After hurricane, facilities reinstate staff, schedules
After hurricane, facilities reinstate staff, schedules
Hospitals convert to hotels and day cares for staff
(Editor’s note: In this second part of a two-part series on surviving disasters such as Hurricanes Katrina and Rita, we discuss how to overcome challenges involving patients, staff, curfews, and military/police checkpoints. We also discuss how to address damaged supplies and equipment. Additionally, we tell you how one surgery provider’s disaster relief efforts encountered bureaucratic roadblocks. We also share the story of two health care workers who provided outpatient surgery in unusual settings. In last month’s issue, we told you about dramatic moments for outpatient surgery managers during and after the hurricane. We told you how they recovered immediately after the storm, how recovery could have been made easier, and how some surgery programs offered hands-on disaster relief.)
"People are waiting three to four hours for gasoline. The electricity is still off in over half of the city. We are on a boil water alert,’ and it’s hard to find food. . . . I am working 16+ hour shifts here at the hospital. We work and then go find a place to sleep for a few hours . . . To make matters worse, it is like 92 degrees with 100% humidity, and nobody has air conditioning."
This e-mail, from a nurse in Mississippi and posted on a perioperative listserv, shows the desperate situations faced by health care providers after Hurricane Katrina. How do you organize your staff — or even find them — and get your outpatient surgery program ready to reopen after such a devastating disaster? To assist readers in their preparedness for all types of emergencies, Same-Day Surgery interviewed surgery managers on the front lines of Katrina. Here is what they advise for surgery centers and departments that need to regroup and reorganize after a disaster:
• Make arrangements for your staff.
It is difficult to locate staff after a disaster, says Shannon McConnell, CEO at Surgical Specialty Centre Hospital in Baton Rouge, LA. As outlined in her facility’s disaster policy, they developed a hotline that staff called to receive updates about the facility. Also, a call list is updated at the beginning of each year and also when the first tropical storm of the season approaches the Gulf of Mexico.
"Employees are instructed to complete a disaster call tree with all possible contact numbers," she says. "The managers then are responsible for calling, if possible, all numbers to locate staff members in the event of a disaster."
At East Jefferson General Hospital in Metairie, LA, phone lines were down post-hurricane, reports Judy Bauer, RN, CNOR, vice president of nursing for Perioperative and Women and Child Services. Instead, East Jefferson used e-mails and media releases in Houston and Baton Rouge, LA, to contact evacuated staff, she says.
"We shuttled them, from an hour and a half away, outside the hurricane area," she says. Additionally, the hospital used outpatient surgery’s 64 rooms for temporary housing for staff and physicians, Bauer says. Each room has a toilet and a sink, she says. For food, the staff ate meals ready-to-eat (MREs).
In Hattiesburg, "there were no restaurants — not even fast food — so we brought our own food," recalls Karen Odom, RN, director of Lowery A. Woodall Outpatient Surgery Facility.
At River Region Health System in Vicksburg, MS, one of the biggest challenges was finding gasoline for employees, says Angie Baldridge, RN, director of surgical services. "The gasoline problem can be diminished by working with one or two stations close to the facility to reserve one or two pumps for hospital employees and physicians," Baldridge advises. Employees showed their badges to obtain gasoline, she adds.
Other challenges included child care for employees whose regular day care centers were closed. "We opened our own day care and staffed it with volunteers from our staff, their teenage children, and those teenagers who had taken a course in baby-sitting," Baldridge says. The conference rooms served as play rooms, and employees brought toys, books, and videos, she says.
Another obstacle for employees is cashing their paychecks when many banks have been damaged, says McConnell. In Baton Rouge, a local banker worked with the hospital, she says. "A specific time, branch, and teller were designated to allow groups of employees to go and cash checks fairly rapidly," McConnell says.
• Make arrangements for your patients.
When East Jefferson was ready to resume outpatient surgery, it faced a challenge. "We had the hardest time contacting the community to tell them we were here to assist them," Bauer says.
The hospital used the media outlets to relay the message that the hospital had a contact number for patients, McConnell reports. "We staffed it 24/7."
When patients called, the staff members recorded their contact numbers and then tried to contact the patient’s physician, Bauer says. For cases that the hospital was ready to provide and that the physician was ready to perform, the staff contacted the patient and made arrangements.
Because no one was being allowed into Metairie, the hospital faxed and e-mailed copies of a note on hospital letterhead saying that the patients were coming to the hospital for surgery. This letter allowed them to pass through military and police checkpoints, she reports. Additionally, the hospital CEO worked with state and federal officials to obtain approval for patients to proceed through checkpoints. The hospital set up shuttles in cities outside of Metairie to ferry patients without transportation to the hospital for surgery, Bauer adds.
• Adjust your schedules to meet disaster relief needs and curfews.
When Surgical Specialty Centre Hospital reopened, it initially performed elective surgeries only in the morning. In the afternoons, employees and medical staff volunteered at shelters where they triaged patients and handed out supplies, says McConnell. Members of the clinical staff were paid by the hospital for hours worked at the shelters during their normal shifts, but many stayed long after their shift ended and worked as volunteers, she says.
"In some cases, staff and medical staff members had no electricity, drove in dangerous road conditions, or even left family members to help assist patients," McConnell says. "They were all very tired, but kept returning every day to volunteer."
Metairie had a curfew that affected the surgery criteria and schedule, Bauer says. Patients had to be discharged and out of the hospital by 5 p.m. "The city got locked down by 6 p.m.," she reports. Additionally, patients had to have housing and transportation available, Bauer adds.
"Our criteria that we set up were ones with which we knew we could provide care safely," she says. "If not, then we weren’t going to put them in jeopardy."
The facility scheduled "lumps and bumps" procedures for the end of the day, Bauer says. "We had to close the schedule by 2:30 so recovery was appropriate and people could get out of here. We were normally a 24-hour stay, so we really had to modify what we represented to our community."
In this second part of a two-part series on surviving disasters such as Hurricanes Katrina and Rita, we discuss how to overcome challenges involving patients, staff, curfews, and military/police checkpoints.Subscribe Now for Access
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