1. Belcher, David

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In the week after Hurricane Katrina hit the Gulf Coast on August 29, Kaye Wilson, DNS, RN, an associate professor at the University of Mississippi Medical Center School of Nursing in Jackson, saw exactly how nurses can hone their skills to use during a massive disaster.


Wilson helped to form a displaced-persons program in that city for more than 2,500 evacuees from the besieged city of New Orleans. In the cavernous Mississippi Coliseum on the Mississippi State Fairgrounds in Jackson, Wilson and more than a dozen nurses from the university medical center and dozens more from other area hospitals-as well as from a public health mobile clinic she manages-were caring for evacuees from New Orleans within three days after the hurricane struck.


"The first people we saw had chronic or acute sicknesses," Wilson says. "But the people we saw several days after the hurricane were people who had been in the floodwaters for days. They're dehydrated, have diarrhea and infected ulcers and cuts."

FIGURE. Kaye Wilson,... - Click to enlarge in new windowFIGURE. Kaye Wilson, RN, left, and Patty Crook, RN, lead nurse of the Central Mississippi Chapter of the American Red Cross Disaster Health Services, at the Mississippi Coliseum.
FIGURE. During a phy... - Click to enlarge in new windowFIGURE. During a physical exam, Anne Norwood, University Medical Center assistant professor of nursing, makes three-year-old Dana Balot of Jefferson, Louisiana, smile as her mother, Michelle Balot, watches.

In addition to her duties at the university hospital, Wilson manages Mercy Delta Express, a mobile clinic funded through the Sisters of Mercy in Vicksburg, which provides health care and dental care to those living in the Mississippi Delta. Since it receives state and federal funds, the unit was mobilized for disaster relief. The university's medical center, also federally and locally funded, became the center of treatment until it was overwhelmed and forced to move to the coliseum. By early September the coliseum was housing about 250 evacuees after most were moved into area homes, churches, and shelters. The coliseum was closed to evacuees on September 12 after all but 200 off them had been housed elsewhere.


In conjunction with the Red Cross, as many as 20 nurses and several doctors and pharmacists from the university medical center set up a clinic that operated for three or four hours daily during the first week of the crisis, treating 250 to 300 people and filling 300 to 400 prescriptions a day. The mobile clinic became a pharmacy with drugs donated by drug companies, and tables were set up to dispense medications, give tetanus shots, and meet numerous other health needs.


This is where nursing skills were put to the test, Wilson says. Because of the immensity of the needs of the displaced people, nurses had to call upon their instincts, their knowledge, and their connections in the health care field. "There were people who were down to their last tank of oxygen, so nurses contacted local companies who could provide new ones," Wilson explains. "As nurses, we must know how to work the system-calling where we need to call to get the help we need."


One problem is mental health, which has been-and will continue to be-perhaps the biggest challenge, Wilson says. "It takes time to build rapport with patients, and time to assess their needs," she says. "Getting them out of a big coliseum and into churches and homes where they feel more comfortable will help tremendously."

FIGURE. Evacuees in ... - Click to enlarge in new windowFIGURE. Evacuees in the Coliseum on the Mississippi State Fairgrounds in Jackson on September 8.

And Wilson feels that those issues will be addressed in the long term. "People's medications have been interrupted, and this goes from the very elite to the person who was already on the street in New Orleans," she says.


Wilson is no stranger to disaster relief, having participated in post-Gulf War relief efforts in 1991 with Kurdish refugees in Iraq, as well as in Puerto Rico after Hurricane Hugo in 1989. "You talk about it and you have modules, but when you see it in real life it's a whole lot different," she says. "But people are comfortable with nurses, and we've been taught how to do holistic care. It's natural for us to look at a huge situation and see how we can make it work."