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Nurses in home healthcare and hospice have much to be proud of. This month is National Nurse Month, and I want to be sure you know how much your skill-set is valued. Our special National Nurse Week celebration is May 6 to 12. There are approximately 2.7 million registered nurses (American Nurses Association, 2006).

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I recently returned from New Orleans. The stories and situations handled by our colleagues in that area and the Gulf Coast would make you very proud. Poignant stories about patients and families "not wanting to evacuate," Herculean efforts to find patients (and team members, too) after Katrina, and the visual reminders of a city forever changed. These visual reminders will be with us for a long time: blue tarps, "FEMA city" trailers, and roofs with holes cut out of them (a reminder of the over 34,000 safe helicopter rooftop rescues made by the Coast Guard). The Home Care Association of Louisiana organized this meeting, appropriately entitled "Transcending Tragedy, Transforming Your Future: Disaster Planning, Response & Rebuilding." Although held toward the end of January, participants were told they were the first meeting to be held in the city in the new year. And the city's devastation is indescribable. I went ostensibly to listen to lessons learned and meet clinicians and managers who would have lessons learned for us all in a future issue of Home Healthcare Nurse dedicated solely to emergency management. But I also went to witness the times and to support our colleagues and the state associations that also came to support the Gulf states in their time of great need. The opening comment set the stage for the meeting. According to Warren Herbert, Executive Director of the Louisiana Association, "We have a moral obligation to help you be better prepared." Speakers were people you know from the news and watching TV; they included the first Secretary of Homeland Security, Tom Ridge; Bernard Kerik, the commissioner of the New York Police Department on 9/11/01; and Lieutenant General Russel L. Honore, Commanding General First United States Army. The last speaker, Lt. General Honore is a native of Louisiana and gave a stirring overview of Katrina, complete with maps and photos from Ground Zero (in Mississippi) and surrounding environs. This tall gentleman walked in looking like a cross between John Wayne and Clint Eastwood. His commanding presence was one of the highlights of the conference; there would be no doubt who was "in charge" with this gentleman in the room!! Home care speakers included The Corridor Group, Fazzi Associates and Simione, as well as Tom Williams, Heather Rooney, and Barbara Citarella.


Here were my take-away "lessons learned":


* Back-up your plan: what happens if your right-hand/logistics person is gone?


* Can your staff get in the gas lines? (These are prioritized in times of crisis.) Communicate with your area gas stations now and make sure that you all have full tanks of gas before the storm.


* Get cash before the storm (ATMs won't work if there is no electricity).


* Know how/if your staff can move past the emergency lines. In some parts of the country, nurses were turned back, whereas in others they showed their ID or a stethoscope and got through (some came from all over the United States and were there when the first responders arrived)!!


* Have a home care/hospice representative on your community emergency management team.


* Know before hand what shelters are open and where patients can be evacuated (and think about how to get them there).


* Patient tracking is a priority; start early and have a plan. When admitting patients, consider asking for a next of kin (also) that is not in the immediate area.


* Consider satellite phones for these emergencies (remember cell phones and home phones will not work or, at best will work occasionally).


* Ham radios helped and were able to communicate; develop those relationships.


* Protect your information and have a backup plan for patient data, payroll, etc., for continuity of operations.


* Take control of what you can take control of and then reach out to other organizations, HHAs, and hospices.


* If you have generators (this goes for hospitals, too) they need to be high up. The problem seen in Louisiana was that when the flooding happened, the generators were not high up, were flooded, and then no longer worked.


* Do not be overwhelmed; big plans require small steps. Start today.



Lest you think that all of New Orleans is destroyed, it is not. The Garden District, Canal Street area, and French Quarter were up and noisy and active. There is no question this special city will prevail and continue to be a unique city in our country. The Mardi Gras and Jazz Festival are planned as usual. They would love to have you visit!!


This month's issue is focused on diabetes mellitus (DM) and its management in home care and hospice. According to the United States Agency for Healthcare Research and Quality's (AHRQ) "News and Numbers" there were more than 500,000 hospitalizations for DM in 2003. Sadly, "the most common procedure performed on patients hospitalized with DM with complications was amputation of the lower extremity. Nearly 10% of patients hospitalized for DM with complications underwent this procedure in 2003." Home care can have an impact on these numbers for patients who are receiving home healthcare. The article by Colleen Miller addresses some of these important fundamentals. We can make a change.


Thank you for all that you do to care for patients and their families every day, and a special thanks from the team of Home Healthcare Nurse!!


P.S. If you have a story that you believe your colleagues would like to hear about or wish to submit a manuscript about your emergency management program after Charlie, Rita, Katrina, or any storm/disaster, please e-mail me at Because not all emergency preparedness is related to hurricanes, we welcome your stories of other incidents, including floods, fires, and blizzards. If you must use your emergency management plan because of events causing organizational operations disruption, we would like to hear from you. This can include your lessons learned, manuscripts about the process, or stories about the problem and your experience. We can all learn from each other.




American Nurses Association. (2006). Retrieved January 20, 2006 from [Context Link]


U.S. Agency for Healthcare Research and Quality (AHRQ). AHRQ News and Numbers: Hospitals treat more than half a million patients for diabetes. Retrieved October 18, 2005 from HCUPnet. Available at