1. Kennedy, Maureen Shawn MA, RN, news director

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As a former New York City firefighter, Mike Nilsson, BSN, RN, has seen his share of disasters. But as the public health nursing supervisor for the Pasco County Health Department in west-central Florida, Nilsson helped operate two special-needs shelters during the back-to-back-to-back hurricanes of the 2004 season. The experience was a mixture of pride and distress: he's proud of how the public health nurses responded but upset at how they aren't being recognized.


Each special-needs shelter averaged 150 to 200 patients: oxygen dependent, confined to wheelchairs or bedridden, blind, or with Alzheimer disease. Most of the clients were frail elderly people who lived alone, assisted by home health care agencies to enable them to live independently.


Nilsson says the situation needs to be addressed on a long term basis, as Florida's elderly population continues to grow. "Special-needs shelters are a quick fix," he says. "We need a better solution for these frail, often ill individuals who often become stressed and confused in shelters."


He tried to staff the shelters with at least five RNs for each shift, but that wasn't always possible, and some nurses worked double and triple 12-hour shifts. Nilsson says they were "magnificent."


And that's why he's distressed. According to Nilsson, the Florida legislature ignored nurses in favor of pay raises for police officers and firefighters, even though governor Jeb Bush had agreed to "modest and overdue" pay raises for state-employed RNs.


"Public health nurses are mandated by the governor under the same rules as other emergency responders and are often put in harm's way, too," says Nilsson, pointing out that nurses have to travel in unsafe conditions to get to the emergency shelters. Nilsson, who is treasurer of the United American Nurses and president of the state health employees collective bargaining unit, says the RNs are contemplating legal action against the state.

FIGURE. A special-ne... - Click to enlarge in new windowFIGURE. A special-needs shelter resident in Zephyrhills, Florida, awaits Hurricane Frances.
FIGURE. A typical ro... - Click to enlarge in new windowFIGURE. A typical room of a special-needs shelter set up at River Ridge High School in New Port Richey, Florida.