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As community healthcare/home care nurses, we know what emergency preparedness is, we teach others how to be prepared, and we believe that we will know what to do when a natural emergency is pending. This article is not about using the proper "buzz words" that show knowledge about emergency preparedness. Instead, it is a practical accounting of events in one neighborhood, home to several households of adults enjoying their eighth decade of life.


I thought I was well stocked and well prepared for any emergency until August 2011, when Hurricane Irene devastated my small community of seven houses on a cul de sac in Connecticut. Three of the seven houses on our dead end street are home to vibrant, independent older adults who manage their lives well in spite of a number of serious health problems. When the emergency struck we were all prepared in many ways, and yet we were all naive regarding our level of preparedness. The situation caused us to unite as a small community, pool our resources, and taught us how to be better prepared for the future.


Hurricane Irene brought with it a mini tornado that whipped up our street and took down three enormous trees, three telephone poles, and all of the accompanying wires at around 5:00 a.m. on August 20, 2011. Some trees hit houses, others crisscrossed our road and blocked our only path out of our cul de sac. When we awoke at 7:00 a.m., the vision outside the windows was surreal. The sun was out. The woods surrounding our house were filled with fallen trees and branches. The lawn and road were covered in wet fallen leaves. The most amazing vision was the huge 65-year-old oak trees that were thrown totally across the roads. It is incredible to see the top of an enormous tree filling the entire road and the driveway across the street from where it once grew. There was another tree beyond that one, and another beyond that. Not only was all power out, but we were completely trapped on our street with no feasible way to traverse the multiple huge trees, even by foot, because of the live wires lying everywhere.


At first, as each household ventured carefully into their yards, we felt that our needs were urgent and would be dealt with swiftly by emergency personnel because of the downed wires and the fact that we were trapped by the blockage of our dead end street. We all made numerous phone calls to the city and electric company via cell phones, the only mode of communication still working. The city responded that they could not cut the trees away until the electric company removed fallen wires. The electric company responded that they could not remove wires until fallen trees were removed. We remained in this quandary for a full 5 days, unable to leave our street. Cars, fire, police, and emergency vehicles could not get through. Every few days firemen would walk up and ask if we were alright. Nobody had any answers as to when we would be able to leave.


During this time we all learned so much about how to be prepared (or rather, how unprepared we were). The realization hit that we were truly on our own. That in a large-scale state of emergency such as this, communities are simply not reachable by those that we usually turn to. Having bottled water to drink is easy. We all had bottled water. We all had flashlights too, but as 5 days led to 8, my one spare set of "D sized" batteries were almost dead, and flashlights were on their last meager bit of yellow light. I learned never to wait until a day or two before a pending storm to shop for batteries, as everyone is sold out. It was things like this that we didn't think of that rendered us so unprepared.


One elderly gentleman on our street was undergoing chemotherapy prior to the storm and his main diet at the time was canned protein drinks. However, without ice or refrigeration the drinks were not palatable for him, making him extremely susceptible to dehydration and malnutrition. Luckily, my household had a small generator and was able to keep the refrigerator/freezer going for a few hours at a time. We lent him ice and one small emergency was averted. Another older gentleman also had a small generator. However, due to his long history of chronic obstructive pulmonary disease, he found that he was unable to manage the pulley to start the machine without getting short of breath. He waited for hours for neighbors to venture outside and help him. Once we learned of his dilemma and his potential health risks, neighbors worked out a schedule of times to assist him in starting and filling his generator with gas.


Oddly, many of us had not thought ahead to exchange cell phone numbers because we knew each others' land line numbers, never thinking that land lines would be out and that walking next door would be too dangerous. We quickly traversed the slippery leaves avoiding wires to trade cell phone numbers. We also took turns charging neighbors' phone batteries as they ran low.


Given the beautiful weather following Irene, and the lack of anything to do inside, we, as a community, spent many hours each day sitting in our yards marveling at the massive trees and wires in the road. We made periodic pleading phone calls to emergency and hurricane hot lines in the mayor's office, to police and firemen, only to continue to sit and wait. What we didn't expect while we sat was the massive number of mosquitoes that swarmed our yards. They were everywhere, probably due to the torn up ground and massive holes left by the fallen trees, as well as the damp leaves covering the ground. There were hundreds of them all day long and we had bites everywhere. Bug spray became a precious commodity and we again pooled our resources and shared the noxious but necessary spray among households.


Everyone in the neighborhood was prepared for 2 or 3 days without power. We were not prepared to be landlocked for 5 days and we were certainly not prepared to be without power for eight. Food began to run low. Everyone knows that to be prepared, one must buy nonperishable foods. We all had plenty of canned foods in stock. However, many items such as soups need to be heated. One elderly couple had plenty of canned soup, but no way to cook it. Someone lent her canned sterno, which she used to cook over. People without generators used or disposed of whatever melting, warming items were in coolers after the first few days. Bread and peanut butter were running low. In the future, I will remember that nonperishables that fill many cupboards are not necessarily edible if you cannot cook or properly prepare them-especially if they require milk, butter, eggs, or a hot stove to render them edible!


Medication availability became an issue for some. As a home care nurse I have never condoned sharing of medications until this exceptional circumstance. One neighbor dangerously ran out of prednisone early in the week before any signs of movement from the street were evident. Thankfully for her, another neighbor had the same prescription, and lent a few days worth of pills to the woman in need. Nobody ever thought we wouldn't be able to get out and get medications renewed after a day or two. A lesson learned for the future: have home care patients (or anyone) renew prescriptions that may be running low when we have the bonus of a warning that a natural or other emergency is pending.


Our basic needs were in danger of not being met. Food was running low or was just not palatable; medications were running out; it was too quiet other than the annoying buzz of generators. People were getting tired of cold showers. After a few days we hooked our generator up to our small camper, enabling us to take short warm showers, a luxury we shared with our neighbors. There is truly nothing as comforting as a warm shower when so many other comforts are lacking.


Although everything else seemed to be running low, tempers were starting to run high. People were frustrated with the system and lack of support. Nobody felt satisfied with cold food and warm drinking water anymore. We were stressed and tired, and nobody was sleeping well. We heard about break-ins at nearby houses and generators that were stolen from yards at night. We realized that this was a true emergency situation and we only had ourselves and each other to get through it. We were all grateful that there were no injuries and that our houses were standing despite damage to some of them, but frustrations and the feeling of being trapped began to consume us.


On the evening of the fifth day, pushed into action by fear, some people took it upon themselves to cut a path wide enough for cars to pass the massive tree. One community member was wearing a cardiac monitor due to recent acute cardiac episodes, and we were all especially concerned about her ability to get help if needed. We cheered on the chain saws, and cringed with worry about the obvious safety issues in using a chainsaw with wires down! This is not something I would ever suggest to others. However, once the path was cleared, some of our troubles were over in that we could at least get out to buy supplies, medications, and food. After 8 days the power was finally returned to us. After 10, most of the fallen trees were removed.


For many weeks our small community reflected on the stressful and dangerous situation we were in during those first 5 days. We strengthened our bonds as friends and neighbors, and we learned valuable lessons about what constitutes preparedness. As I do my work in home care, I will always remember ways to help my patients prepare. I will say a lot more than "make sure you have bottled water and nonperishable food items." I will help them to think of things they may need in the coming days or weeks, including their medications. I will always encourage people to have spare batteries, not only a day before a storm is coming because by then it's too late to get them. I will never assume that older adults will be able to use land lines instead of cell phones. I will also be sure to remind them to swap cell phone numbers with a neighbor or two, as it may be the only way to contact each other even if they live only one house away. I will remind patients that a first aid kit in the home should include bug repellant. I will also advise patients to write down not only their doctor's phone numbers, but also the mayor's office, the electric company, the phone company, and nonemergency numbers of police and fire departments, as you can't look these numbers up online if power is out and you can't call information if the phone is down. It's also hard to look up numbers in a phone book in the dark. Finally, I will encourage older adults who have the benefit of a generator to make sure they are safely able to start it, and, if not, to make contact with a neighbor before the power goes out. Hurricane Irene knocked down a lot of trees and poles on my street but she certainly didn't knock down our sense of community and friendship. I learned so much as a nurse, as a neighbor and as a community member and I will not soon forget these valuable lessons.