1. Pinkerton, SueEllen PhD, RN, FAAN, Editor-in-Chief

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The relief efforts under way in the wake of recent hurricanes bear evidence to the health care industry's integral role in natural disaster response. Every organization in the wake of these destructive storms has experienced challenges. One has only to read the news or speak with colleagues to realize the amount of service health care organizations provide during such times.

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Without exception, every health care organization has a disaster plan to manage conditions such as hurricanes, tornadoes, floods, snow and ice storms, and biohazard contamination. Plans may go into effect with the release of as many patients and residents as possible from inpatient and extended care facilities and the effort to accommodate special needs patients. Although most communities have special needs shelters to care for individuals who need services such as oxygen and ongoing care, health care facilities are often the backup provider. Areas such as postanesthesia care units and day surgery will act as special needs shelters and provide staff to care for the patients. Physicians often make rounds and care for patients with complex skin breakdown or nutritional needs, providing a much needed service. Home care nurses and other health care volunteers often staff community special needs shelters. Community plans coordinate with health care facility plans to organize and activate these shelters.


The amount of time the staff spends at shelters and health care facilities during a disaster is commendable. They often leave their families and homes, anxious about what may happen to them. When power goes out, usually the telephone landlines and cellular towers follow suit, making it hard to communicate and reassure family members of staff safety.


To help allay anxiety about being away from family, many health care facilities open their doors to the families-and even their pets-providing shelter and food during the disaster. In return, family members accept volunteer assignments, from cafeteria work to supporting patients and residents in some appropriate way.


Although most disaster plans call for the switching of shifts every 12 hours, the best-laid plans are often severely tested. Unexpected events, such as road flooding, mudslides, and bridge closures, often call for creative shifts in the workforce so all patients and residents receive care.


Health care facilities often become homeless shelters. Although other shelters for homeless people and families may exist in the community plan, last-minute events may necessitate extending help to the homeless. Again, staffing is needed to organize sheltering the homeless, and additional food and water are needed to feed them. As one can see, it is a complex task to plan for providing extra supplies and nutritional support for staff, families, homeless individuals, special needs individuals, patients, and displaced residents.


In some cases, health care facilities have had to evacuate patients and residents. This has been completed without complications, and staff has gone with the patients and residents, putting their care and well-being first. Despite the evacuation, staff has continued to offer emergency care for the community members.


Much of this may not be news to those familiar with disaster plans and those who have experienced a disaster first-hand. However, staff's actions should be commended, and staff members should be recognized. They provide a valuable community service and support at a time when community members are most vulnerable [horizontal ellipsis] similar to the care of individuals during the vulnerable time of unexpected illness. Congratulations on a job well done.


SueEllen Pinkerton, PhD, RN, FAAN