MY EXPERIENCE:

My name is Sarah Klein. I am a registered nurse in Bismarck, ND. Specifically, I work on the medical-oncology floor at St. Alexius Medical Center. Because nurses have an innate desire to help people in need, I felt compelled to respond when Hurricane Katrina destroyed the gulf coast.

I contacted the American Red Cross and was told that I would need to commit to three weeks of volunteer service. Within days I had completed the necessary training courses and received my instructions and flight information. Less than one week after initial contact with the American Red Cross, I took an unpaid 3-week leave of absence from work, took my 3-year-old son to my parents house and boarded a plane headed south.

I spent three weeks in Gulfport, MS with the Healthcare division of the Red Cross. The vast majority of my time was spent at sites called Service Centers. These centers are designed to provide financial assistance to individuals and families in need. Sometimes we found ourselves using an old school to work out of. Sometimes we simply set up a tent on a baseball diamond. Each site was unique, with a different set of challenges, assets, and setbacks. But each site was uniform in the fact that every day we were met with thousands of people whose lives were affected and often destroyed by Hurricane Katrina.

The first week of my experience was spent working with the people. With my colleagues, we distributed food and water to those who had been standing in the sweltering heat for often 12 hours. We spent countless hours weaving amongst lines of people searching intently for signs of heat stroke, diabetic emergencies, and any other medical conditions that may arise.

After a week I was promoted to “team leader.” In this position, I was responsible for the healthcare staff at two different service centers. It was my responsibility to deal with staffing issues, ensure we had necessary medical supplies, keep the Red Cross headquarters informed of how many individuals we were contacting on a daily basis, file appropriate paperwork, and many other random tasks.

My experience in Mississippi was life changing. I am extremely proud of what I acomplished and of the people I worked with. I would do it all again in a heartbeat. But the national response to Hurricane Katrina was clearly flawed. There was a large amount of chaos and disorganization within the American Red Cross. It quickly became clear that numerous changes need to be made to the organization. I have made a list of the most major inadequacies (in my opinion) and because something cannot be changed simply by awareness, I have offered some suggestions for implementing change to these flaws.

FLAWS/INADEQUACIES OF THE RED CROSS:

It is important at this point to point out that my experience with Hurricane Katrina is completely limited to the American Red Cross. Therefore I cannot speak for other organizations. I have an enormous amount of respect for the intentions of the American Red Cross and every other group who is involved in the national disaster response.

To me, the most important flaw within the American Red Cross is scope of practice. Red Cross policy is “first aid only.” Although I understand the policy, I was busily handing out water and trail mix while my education, training, and experience allows me to be doing things such as administering tetanus shots or providing IV hydration. Allowing volunteers to work to their legal potential would save an enormous amout of time and effort for medical response personnel throughout the community. For example, If I could check someone’s blood sugar and determine that it is low, I could provide a snack for that individual to bring it back up or if necessary, administer dextrose via IV. Instead, we could only guess that a patient’s blood sugar might be low and more often than not, the patient ended up being sent to a hospital via ambulance, thus busying both the ambulance crew and hospital crew when the problem could have been solved at the site. It seems redundant to have physicians, nurses, EMTs and paramedics assess someone and determine that he needs medical attention and then call the EMTs and paramedics to transport the person to a clinic or hospital where their medical needs are addressed by a team including nurses and physicians.

Inconsistancy. This was espescially a problem within the management positions. As nearly all individuals assisting in a disaster are volunteers averaging a three week visit, there is a lot of passing the torch. In my case, I worked in the field for 6 days, trained into the management position for 2 days, worked in management for 9 days, and trained my replacement for 3 days. At this rate, you have a new boss every 2 weeks, which is extremely inconsistant. Rules change with each one. Goals change with each one.

Availability. It was almost an act of congress in order to get supplies to my crew. I had to first go to the red cross headquarters and fill out a requisition form. This form had to be approved by my supervisor. The signed requisition then had to be taken to someone else to look over and approve. Finally, I had to take it to the warehouse. The supplies on the list may or may not be available and if they were, we may or may not get the quantity needed. A half day would be wasted to get a quarter of the supplies needed and a plethora of supplies that we didn’t need and wouldn’t use.

SOLUTIONS/PROBLEMS WITH SOLUTIONS:

Scope of practice: The biggest potential problem to improving the scope of practice of volunteers comes from a legal standpoint. Legally, I can act as a nurse anywhere in the state of North Dakota. I cannot legally function as a nurse in Mississippi or most other states. The same will be an issue for physicians, EMTs, and all other health care personel. Ideally, we will need to work with the board of nursing for each state to convince them that in the event of a disaster it would be benificial to provide temporary licenses to individuals working with the Red Cross (or whichever organization). These temporary licenses would need to be available immediately, which is a problem. An alternate to this is for the federal government to pass a law stating that in the event of a national disaster, the government assumes the responsibility for approving temporary licensure for the area necessary. These could be approved simply by verifying with that state that the license is current and has no grievances against it.

Inconsistency: In the event of a disaster, individuals in a management position need to be paid, thus increasing their length of stay and consistency of care. For example, my leave of absence was unpaid. At the end of three weeks, I wasn’t ready to leave, but financially, I couldn’t stay any longer. Had I been offered the option to stay as “Team Leader” for pay, I would have been more than willing to stay until I was no longer needed in the area.

Availability: The supervisor of the crew needing supplies needs to have access to the supplies. If a site needs medical supplies today, tomorrow isn’t soon enough. This is more difficult to provide a solution because the Red Cross relies on donations for supplies. I guess the most obvious solution would be to provide a website containing a list of items needed for donations. This would need to be updated regularily and should also include a list of items that are unnecessary.

I have an extremely difficult time referring to Hurricane Katrina as a “learning experience,” but it truly should be treated as such. Our nation had not seen a disaster of this magnitude for quite some time. It is only natural that there are flaws to the system. Let’s ensure that we will not be so ill-prepared next time.