1. Sofer, Dalia

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When Hurricanes Katrina and Rita hit the Gulf region in August and September, the human, historical, geographical, and architectural devastation left in their paths were immediately recorded through harrowing photographs of flooded streets, caved-in roofs, and despondent faces. But what may take longer to document are the demographic shifts that may eventually occur as a result of the mass evacuations. Among these is a potential shift in the nursing population.


About 500,000 people are believed to have evacuated the Gulf Coast region; some 250,000 are now in Texas. Georgia, Arkansas, Tennessee, California, and the Carolinas have also received many evacuees. According to a survey conducted in mid-September by the Washington Post, the Henry J. Kaiser Family Foundation, and Harvard University, nearly half of those who were staying in Houston shelters said they don't intend to return. And it's safe to assume that with nearly a dozen Louisiana hospitals closed, many nurses will settle elsewhere.


"We're losing our nurses and nursing students, and we're afraid they're not coming back," says Marilyn Sullivan, treasurer and immediate past president of the Louisiana State Nurses Association (LSNA). According to the American Association of Colleges of Nursing, more than 3,000 nursing students have been displaced as a result of the hurricane. Schools throughout the country are accommodating displaced students as best they can.


Texas, while dealing with its own devastation after Rita, has welcomed many of Louisiana's nurses and nursing students. According to Clair Jordan, executive director of the Texas Nurses Association, 200 Louisiana nurses have received temporary licenses from the Texas Board of Examiners in order to practice in Texas, and some 400 nursing students have enrolled in Texas universities.


This migration is also likely to harm Louisiana's health care system. In an attempt to retain its nurses, the state is extending the expiration date for the 2005 license to March 31, 2006, and has waived the 2005 continuing education requirement for relicensure. However, says the LSNA's Sullivan, it cannot offer its nurses greater incentives, because it simply cannot afford to.


Still, despite its precarious situation, creativity has not altogether vanished from Louisiana. For example, a local movie theater in Baton Rouge occasionally turns into an auditorium classroom for the nursing students of Louisiana State University, and a ferry that had sailed the Baltic Sea for 30 years now serves as housing for the students. And the state's free physician recruitment program-MedJob Louisiana-has expanded its services to all health care professionals displaced by the hurricane.


Louisiana's devastation has largely overshadowed that of Mississippi, Alabama, Florida, and Arkansas, states also damaged by Katrina or Rita or both. While the overall impact on these states is unlikely to be as severe as that on Louisiana, the heartache and hurdles experienced by the residents-among them nurses-are great. Shirley Rainwater, a nurse at the University of Texas Medical Branch in Galveston, whose home in Orange County sustained damage as a result of Rita-and remains, at the moment, unlivable-has relocated with her husband, her daughter, and her newborn grandchild to a 600-square-foot apartment in Galveston (which she sometimes used in order to be closer to work).


"It's pretty tight!!" she says of their new living arrangement. Unable to evacuate during the hurricane because she was on emergency status, she remained for several days without news from her family members. She and the rest of the hospital staff were eventually evacuated by plane and taken to Dallas. She says she has no plans to leave Texas, although she does joke about it. "I have a friend in Maine, and I told her I'd rather put up with snowstorms. At least once the snow melts," she laughs, "everything is intact."

FIGURE. Toshika Barn... - Click to enlarge in new windowFIGURE. Toshika Barnes, a nurse from New Orleans, speaks about being unable to return home after she and her family took refuge from Hurricane Katrina in Houston in late August. In an attempt to retain its nurses, Louisiana is extending the expiration date for the 2005 license to March 31, 2006.