On the afternoon of Nov. 5, the patients in the ED at Scott & White Hospital in Temple, Texas, streamed in at a normally fast pace, and nurses worked quickly, yet calmly, to care for them that is, until reports began pouring in about the shooting at Fort Hood in Texas 26 miles away. Nurses and other staff quickly learned they would be called to care for victims cut down by what turned out to be a lone gunman alleged assailant Maj. Nadal Malik Hassan, an Army psychiatrist, who was taken to Brooke Army Medical Center in San Antonio, where he received treatment for his gunshot wounds. Ten of the victims (13 dead, 30 wounded) arrived within a span of an hour and a half via helicopter and ambulance, putting Scott & White nurses, and other staff members, and its mass casualty plan to the test.
The call came in from Emergency Medical Services just before 2 p.m. that Scott & White, the closest level 1 trauma center to the Army base, would be receiving multiple shooting victims from Fort Hood. Soon, the hospitals mass-casualty plan was activated. Shocked that the tragedy could happen so close to home, Sicily Reed, RN, BSN, MHA, director of the ED, prepared to receive victims. Since the ED was full, we formed a triage team to provide medical screening exams for any of our lower-acuity patients.
Reed says hospital administrators and safety directors utilized the emegency management contact list and paged all inpatient nursing leaders to transport ED patients who were given bed assignments. The nursing staff quickly worked on clearing admissions out of the six trauma bays in the ED, she says. Im very proud of the staff. They are well trained; this is what they do every day. In such a tough situation, we just had to do our everyday jobs on a much larger scale.Scott & White Hospital ED nurses (Back row-from left) Christa DeLa Garza and Melissa Saltzer. (Front row-from left) Rachel Barber, Angela Gentry, and Teresa Drake.
As part of the plan, Reed requested help from the security department to ready the ED for the onslaught of law enforcement, media, family members, curious onlookers, and concerned members of the community who might converge on the hospital. The hospital also was locked down, which strictly limits access to hospital and clinic entrances in order to secure the 500-bed facility and large clinic area.
It was amazing to see how quickly we could move, Lindsey Stonebrook, RN, BSN, CACP-SANE, ED charge nurse, says. There were many unknowns, but you had to be ready. The first helicopter that landed with a patient made it all real.
Stonebrook was responsible for helping to organize the flow of care and making sure everyone knew what his or her role was. We were ready; our drills helped prepare us for anything, she says. We didnt have time to stop and think, but instead did what comes naturally to us [as nurses]. That day reconfirmed my decision to be a nurse.
Stonebrooks fiancé, a sergeant in the 1st Calvary Division, was on post at Fort Hood that day. After we had received our last patient from the shooting, I finally heard from my fiancé letting me know he was OK, she says. My heart goes out to all the families who were affected by this tragedy.
Angela Gentry, RN, staff nurse, provided hands-on care to two critical shooting victims. Thats the hardest Ive ever worked on a patient and as part of a trauma resuscitation team, Gentry says. Administrative and nonmedical staff brought supplies to those of working on patients. When something like this happens, it gives you a sinking feeling in the pit of your stomach. I was proud to be at work that day, and would not have wanted to be anywhere else.
Jessica Richter, RN, CEN, ED charge nurse and unit educator, was having a lightning-paced, break-time baby shower for a co-worker when the mass casualty call came in. Adrenaline is something ED nurses dont experience often because we do this type of work every day, but I felt it that day, she says. Waiting for patients was agony. We just wanted to get them in here and take care of them.
Ive been a nurse for 9 1/2 years, and Ive never been involved in a mass casualty, Richter says. This was something I worried about after 9/11 and working so close to an Army base. But one thing that sticks out in my mind is how well our team pulled together to care for the people who fight to protect our country. It was an honor to have that opportunity.
Reed, Richter, Gentry, and Stonebrook all speak with great admiration about the teamwork at Scott & White including physicians, EMS personnel, chaplains, and members of the security and maintenance departments, among others but also about the reaction of the surrounding community. We had a lot of people coming to the facility offering to donate blood, including community members and staff, Reed says. Its a very tragic, sad event that occurred, but I was so proud of how the staff treated these victims.
Editors note: Scott & Whites Project HomeFront provides counseling to Iraq and Afghanistan veterans and will provide critical incident stress management and counseling for families, first responders, hospital workers, and military personnel affected by the tragedy at Fort Hood. To donate to the project, visit www.sw.org.