As she tried to control the desperation in her voice, the nurse at Charity Hospital in New Orleans described on CNN the working conditions she and her colleagues were facing a few days after Hurricane Katrina — without electricity, they had to ventilate patients by hand; without water, they had to leave patients lying in feces. Later, reporters told how healthcare professionals were forced to “black-tag” patients — deciding who would receive care and who would be left to die.
As I watched the coverage, I thought about the South African physician, Bruce Sparks, MD, who spoke at the Global Alliance for Medical Education conference in June about the struggles of healthcare professionals dealing with the AIDS crisis in Africa. The hardest thing for them, he said, is witnessing so much death, seeing the terror in patients' eyes, and breaking more bad news to people who have lost their whole families. What they need is not CME about clinical treatment, he said, but education about how to survive emotionally and how to provide psychological care to patients and their families.
The healthcare professionals who were on the front lines immediately after the hurricane, the hundreds who volunteered to go to the affected areas afterward, and those around the country who will treat relocated victims and others touched by the tragedy, will need similar assistance. One way to offer support is to provide a forum for people to tell their experiences. In the days following the hurricane, numerous medical associations posted information on their Web sites about how to help members and other victims. In addition, the American College of Emergency Physicians created a “Share Your Story” button, encouraging members to tell their colleagues about how their emergency departments were damaged by Katrina and its aftermath.
Meetings provide an excellent platform for sharing stories. As Executive Editor Sue Pelletier reported in "On the Agenda: Healing," (July/August 2002 issue), at the National Association of Orthopedic Nurses' Annual Congress, held in May 2002, three New York City nurses told the standing-room-only crowd about their experiences during the 9/11 attacks and how they coped with their emotional trauma in the aftermath. An observation by one of the speakers is as relevant after Katrina as it was after 9/11: “Everybody knows that the potential is there for all healthcare workers to have to deal with a tragic situation like that, but you never think you'll have to be the one to do it,” said Doreen Johnson, RN, nursing educator, the Hospital for Special Surgery. “[Attendees] said it was inspiring to hear how nurses spent endless hours trying to help victims and families, and to share their stories — many, many stories.”
After 9/11, the CME community responded by developing bioterrorism and emergency-management education. The healthcare community needs to go much further now. As the investigations proceed into the enormous failure of local and national emergency-response systems, the voices of healthcare professionals must be heard. I hope medical conference organizers will give attendees the opportunity to come together and organize efforts to fight for more effective disaster-preparedness plans to help ensure that health workers, such as the nurses at Charity Hospital, will never again be forced to make such desperate choices.