It was with relief that NuHealth survived Hurricane Irene in 2011-the storm of the century had grazed but not injured our health system, and we felt comfortable that we had another 100 years before a similar storm came by. OOOPS!!!
Friday, October 26 was the day our Sandy journey began. We spoke with the leadership at Long Beach Medical Center (LBMC) and agreed that, like the year before, we would partner on evacuating the hospital and affiliated nursing home. Saturday was preparation day; their team faxed over face sheets with patient information and prepared transfer notes including the medical, pharmacologic, nursing and other issues being addressed during the hospitalization. Our team worked on the challenge of accepting 55 acute care and 35 nursing home patients-staffing, beds, food, medications, and facility support. The 20 patients from the inpatient psychiatric ward required the opening of a previously closed unit.
Sunday was transfer day; patients were transported by LBMC staff and were met near their entrance point by a triage team consisting of the chief medical residents, a hospitalist, psychiatrists and nursing staff. They reviewed patient records, assessed medication regimens, and facilitated the admissions process. Over a period of 6-8 hours these patients were integrated into our hospital. At the same time, 35 patients were received at our extended care facility (A Holly Patterson or AHP) and, because their close to 100% census, admitted to a redesigned auditorium. And then, we waited for the storm.
Despite the dangerous winds and rain, our physical plants endured; electricity was never lost and there was no need for generator power. Around us, however, communities were destroyed; patients suddenly had no access to pharmacies, medications and primary care physicians. At the same time, our staff was dealing with loss of homes, electricity and family concerns. Each shift challenged us to identify how many employees were unable to come in because of floods, blocked roads, or family emergencies.
The hospital’s baseline inpatient census is usually 385-390 and our usual stress point is at 410-420—in days we had surged to 560 patients. AHP went from a full census of 579 to 630. In addition to the opening of the previously closed psychiatric unit, a med-surg that was being refurbished had construction halted and was reactivated and rooms on a former patient floor that were now being used for resident sleeping quarters were reopened for patient use. In the days after the storm there was a marked increase in trauma related to the cleanup of debris and fallen trees, and carbon monoxide poisoning cases related to the incorrect use of portable heaters.
It was a stressful time for the direct patient care staff as well as pharmacy, facilities, social service, human resources, nutrition, and everyone else. Towards the end of week one, with our staff overworked, under rested, and exhausted, we received support from the Federal Government in the form of a Disaster Management Assistance Team (DMAT) with fifty health care professionals (physicians, nurses, paramedics, x-ray technicians and pharmacists) from Texas, Ohio and Kentucky.. Although the usual model for the DMAT team is to work in tents outside the hospital, we decided to imbed them among our staff. The plan worked to perfection and unbelievable and the feedback from our staff and the DMAT team were extraordinarily positive.
38 of our own staff lost housing while others needed child care, food, and a variety of support, while continuing to care for our patients. We were able to arrange for on campus housing for them in unoccupied resident apartments. One individual, unable to come by car, walked from Freeport to East Meadow to care for her patients. An unanticipated problem was the development of a gas shortage which made it difficult for our employees to get to work. We were fortunate to receive an offer from the owner of a local gas station (a happy former patient) to allow NuHealth employees to have their own line at the station.
By November 15 we had stepped down to 450 patients. We still have a number of patients for whom no housing is available, or whose family was severely affected by storm and cannot take them into their house.
The staff at NuHealth deserves to be recognized for their performance. Safe patient care was provided continuously, people worked as partners and teammates, and morale was high throughout the event. We took care of our colleagues whose lives were turned upside down by the storm, and emerged as a healthy and proud health care system.