IamA Registered Nurse on disaster activation in one of Houston's major hospitals, AMA!

Thank you, first of all, for everything you do on a daily basis.

What kind of storm related injuries/illnesses are you seeing there? I'm guessing a lot of dehydration, pre-existing conditions worsened or in need of medication that was lost in the storm, etc.

Any awesome hero stories about the rescuers? Honestly I love to follow these stories but because of my current anxiety I've had to stay away from the news.

I haven't actually seen any storm victims in my unit yet. If there are any that came to the hospital, they were probably treated for minor injuries or such since we only take critically ill patients in ICU. If I had to guess, right now the main people that are going to be coming to the hospital (in quantity) are going to be chronicly ill patients that are dependent on ventilators and other mechanical devices that have lost power wherever they are.

Couldn't tell you any awesome hero stories about the storm right now. The hospital is a very divided, but uniform structure. Emergency Department nurses would know everything that's going on outside of the hospital at the moment. Whereas me as an ICU nurse, I only know about the critically ill patients, which not many of the patient that are walking in right now are.

edit we had a few diabetic patients run out of insulin and they went into DKA come in. A few vented patients also were received.

So your ICU doesn't take ventilator dependent patients? Wouldn't requiring an advanced airway classify them as critically ill.

Not OP, but I think "going to be" - not arrived in the hospital as of yet.

Spot on. Thank you.

We do. We haven't gotten any vented transfers yet.

We've had several from Victoria in Austin

That's great. Stay dry up there.

Wow. Thank you for what you do. I have a couple of questions

1. Are you staying at the hospital because it's too flooded/dangerous to leave or because they asked you to?
2. Where do you sleep/shower and such? Are you working the same shift as before or more?
3. In what way has the hurricane affected how medical care can be implemented, if it has?

1. More like it's mandatory unless if you just absolutely can't get to the hospital

2. we've been sleeping wherever we can find space, except for patient's rooms obviously and away from clinical areas. We are also taking turns showering in empty patients' rooms. and I'm currently staying on my night shift schedule. They won't swap us shifts, that's just cruel.

3. The hurricane has made a large impact on our supplies right now. We're all using our supplies very very sparingly because the delivery guys obviously can't make their shipments. Scheduled surgeries are also being cancelled. Some of the doctors cannot come in and so the ones already here are being forced to work longer hours, which as you know may affect medical care in negative ways.

Ate you currently still assigned to the ICU or are you posted in another unit? If there is an overcrowding in the ED are people causing havoc to be treated first? On a personal note, are you and your family ok?

I'm in ICU right now. It is my "homebase." If needed though, I could be moved to work in an intermediate care unit, which is a step down from ICU. But that's only if they were short staffed and needed one of us to float there. Doesn't seem to be much craziness going on in the ED at the moment. Then again, there are a handful of other hospitals very close in vicinity to my hospital, so more people might be going to those hospitals rather than coming to mine.

I live alone in Houston and am in pretty good condition at the moment, other than the fact that I didn't bring anything (change of clothes, food, toiletries), but the hospital is accommodating us, the employees, fairly well so far. The hospitals are still pretty safe to be in.

Thank you for all you do, I currently manage a hospital kitchen in New England. Times like this are what we're made for. Sticking together, being a team, and taking care of people who need it. Stay strong and stay safe!

absolutely. The kitchen is the most important unit of the hospital. Without food we would all die.

are you being paid?

what is the evac plan for intubated pts since your the tertiary center.

cheers and well done

Yes we are getting paid. I think it would be illegal if they didn't pay us. I'm actually in the greater part of Houston. North. So, we haven't been hugely impacted as our sister hospitals just 45 minutes down the highway. They are evacuating some of the patients to neighboring facilities.

How much of your job is legitimate altruism? My friends who are nurses constant post memes about how they're underappreciated. Why do you do what you do?

I think some nurses are more altruistic than others. Obviously there are good nurses and bad nurses, same with any other job. Good engineers, bad engineers. Good presidents, bad presidents. But to be a nurse, you have to have at least a little bit of compassion and altruism to do this job.

I definitely feel your friends on being underappreciated sometimes. Some people just don't understand what we do. Patients, family members, patient's visitors, and even the doctors--some of them just have no idea how stressful, demanding, and outright nasty our work can be.

I do what I do for many different reason. Some reasons are realistic, like for example. Job security and decent pay. And then I also do take pride in what nursing is and does for the people and community, which is another reason why I do what I do.

I hope that y'all keep power and sewerage - that was gone almost instantly during Katrina at New Orleans hospitals. One RN friend was at the hospital she worked for 3 weeks. Have y'all evacuated your most serious patients, ie. neonates, ventilator dependent patients?

Dang, yeah I know Katrina was just chaotic and nothing was prepared in advance. The engineers in my hospital did a lot of generator testing before the storm hit, so I think we're good. We aren't evacuating yet. My location is North in Greater Houston. The serious flooding is going on in South Houston and those hospital are evacuating.

What can people do to make the recovery effort move in a more efficient way?

What I'm hearing on the news is that there isn't really much anyone outside of Houston can do for us, until the rain has subsided at least. It's getting too deep to try and drive in, unless if you've got some sort of boat or something. The rain is supposed to keep coming until Thursday to my understanding. Haven't been watching the news in the past day, nor have I been able to step foot outside since last week.

How do you have time for an AMA during a disaster activation? Is the calm before the storm? How long do you expect to be on duty? Are there legal limits to how long you can work?

Yes, I'm only doing this on my downtime. I'm not exactly sure how long they can legally hold us at work for, but I've been working and sleeping at the hospital since Saturday evening. A few of my other coworkers on the unit are going on 5 nights now (started working Thursday of last week). We're projecting to be stuck here for another few days/nights.

?I was told my last comment was deleted since wasn't officially a question so I will start with a question. Are you surgical, medical, or cardiac ICU? Now, just showing support. I worked a natural disaster MCI in the ER in WV but nothing of this magnitude. Keep doing what your doing. ?

Hey thank you very much and sorry your previous comment got deleted. I'm in Medical 90% of the time.

What would you recommend to a nurse coming in from another state? My hospital in Utah is part of a national network with hospitals in Houston. They are asking for nurses that would be willing to help. I have volunteered to go. I would like to know what I can do to prepare/bring with me to be most effective and be less of a burden when I get there.

Not really sure what I could recommend. Obviously bring enough clothes, toiletries, supplies, or whatever you need personally for your time here. Most of us are friendly people down here so don't worry about that. I'm not sure if your skillset would matter? I'm sure they would put you where you are most useful. You're doing a good deed. Texans will thank you for what you're doing.

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I'm in MI. So in a natural disaster, SI would get busier theoretically because they also take the traumas. However, in MI we would get the overflow, so we could also take the traumas and surgeries too that SI couldn't. Not entirely sure what would happen if the units filled up, but there are about 4 neighboring hospitals in the vicinity that probably have room.

How hard is it to become a trauma nurse?

I'm not a trauma nurse, but it's not hard. You just need to work in a trauma or surgical specialized ICU and then you just basically learn on the job and do some home studying on your own time.

Is the rest of the country getting accurate details about the flooding?

To tell you the truth, I haven't been outside since Saturday evening so I have no idea what's going on beyond the television. However, apparently my apartment is starting to flood and creeks the run to local lakes are starting to overflow. So, yeah, I guess they are pretty accurate.

Thank you for everything you do everyday!

How are you?

How much extra stress (patients, storm... etc.) you deal with due to the storm?

Hey, it's been about 3 days since the storm subsided. Sorry I'm just now getting to this. I'm good though. The thing that stressed me out the most during the storm was the fact that we had to basically live at the hospital during the duration of the hurricane. I had to sleep there on the floor with no change of clothes or toiletries. I was bumming food and water from my coworkers, and I was sleeping in my dirty scrubs that I worked in from the previous night. Also, no underwear. Yes, I did come unprepared, but even those that came prepared were complaining about it because it's just really hard to get good sleep when you're not in your own bed.

Do you have a NICU there?? There is a call out on Health Source for NICU RN's and I am trying to head that way asap!

We do have a NICU

Do you work at a Magnet hospital?

Yes, but I don't know what that has to do with the hurricane.

Should Congress support financing disaster recovery after so many from Texas didn't support hurricane Sandy relief? Shouldn't just pull yourselves up from your bootstraps or whatever it is you say in texas

To my understanding FEMA is supporting us through this storm. I don't know about Hurricane Sandy and the politics. I just know we're getting a lot of support from other states and the government as well.

what's your favourite movie?

Probably Inglorious Bastards, but I like most war movies even if it's bad.

shouldn't you be busy?

She's probably doing this on off hours

I'm a he. ;)

I get some downtime during my shift.