When a strong storm blew ashore on the northern Oregon coast in early December, it snapped trees, cut off power to more than a million homes, sent floodwaters pouring into communities and left serious damage in three counties. Hundreds of people were plucked from their rooftops by helicopter rescue teams, at least seven people were killed, and the latest estimates on the damage are $145 million.
In times of crisis, community hospitals serve as beacons of hope. The doctors, nurses and medical personnel that work in these hospitals are most needed when times are at their worst. A solid emergency plan and a highly-prepared staff made one hospital stand tall.
Disaster Plan in Action
Winter storms are common in the northwest but it isnt everyday that hurricane-force winds batter the area. The storm, which battered coastal Washington and Oregon on Dec. 2 and 3, had recorded wind speeds of up to 81 miles per hour and dumped more than five inches of rain in part of the region.
When the storm roared ashore, the 140-bed Grays Harbor Community Hospital in Aberdeen, Ore., was virtually cut off from the outside world. High winds downed power lines, shutting off electricity to thousands, and blew trees over onto roadways, blocking all ways in and out of the community. Traffic was ground to a halt, gas stations were unable to pump gas and most landline phones became inoperable.
At one point, the city of Aberdeen was totally isolated except for the emergency crews that were able to cut their way through. All of the roads in and out of town were blocked by fallen trees and power lines, said Dori Unterseher, RN, director of emergency, critical care and ambulatory infusion services.
The hospitals emergency generators kicked into action and the facility went into a Code 3 disaster mode that initiated lockdown procedures to maintain safety and security for the patients and staff that were there. Activated on Dec. 3, the Hospital Incident Command System called for the closing of non-essential and non-patient care departments, shifting those staff to other parts of the hospital.
While there are many dangers to be encountered during a storm itself, many injuries and accidents occur immediately after the event and hospitals can see a surge of patients once the winds subside. Unterseher said that the hospital had one fatality arrive when a man was hit by a falling tree in a neighbors yard. Other admissions to the ER included two men that were pinned and crushed in their wrecker by a falling tree.
On Dec. 5, a surge of 21 people flowed into the emergency room to be treated for carbon monoxide poisoning they got from generator fumes in a nearby grocery store. While Grays Harbors emergency department has only 19 beds, they were treating 42 patients at one point.
All of our beds were full and we received an additional 20 patients within a short period of time. It was tough but we felt that we were well-prepared to take care of our staff and patients, said Unterseher.
Preparation: The Key to Success
While most people on the Oregon coast didnt know a powerful storm was blowing their way in early December, Grays Harbor Community Hospital was prepared. They had drilled for disasters numerous times during the year, revised their disaster plan and prepared for worse-case scenarios.
Nancy Davis, senior vice president and chief nursing officer of Ochsner Health System in New Orleans, had even come to speak to hospital administrators just two weeks before about her experiences during Hurricane Katrina. Although hurricanes can be charted from thousands of miles away and usually give advance notice, the disasters facing the northwest can strike without warning.
Grays Harbor Director of Education Judy Rocquin, RN, fell into the role of incident commander during part of the week. Serving as a point person between various areas and departments of the hospital, she kept an open line of communications with county officials to see what was going on outside of the area.
Overseeing the security of the buildings and organizing human and supply resources, Rocquin said she was inspired by the acronym that Nancy Davis had used just two weeks before YOYO: youre on your own.
We had to figure out how we were going to manage should we not be able to get supplies and not immediately have the resources we were going to need. You always drill for the what if and it had really come, said Rocquin. We were very well prepared.
Along with a sufficient level of supplies, an effective emergency disaster plan includes ensuring alternate means of communication, the establishment of a command center and the direction of personnel to critical operations. For many hospitals, an emergency disaster plan also calls for the housing of employees and often, their families. Hospital spokesperson Linda Brown said that because gas wasnt readily available and because many roads were blocked, a large number of employees stayed at the hospital for a few days.
A lot of staff also didnt have power at home so we set up a shelter on our east campus where they could spend the night and have a hot shower, said Brown.
A Collaborative Effort
When disaster strikes a small hospital, the lines between roles and job duties can quickly blur as the need for any available manpower becomes critical. Clerks might be called to transport patients, nurses to answer phones and cleaning staff to direct visitors throughout the facility. Brown, who usually spends most of her time dealing with the media and communications, also fell into other roles to lend a hand.
We all did a lot of everything. It was a real eye opener for a lot of us who arent in the trenches like the nursing people are. I talked to a couple of people who were in accounting and pulled a shift in the ER. It was a terrible experience but one that was valuable for all of us, said Brown.
Unterseher said that one of the nurse practitioners manned a separate phone just to answer some of the questions that people were calling in with. An ER physician gave prescription orders to people who were looking to get them filled and some people were even allowed to come into the hospital to charge their cell phones. Unterseher said that times like these let hospitals and medical workers directly see what their profession is all about.
Our mission here is to provide care and compassion to the community that we serve and [this event] really reaffirmed our real mission. It was a terrible disaster but we really saw how everyone could come together, said Unterseher.
December Disaster of 2007
The storm has yet to be officially named but many Oregon residents are pegging it the December Disaster of 2007. When the National Weather Services station at Hoquiam lost power and the wind gauge went out, winds were roaring at 81 miles per hour with gusts of well over 100 miles per hour. Many residents say it was the worst storm to hit the region since 1962.