MaleNurseMagazine.com
Team Hope Project
Report on Hurricane Katrina Response
By: Jerry R Lucas RN
Date: September 13th, 2005
This program has been put together so people may understand what I and my team done while working in areas of Ocean Springs, Pass Christian, Long Beach, Biloxi, and Gulfport. My team was not a group that FEMA (Federal Emergency Management Agency) or MEMA (Mississippi Emergency Management Agency) made up or put together, it was 3 Nurses, 1 Medic and a driver.
Although I did come down from the Mississippi Board of Health and I was invited there by the Board of Nursing for the State of Mississippi once on the ground in the disaster area I was on my own to work in areas as needed. A quick survey of Ocean Springs and one could not see much, it was late at night and on the 7th day of September some power in that area was on. I found a driver and asked him to take me into Biloxi to see what I could do to help in that area.
I was issued a tag in Jackson Mississippi at the logistics center to gain access to any area in which I might need to work. I quickly found that the residents of the Historic Biloxi need more of a door to door, house to house, person to person plan of care. The Federal and State governments had completed most of the search and rescue, yet there were still people that need much more care and support this would be the mission that I would take on.
Background
My back ground has been mostly in Emergency Medicine and supervision. I served as a 91B Combat Medic, 91C Nurse Specialist, and 91P X-Ray Specialist in the United States Army and Indiana National Guard.
Operational experience and training
Ground Zero September 2001
Hurricane Katrina September 2005
Associate of Science in Nursing, Indiana University
Certificate of Completion Vocational Nursing, St. Philips College
Combat Medic, Academy of Health Science
X-Ray Specialist, Academy of Health Science
Emergency Management Institute (EMI)
IS-1 Emergency Program Manager
IS-240 Leadership & Influence
IS-241 Decision making & Problem Solving
IS-242 Effective Communication
IS-275 Role of Emergency Operations Center
Emergency Response Terrorism: Tactical Considerations: Emergency Medical Services
Certifications
ACLS (Advanced Cardiac Life Support)
Breath Alcohol Technician
CPR/BLS Instructor
Haz/Mat First Responder
Indiana Registered Nurse
Kentucky Registered Nurse
PALS (Pediatric Advanced Life Support)
PALS Instructor
Trauma Nursing Core Course
Operational Phase
What is the operation phase? This question must be known and answered to understand what help we are going to need to give. In the Federal level and even at the State and local level there should be plans that can be put into place to cover any disaster. After this current event we must all now look over the plans in place and wonder if we have covered all the options.
Actions are taken in four phases in emergency management.
Mitigation: Refers to activities which actually eliminate or reduce the chance of occurrence or the effects of a disaster
Preparedness: Is planning how to respond in the case an emergency or disaster occurs and working to increase resources available to respond effectively.
Response: Is the next phase of emergency management. Response activities occur during and immediately following a disaster. They are designed to provide emergency assistance to victims of the event and reduce the likelihood of secondary damage
Recover: Is the final phase of the emergency management cycle. Recovery continues until all systems return to normal, or near normal. Short- term recovery returns vital life support systems to minimum operating standards. Long-term recovery from a disaster may go on for years.
Now that you have some back ground of how Federal, State and local governments for a disaster I will try to break down the “what happened”, and “what went wrong” scenario.
Plans are only good for the module in which they are cast. In the event of a total break down of all services what would we do? It is not factored into plans that when your first line of response is gone then what. As we have seen in the aftermath of hurricane Katrina we not only lost lives but, all semblances of humanity. The basic break down of all services and the lack of proper treatment was at the very heart of the problem.
At this point I would like to return to the Response Phase. Remember, that in this phase we wanted to give immediate clear and direct care to the problem to lessen the possibility of secondary damage. I can not speak to the events on the ground in the State of Louisiana, so I will just be covering the events on the ground in Mississippi and my team’s response to that.
The team that was made up of three nurses, 1 medic and a driver we named “Team Hope”. I felt that we would try our best to give hope and try to fill that little hole between the search and rescue and recovery. It is important to understand that make up of our team again most did not belong to any agency they came on there own at there cost. They came wanting to help in any way they could but, again the big agencies could not direct them where to go or what really to do.
Team Hope
1: Bob Hillebrand (driver) Charlotte, NC
2: Dennis Blocker II (Medic) San Antonio, TX
3: Amy Davis RN (Nurse) Indianapolis, IN
4: Judy Bringard LPN (Nurse) St Joe Beach, FL
5: Erin Workman RN (Nurse) Bates, OR
6: Jerry Lucas RN (Nurse) Deputy, IN
This is the team and with a quick look you can tell that we had people from all over the state. We started our mission each day with a team briefing about safety and what we need to do while down town. The rules are simple no one went into a home alone. No one could leave the group with out a partner and even if you were are so mad you can see straight keep it to yourself until we get back to base camp. We moved from street to street and house to house look at patient care. We saw many different wounds from open laceration, fractures, bad blood pressures and blood sugars.
The Federal government had DMAT teams (Disaster Medical Assistant Teams) that where staged outside of the areas that were hit by the storm. This is the first mistake made, because most in these areas felt left behind. They had no cars and no way to get to the medical care need. They lost their medication along with their homes. The radio told most in the effected area that if they took the old medicine bottles to the pharmacies they could get a 7 day supply of medicine. Again another mistake as most had no way of getting to the pharmacies.
My first plan for this:
That we should have a mobile pharmacies that can role into an area in which a team of health care workers can go right to in order to fill on the spot. This was covered under response phase to lesion the possibility of secondary damage.
That if DMAT is in use it must be closer to the action and must have teams made up to follow up each day as some will not leave where they are. They must know that each day we will be there to follow up with them right up to the recovery phase. Lack of this will strain the medical facilities in that area and cause undo stress for the public.
That all the hospital in the United States should encourage staff to get involved in teams of first strike help. The teams should be able to move into an area see patients door to door even if they are not hurt. The question will be asked about EMS and its response. Some would say that this will just get in the way of EMS. NO if you treat right on the spot with train personal only the critical will reach the area emergency rooms. This will lesson secondary damage.
The team and I worked are ways up and down the cost in a constant movement. We would follow up each day with those we seen the night before and we would find more that need care. Again we had a failure of basic services. EMS had been over run, 911 was down no power and no water. It was better to treat them in the street then to try and move them to a hospital or DMAT center. This also gave them hope that they where not forgotten.
Central supplying was an issue because there where supply points outside the city and some small ones in side the city yet; no one had a way to get to the supplies. We found a trailer and took supplies with us water, MRES, juice, food of many different kinds, baby food, diapers, and much more. It was the little things that give hope to all.
A young boy asked about a bucket of candy we had. He wanted to know if he could have some. I said yes and we started to give it out. The young boy asked how much it cost and I said it was free. He said that was good because all their money was gone or wet. Response to this is so very important to keep the mental health of not only the adults but, the young.
Another man by the name of Ralph Cook a resident that told me I could tell his story said that at the height of the storm he had to swim his two sisters out of there home and onto the roof. His father who was an amputee also had to be saved. Mr. Cook said that he could hear the screams of his friends that lived on his block. Each day we returned to talk with this man because we felt he needed to release what he had seen and done. He needs to know that life would return to normal.
Supply to these people was very important. Each day we would go over our list to see if we could get what was requested. I remember walking up a street and kids screaming “mommy the medical man is back” sitting on the porch or standing there talking about there needs and each time that said they where blessed because we were there. They had nothing yet they felt blessed we where there. We had a central spot right down town called the “Heart Break Hotel” some old veterans put up this sign and we found it a good place to drop supplies. We also made this an area to see patients. As people came by the men that stayed here would tell them that we where coming. So it became a central spot for us as we moved through the city.
Time to move out of the response phase and how do you know that it is time. The team and I seen more supplies moving into the city. We started to see people needing less from us. Then a church group stopped at the heart break and asked us if we want a hot meal. I look at the team and asked if we really look that bad. More of the groups of volunteers where pouring in and soon they will over run the city.
What we have learned
One can not walk away from this not touched. Black white good or bad part of town in any town USA if you treat people as a human being they will accept you for what you are.
The State Board of Nursing in each state should develop teams of nurses not just MSN, PhDs that can tell you what data says but, nurses that feel the need to work in these hard hit areas. The team should be outside of any DMAT control and that list of nurses should be shared with each state. The team should be ready to move into an area with little to no basic services and treat on the spot. Doctors are not part of this as it can slow you in the field and it will. Keep it simple stupid (kiss).
Each team would be given a grid or square blocks and your job is to treat this area for up to 2 weeks. Each team would also need a medic supplies are simple and should not be overlooked. Any case that needs to be sent out of the area can be done.
Pharmacies should be mobile so that any team in an area could fill a prescription on the spot. Again these people may not have the means to get to you so we most get to them with everything we can.
Training is important but, we have lost the importance of the human touch. We must not forget that people react to what we do. Shake a hand, hold a hand, do not look down at me but, offer me your hand up. The color of a person is not what they are made of I have felt nothing but, love a kindness from those hit in this disaster. Each time I want to sleep I heard thank you for what you are doing. The question of where are the Red Cross and FEMA came and went. Each time a person said “we are blessed to have you” and god really blessed us because you are here” well for must of my team as with me we waited to get in the trucks and cried.
As with anything understand that we must look for the one thing we have not planed for. It is important for us to remember us teams of people that know what works because they have been there. When you sit in a seat some where and ready a report it will not show you what was seen. Be very flexible on your time table it could take a week or 2 days but, people need you door to door as this will decrease there stress.
