We were relieved NuHealth survived Hurricane Irene in 2011 – the “storm of the century” had grazed, but not injured, our health system, and we felt confident that we had another 100 years until a similar storm came by. Oops!
Friday, Oct. 26, was the day our Sandy journey began. We spoke with the leadership at Long Beach Medical Center (LBMC) and agreed that, like the year before, we would partner on evacuating the hospital and affiliated nursing home. Saturday was preparation day. Their team faxed over face sheets with patient information and prepared transfer notes, including medical, pharmacologic, nursing, and other issues related to the hospitalizations. Our team worked on the challenge of accepting 55 acute care and 35 nursing home patients: staffing, beds, food, medications, and facility support. The 20 patients from the inpatient psychiatric ward required the opening of a previously closed unit.
Sunday was transfer day. LBMC staff transported patients and a triage team – chief medical residents, a hospitalist, psychiatrists and nursing staff – met them near their entrance point. They reviewed patient records, assessed medication regimens, and facilitated the admissions process. Over a period of 6 to 8 hours, these patients were integrated into our hospital. At the same time, our extended care facility, A. Holly Patterson (AHP) took in 35 patients and, because it was close to 100 percent census, admitted them to a redesigned auditorium. And then, we waited for the storm.
Despite the dangerous winds and rain, our physical plants endured; we never lost electricity and, therefore, didn’t need generator power. Around us, however, communities were destroyed. Patients suddenly lost access to pharmacies, medication and primary care physicians. At the same time, our staff faced the loss of homes and electricity, and other family concerns. Each shift challenged us to identify how many employees were unavailable due to floods, blocked roads, or family emergencies.
The hospital’s baseline inpatient census is usually 385 to 390 and our usual stress point is at 410 to 420; in days we had surged to 560 patients. AHP went from a full census of 579 to 630. In addition to the opening of the previously closed psychiatric unit, we halted refurbishment work on a med-surg to reactivate it and reopened for patient use rooms on a former patient floor that were being used for resident sleeping quarters. In the days after the storm, there was a marked increase in trauma related to the cleanup of debris and fallen trees and carbon monoxide poisoning cases related to the incorrect use of portable heaters.
It was a stressful time for the direct patient care staff, as well as pharmacy, facilities, social service, human resources, nutrition, and everyone else. Toward the end of week one, with our staff overworked, under-rested, and exhausted, we received federal support in the form of a Disaster Management Assistance Team (DMAT), with 50 health care professionals (physicians, nurses, paramedics, X-ray technicians and pharmacists) from Texas, Ohio, and Kentucky. Although the usual model for the DMAT team is to work in tents outside the hospital, we decided to imbed them among our staff. The plan worked to perfection and elicited extraordinarily positive feedback from our staff and the DMAT team.
Thirty-eight of our own staff lost housing, while others needed child care, food, and a variety of support, even as they continued to care for patients. We were able to arrange for on-campus housing for them in unoccupied resident apartments. One individual, unable to come by car, walked miles from Freeport to East Meadow to care for her patients. An unanticipated problem was the development of a gas shortage, which made it difficult for our employees to get to work. We were fortunate to receive an offer from the owner of a local gas station (a happy former patient) to allow NuHealth employees to have their own line at the station.
By Nov. 15, we had stepped down to 450 patients. We still have a number of patients for whom no housing is available, or whose family was severely affected by the storm and cannot take them into their house.
The staff at NuHealth deserves recognition for their performance. Safe patient care was provided continuously, people worked as partners and teammates, and morale was high throughout the event. We took care of our colleagues, whose lives were turned upside down by the storm, and emerged as a healthy and proud health care system.
Steven J. Walerstein, MD, FACP
Executive Vice President for Medical Affairs and Medical Director