In the months since Superstorm Sandy struck the New York/New Jersey metropolitan area, hospital staff members have worked feverishly either to return to serving patients or to adjust to a lengthy surge in ED visits and admissions.
“It has to be one of the most challenging experiences I have had in my career, but it is also one of the most satisfying to see what people can do,” said Cynthia Caroselli, RN, PhD, associate director for patient services and CNE at the VA New York Harbor Healthcare System. “Our staff stepped it up and did what was needed to take care of our patients, and I am grateful for that.”
Staff safely evacuated about 100 patients at the Manhattan VA campus to other VA facilities before the late October storm. The basement and subbasement flooded, causing catastrophic failure of all the major utility systems and damage to clinic space and an MRI unit.
The VA has stationed physicians, pharmacists, social workers and other staff in the lobby to assist patients and triage needs, and it is providing some care in mobile vans. It also has opened a unit at its Queens extended care facility, as well as additional dialysis, inpatient and psychiatric units in Brooklyn.Mary Walsh, RN
“There has been a tremendous effort to transform every bit of usable space at the Brooklyn campus,” Caroselli said. Manhattan VA nurses have dispersed to wherever they were needed within the VA system.
Crews are repairing 150,000 square feet of flood-damaged space at the Manhattan facility. “We are taking it a day at a time, and we are making wonderful progress,” Caroselli said. “There is an incredible amount of work going on.”
Caroselli hopes to begin outpatient services at the Manhattan campus in March, but no date has been set for an inpatient care reopening. No cost estimates were available.
Working together for a common goal also has paid off at Coney Island Hospital in Brooklyn, a New York City Health and Hospitals Corp. facility.
“The teamwork this staff did during and after the storm is nothing less than miraculous,” said Terry Mancher, RN, who serves as CNO and deputy executive director at Coney Island. “There is nothing I could be more proud of than the staff working together.”
Before the storm, Coney Island had transferred ventilated patients, and nurses prepared information packets with medications for the rest of the patients. HHC president Alan D. Aviles rode out the storm at Coney Island, a boost for staff morale, Mancher said. As Sandy came ashore, water surged into the hospitals ED. The facility lost power when water rose so high — nearly 15 feet — that it threatened backup generators. Nurses stayed one-on-one with each critical care patient.Cynthia Caroselli, RN
The next morning, with the basement flooded — knocking out dietary, laboratory and other services — the hospital safely evacuated more than 200 patients.
“Our main building was shot, so we could not maintain our inpatients,” said Mancher, who credits the smooth response to a previous evacuation in preparation for Hurricane Irene.
Coney Island first reopened outpatient, urgent care, pharmacy and behavioral health services. It hoped to begin admitting inpatients this month. In addition, two mobile medical vans are serving the community. Construction crews tore out wet drywall and removed floor tiles and ceiling panels, which could hold in moisture.
“Its the cleanup and electrical,” Mancher said. “You cannot let anyone in until its absolutely safe.”
Coney Island redeployed its nurses to other hospitals, primarily Kings County and Woodhull hospitals. Both Brooklyn HHC facilities had received some Coney Island patients. “It took a lot of coordination to know where everyone went,” Mancher said.
HHCs Bellevue Hospital Center evacuated 715 patients after 17 million gallons of seawater flooded the 180,000-square-foot basement and damaged more than 200 pieces of electrical, communication, heating and air conditioning equipment, along with emergency fuel pump equipment needed to keep the facility running.
Bellevue is offering nonemergency ambulatory care and pharmacy services and expects to resume operations in February.
The New York City Council has approved $300 million in repairs to HHC hospitals, according to HHC spokesman Ian Michaels, but total repair costs are anticipated at more than that. HHC also will assess how to make its facilities less vulnerable to future storms.
Facility hardening also is a priority at NYU Langone Medical Center in Manhattan, which suffered more than $1 billion in damages, including the loss of four MRI units, a gamma knife and a linear accelerator, and safely evacuated 322 patients.
NYU Langone reopened in January. Robert I. Grossman, MD, dean and CEO at NYU Langone, said he credited the perseverance, resilience and grit of faculty, staff and students.
“Sandy was devastating but presented us with a unique opportunity to come back stronger, better, more efficient and more patient centered than ever,” Grossman said at a recent news conference.
The majority of NYU Langone nurses worked at other facilities in the region while the hospital was closed or were redeployed to NYUs ambulatory sites, spokesman Craig Andrews said.
With a number of hospitals out of service after Sandy, other hospitals have experienced increases in patient volume.
Some NYU nurses went to Beth Israel Medical Center in Manhattan to care for NYUs transferred cardiac surgery patients. But with NYU reopening, those nurses have left, said Mary Walsh, RN, MSN, NEA-BC, vice president of patient care services and CNO at Beth Israel.
“We have really felt the pressure in the emergency room and in medicine,” Walsh said. “Our nurses have risen to the occasion and welcomed this new volume of patients.”
Beth Israel Medical Center has cared for more than 400 ED patients daily since the storm. The hospital has brought in per diem and travel nurses to supplement its staff, which has worked many overtime hours. It converted a chemical dependency rehabilitation unit to a medical floor to handle the influx and retrained nurses.
“Its been rewarding,” Walsh said. “I am humbled to work with our nurses. They are great.”
Beth Israel Brooklyn also has received an influx of patients and has had difficulty discharging patients requiring long-term care, since seven area nursing homes have closed, two with ventilator units, said Marguerite Corda, RN, MSN, vice president of patient care services at Beth Israel Brooklyn. The hospital has brought in travel nurses to handle the additional volume and ordered more food, linen and other supplies.
“Were still surging with patients,” Corda said. “Its been a wonderful team effort. Everyone has been pulling together.”
Debra Anscombe Wood, RN, is a freelance writer.
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