The 9/11 terrorist attacks forever changed America. In the years that followed, events such as Hurricane Katrina, the H1N1 pandemic and more recently, the May tornado that struck Joplin, Mo., and Hurricane Irene on the East Coast, have tested the healthcare community’s ability to care for patients during a major emergency.
As New England area RNs reflect on the 10th anniversary of 9/11, Nurse.com Nursing Spectrum asked them how the attacks impacted jobs and disaster preparedness roles at their facilities. Findings indicate that disaster preparedness, whether the event is natural or man-made, is something that always has been at the forefront for nurses.Barbara Spodnick, RN
Barbara Spodnick, RN, MSN, CCRN
Bedflow/RSU Manager • Bridgeport (Conn.) Hospital
“The events of 9/11 have changed our lives in ways that are now so ingrained that being asked to identify them is a daunting task. While hospitals have always had emergency and disaster plans, the plans are more comprehensive and include other area hospitals and local agencies. Emergency Preparedness drills are regularly held and specific scenarios are presented and responded to by the team. All staff are educated with an online course, Emergency Management.
Always a major Trauma center including the only Burn Center between NYC and Boston Bridgeport Hospital has been poised to handle any natural or man-made disaster. In the years following 9/11, Bridgeport Hospital has focused on the need for both immediate and long term support in the event of widespread devastation. Our plans not only include housing citizens impacted by disaster, but children of employees and even their family pets should no one be at home to care for them.
As Bedflow Manager, my role during a disaster is to review bed availability including patients who can be discharged home, the number of available beds including pediatrics, med/surg, telemetry and ICU. Plans to sustain adequate staffing levels and planning for their rest, meals and sleeping accommodations are also assessed. Interestingly, last year we were planning a drill to assure competency and critique the process when a tornado struck Bridgeport within a mile of our hospital necessitating the activation of the emergency operation plan negating the need for the scheduled drill. Our team was well prepared and performed like a well-oiled machine as a result of our regularly scheduled mock drills. The damages to local structures were extensive and the victims we received did not sustain life- threatening injuries. Our hospital was well-staffed in addition to unscheduled staff who called in to check if their services were needed. I was especially proud to be a part of the team that day.”Patti LaMonica, RN
Patti LaMonica, RN, MSN
Director of emergency and clinical support services • Saint Francis Hospital and Medical Center, Hartford, Conn.
“9/11 has changed the way our entire country views the world, including how hospitals prepare for a disaster. At Saint Francis Hospital and Medical Center, staff have become more actively involved in disaster preparedness through planning, training and drilling for disasters, including acts of terrorism. We provide leadership to the region by participating and chairing the Capitol Region Emergency Planning Committee. Federal grant money has also helped fund consultants who assist us with planning and drilling, along with the purchase of emergency preparedness equipment. One area we focused on was the ability of our ED staff to utilize specialized emergency equipment, such as respirators, with expertise, even though this equipment is typically used infrequently and only in unique situations such as with mass decontamination. We also expanded the role of one of our ED technicians, primarily responsible for overall stock and equipment in the ED, to help lead our EDTs in becoming the primary providers of decontamination at our facility. EDTs now assist the EMS coordinator in providing regular training to staff on use of the equipment, along with oversight of its storage and maintenance. With the addition of the new Emergency Department in the 10-story John T. O’Connell Tower, we have added a mass decontamination unit that has the ability to provide decontamination for up to 100 patients an hour. This includes a separate entrance into the department, enhancing the ability to care for victims of disaster.”
Jeanette Ives Erickson, RN, DNP, FAAN
Senior vice president for patient care and chief nurse • Massachusetts General Hospital, Boston
“Massachusetts General Hospital made a variety of key changes post 9/11 that were connected to our mission of serving local and international communities. We restructured our Emergency Preparedness program, adding a manager to help streamline hospital-wide evacuation, hazmat, disaster response, and overall mass-casualty planning. A new hazmat coordinator manages and trains a 90-person interdepartmental team to ensure our ability to perform decontamination following a large-scale disaster, treating those who’ve been exposed, and protecting facilities and clinicians to ensure uninterrupted care delivery. We expanded our chaplaincy staff, both in numbers and diversity to better respond to spiritual needs caused by an unexpected disaster. Chaplains also train as first responders. The MGH Center for Global Health was an outgrowth of our response both to 9/11 and various international disasters. Its mission is to provide leadership and support to reduce health disparities for the world’s most vulnerable and crisis-affected populations through education, research and service. Mass General’s history of providing post-catastrophe medical care uniquely positions us to rapidly respond to health and humanitarian emergencies globally. The center is committed to expanding that capacity and defining the ‘science’ of disaster response.”
Scott Brennan, RN, BSN
Clinical educator, ED • St. Vincent’s Medical Center, Bridgeport, Conn.
“St. Vincent’s Medical Center’s existing disaster planning efforts was formalized into our Emergency Preparations Committee after Sept. 11, 2001. Representatives from across our organization assess and evaluate both internal and external hazards and vulnerabilities, create or update our emergency plans to address those hazards, and routinely organize disaster drills to test these plans. While we have not added jobs or titles, we have broadened the responsibilities of all committee members and all front line nurses. Disaster preparedness was major focus in the design of our new Emergency Department expansion. Our facility now has a large fixed patient decontamination system, six negative pressure isolation rooms, and surge areas for increased patient capacity. We have utilized emergency preparedness grants to purchase disaster equipment such as ventilators, personal protective equipment, and various medical supplies. We have received very valuable training in disaster response and management, reorganizing our plans to utilize the Hospital Incident Command System, a national standard that complies with the National Incident Management System, which was federally mandated after 9/11. Perhaps the best example of how we changed since 9/11, is the relationships we have established with other hospitals, public safety and other response partners to plan prepare and drill for disasters. This in itself allows for our organization to continually test, evaluate, and share knowledge in disaster preparedness.”
Deborah L. Smith, RN, BSN
Manager, clinical services • Yale New Haven Center for Emergency Preparedness and Disaster Response, New Haven, Conn.
“In the wake of 9/11, the Yale New Haven Health System established the Center for Emergency Preparedness and Disaster Response (CEPDR) to address the new and evolving emergency preparedness policies and guidance established by federal government. Upon CEPDR opening its doors, the department consisted of five staff members with a single nurse hired into the new position of Clinical Education Coordinator. Since that time, YNH’s CEPDR has evolved into a Center of Excellence for CT’s Department of Public Health, teamed with the Department of Defense for integrated civilian military emergency preparedness and has been named a collaborating Center for Emergency Preparedness by the World Health Organization with more than 45 staff, including six nurses. The nurses within the department provide expertise in state and national healthcare emergency response planning, education and evaluation of drills and exercises. As CEPDR continues to develop, the role of nursing continues to evolve, providing greater opportunities to expand their knowledge and expertise.”