1. Daigle, Richard

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In a Pensacola Hospital

When Hurricane Ivan roared through in the early hours of September 16, nurses at Sacred Heart Hospital in Pensacola, Florida, received an unforgettable hands-on hurricane education. A Category 3 hurricane with winds exceeding 120 mph, Ivan killed 12 people, destroyed more than 6,000 homes, and damaged another 12,000.


Debbie Bostic, MSN, RN, vice president of operations at Sacred Heart, along with other Sacred Heart administrators, literally lived in the hospital for seven nights, working to keep it operating. This included contending with power and water outages, as well as organizing the federal Disaster Medical Assistance Team and public health nurses who came to relieve exhausted hospital employees. Bostic said another reason she stayed was because her commute to work, typically 40 minutes, was now four hours because of hurricane debris on roadways.


"We worked day and night, running on adrenaline," she says. Even with plenty of available staff, the workload was so overwhelming that Bostic and other administrators averaged only two hours of sleep for the first three nights.


Some 4,000 people packed into the 449-bed facility on the night of the storm. In addition to patients, hospital employees, and their families, busloads of special-needs patients arrived from overcrowded shelters. These were patients who used oxygen, home ventilators, or other medical equipment. With electricity out in 90% of Pensacola, they came to the hospital where power was available from emergency generators.

FIGURE. Devastation ... - Click to enlarge in new windowFIGURE. Devastation in Pensacola, Florida, from Hurricane Ivan, whose winds exceeded 120 mph.

Despite the chaos of the storm outside, people remained calm inside. When hurricane winds threatened to tear down doors in a waiting area during the peak of the storm in the early morning, Bostic had to quickly move hundreds of people, as hospital facility workers held the boarded doors shut for several minutes to keep them from blowing open.


Nurses in labor and delivery (L&D) provided care to 22 pregnant women and assisted with five deliveries, including two Cesareans, which occurred while Ivan raged outside. Because of low power, they had to use flashlights.


"I'm the coordinator-but that night Ivan was coordinating for me," says Maureen Larsen, RN, coordinator of L&D. "He was calling the shots."

FIGURE. Sacred Heart... - Click to enlarge in new windowFIGURE. Sacred Heart nurses Maureen Larsen, RN, left, and Beth Castner, RN, were on duty the night Hurricane Ivan roared through.

The backup power from hospital generators didn't power air conditioning, so room temperatures were more than 90[degrees] F. Larsen and Beth Castner, RN, patient care manager for L&D, used damp towels to cool down the babies and mothers-and themselves. There was no need to put babies in warmers because temperatures were so high. Every available fan was brought in to circulate air.


Kimberly Ernst, an RN in Sacred Heart's 60-bed neonatal intensive care unit, cared for two preemies who, like other babies, struggled with the heat.


Ernst's husband, who is in the Air Force, left for Afghanistan two days before the storm, leaving Ernst to finish hurricane preparations at home and care for her two daughters, ages 12 and six, who stayed with Ernst at the hospital on the night of the storm. She and her daughters were forced to leave their home in the middle of the night to move to safer quarters within the hospital.


The storm's fury surprised her.


"Ivan was a monster. I've never heard anything like that, just howling and growling," she says. "I thought we were going to just get swiped up."