans region.

The magnitude of the difficulties is analogous to an iceberg. Even hearing first hand of the problems, it is difficult to adequately place it all in context.

My work is just one element of the multiple needs here. Accounting of death has not been attempted. The survivors tell stories, but obviously the young and old, weak and frail were most vulnerable in the hurricane.

Enduring in the subsequent flooding, lack of water and electricity, and the mandatory exodus has been a burden many have poorly tolerated. Families are missing, couples have been separated; the disruption and the task of reconnecting is a great unknown. “I last saw my daughter a day after the storm hit… “

Medical issues range the complications of untreated chronic problems asthmatics, diabetics, atrial fibrillation / cardiac problems, arthritic / orthopedic; plus new stressors of injury and infection.

Mental health issues are extensive, burdensome, and are difficult to address.

Complicating all these is a basic lack of clean water, simple food, underclothing, and shoes for bare feet. “If I could have just a shower… “

Financial complications with car, home, job are included in the phrase, “Nothing will be the same, “ for so many here.

The chapel is room and board for about 50 medical providers: physicians, nurses, EMTS, and more. It’s about a 1 mile walk through the lovely campus of LSU, to the P-MAC, now seeing patients 24/7.

I attended church on Sunday and one parishioner told a story, finding a family of four, parent and young kids, standing by their car in a downtown area of Baton Rouge.

He wanted to be a Good Samaritan, and offered them help -- perhaps a shower and an opportunity to so some laundry. The family had been living in their car for the past five days, and was greatly relieved at the parishioner’s offer. But they also wanted to bring the “rest of the family,” also in cars. Suddenly 15 people were chatting with the parishioner. Then, as word spread among the parked cars, this became an extended family of 37, ages from 1 to 87. The “family” stayed 36 hours, bathed, and ate and they planned to continue to drive north for potential resettlement.

Saturday, Sept 3, 2005
: This day had been spent at the P-MAC, the Pete Maravich  Assembly Center at LSU which has been accepting helicopters, ambulances and busloads of people who are the evacuees from New Orleans.

The mix of staff and volunteers is extensive. Border Patrol guards hefting M-16s provide excellent security, although the contrast with the lush, contemporary and stately campus exaggerates the effect. National Guard personnel provide the logistics of coordinating the extensive supplies, organizing the flow of patients and providers, and troubleshooting any rough spots. Nurses, docs, technicians, and eager students are all volunteers. The providers have been nephrologists, ER physicians, pulmonologists, orthopedic surgeons, and more.

Local physicians have been helpful with describing Louisiana "Good Samaritan" laws, which are applicable for volunteer medical providers in protection for liability concerns.

I was assigned to a team with two nurses, two techs (med students). The level of respect and communication has been excellent. Folks from this area are pleasantly surprised that health professionals have come from Ohio, Florida, and New York.

I have seen very few traumas, but mostly medically related problems, such as diabetics with foot injuries, dehydration, lost meds, cellulitis, COPD exacerbation, and many other acute-on-chronic variations.

The stories are multiple: Patient is status post CABG x 2yrs when the levees broke. Water entering the living room, and patient dropped the NTG, now floating right out of the house. Patient chases, winds up treading water for 30 minutes with substernal chest pain, finally rescued by patrolling boat.

Volunteer is radiology resident who ended 24-hour shift when Katrina hit; she stayed in a purgatory of providing care for patients for five days straight, through no water, no electricity, extensive bagging of some patients. Rescue finally comes for patients by helicopter, but the medical personnel are told to go to the hell occurring at the Superdome.

People overall have been positive and upbeat through miserable circumstances. I personally have been feeling very well accepted as a PA, working with my assigned team and the other providers.

It is a fine privilege to be in Baton Rouge today.

September 6, 2005 in Hurricane Katrina: Nurses and NPs Help | Permalink | Comments (1)

Physician Report from the Astrodome

Amy is an MD who volunteered at the Houston Astrodome.  Here is her on-the scene-report.


I don’t even know how to explain how bad it is down here for those of you who aren’t here.  It’s just unreal that so many people are here in Houston,  and it seemed like the Red Cross was unprepared for the onslaught of refugees, even though they knew ahead of time they were coming. 

Well I was watching the news Thursday night as over 100 buses were headed to the Astrodome from New Orleans  and it seemed like all hell was breaking loose. With about 60 people on each bus, that meant that about 6000 people would need to be processed, registered, and settled into the Astrodome. Then I heard that they were also triaging everyone medically too, since so many people on the buses were very sick- so many hadn’t had their medications since the hurricane, hadn’t eaten or drinken anything, had gotten cut or badly hurt in the flood waters, or were simply sick for other reasons. Then, one of the volunteer doctors came on the TV and begged any doctors, nurses, paramedics, PAs, volunteers, etc to come down and help get these people some medical care because they were getting overwhelmed in the ER/clinic they had set up in the AstroHall.

I was only one of about 6 doctors for hundreds of patients, so there was just such a sense of urgency to get these patients seen. So I dusted off my white coat, unpacked my scrubs, and found my stethoscope and drove at 1 am to the Astrodome to help in any way I can. I wasn’t sure what I could do since I don’t have my Texas license yet, but I was willing to hand out Band-Aids if that’s all they’d let me do. I explained my situation to the head MD, and he said since I was a doctor, he didn’t care. They needed help so badly that I saw all my own patients, decided my own treatments, transfers, follow-ups, etc, and just ran it by the attendings if needed. They simply signed off on my charts and prescriptions at the end of the cases, so that I’d be protected in the state of Texas, not that I cared at that point.

Anyway, the patients were so sick. It became routine to see blood sugars over 400 and blood pressures way over 200/100. They hadn’t had their medications for days, along with no food and water. But they were so thankful for the treatment they were getting and were so patient about having to wait so long. They were just so grateful to be in Houston.

I had to hold back tears so many times at how horribly these people had been ravaged by this storm and what it had done to their lives.

My toughest patient of the night was a young man who began seizing in the waiting area -- where he had been waiting for over 12 hours after getting off his bus. He had a grand mal seizure for over 3 minutes, hitting his head hard on the concrete floor when it started. I was the only doctor around at the time, so I had to step up to the challenge. There was no patient chart, no family with him, and no one knew anything about him. His finger stick glucose reading was so high it was off the charts, so we went from there, injecting whatever insulin was available. Then we had to hand hold 2 IV bags wide open while he was still lying on the floor in the waiting room, because we didn’t have enough help to get him up and into a bed yet. Finally we got him into a “room” on a stretcher and he told us that he’s diabetic and epileptic and had been off all his meds since the hurricane. He also hadn’t had anything to eat for 4 days. Since we didn’t have any lab services at that time and our only “EKG” was off of the defibrillator machine, I still had no idea if he was in ketoacidosis or just seizing from his lack of meds. Luckily his sugar came down, he stabilized, and we were able to transfer him to the VA, since we had no Dilantin to load him with, he needed to be ruled out for a possible head injury, and he obviously needed more intensive care. It’s amazing what you can do with so little when you have to. The teamwork and camaraderie around here among the healthcare personnel is awesome, and I think that’s why so much is getting done with so little.

For you orthopods- I also saw a horrible case of tibial osteomyelitis with a draining sinus- the med students were so interested in it. They’re literally seeing things they would only see in a third world country. I had to transfer him to the VA for his pending below knee amputation before he became septic, it was so bad.

The medical set up is pretty impressive and ever evolving. When I got there, it was just a large square area with about 20 curtain rooms, no lab services, no x-rays, no monitors, and very limited medications. The only IV antibiotic was Ancef, which some of you know doesn’t cover the brackish water organisms. There were a few other oral antibiotics, but not many. We had no pain meds, no diuretics (and everyone had edema on their legs!), only a few anti-hypertensives, and one or two types of insulin. There was a free pharmacy that was able to get more home medications, but they had to come back the next morning to pick them up, so who knows if they’ll do it. By the time I returned the following night, it had evolved to where there was an area for each specialty, an xray area, a lab trailer, an area for the ambulances to pull in, fast track and emergent care. And by then there were so many more medications and supplies. I’m so impressed by the way the Harris County Hospital District has handled this. They are really organized and proactive. Most of the medications, supplies, doctors, nurses and other personnel, stretchers, wheelchairs, etc are from Harris County Hospital District so it’s just an amazing effort by these guys to help out in any way they can.

Anyway, I urge everyone just to do whatever you can to help. There’s no way to explain how devastated these people are. But they still have their spirit and dignity and faith.

I included some pics I took. I didn’t take as many as I wanted to, because the people getting off the buses were so fragile. They didn’t need some doc snapping their pic.  The photo here is from inside, where you can see some of the treatment area and the waiting area.

Take care and lots of love. God bless the victims of Hurricane Katrina.

September 6, 2005 in Hurricane Katrina: Nurses and NPs Help | Permalink | Comments (4)