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September-October 2005
Wisconsin Nurses Volunteer in Time of Greatest Need

In the wake of the Hurricane Katrina disaster, teams of SEIU 1199 Wisconsin nurse members volunteered to care for and bring supplies to survivors of Hurricane Katrina throughout the south. Forty-two of our own Wisconsin members heeded the call for action. What follows is a list of these courageous volunteers and some of their very candid first hand accounts of the situation in Louisiana and Mississippi.

Lisa Fernandez, RN, UW Hospital and Clinics

"Here I sit, a 50 year old registered nurse with 12 years experience as a staff nurse in a major teaching hospital and trauma center; co-founder of a non-profit that ships medical supplies around the world, director of a wheelchair project that has provided over 700 wheelchairs in Nicaragua.  Not superwoman, but no wimp either.  I've spent months and months in Nicaragua and have seen poverty and suffering right up close.  Now I am back from 1 week of volunteer relief work in Louisiana with Hurricane Katrina victims, on leave from my job with a diagnosis of Acute Stress Disorder. 

Acute Stress Disorder.  Sounds like a diagnosis of weakness to me.  Was the suffering I witnessed in Baton Rouge and Monroe and Alexandria more than my system could take?  Did it push me over the edge?  No, it did not.

My stress did not come from the work in shelters, the interactions with evacuees, the witnessing of loss and destruction.  It was a gift to be there and be able to do even one little thing to help one person - lend an ear, do a health assessment, diagnosis a dangerously high blood pressure, hold a child, organize a pharmacy and supply room.  Whatever small thing I was able to do.

The stress, the anger, the frustration comes from the terrible waste of resources I witnessed, the waste of time and talent and skill.  The battling of egos and ideologies and wealth.  The turf wars. The academic rhetoric.  The power plays and manipulations.  The disorganization.  My stress comes form the hours and hours of wasted time spent sitting in Red Cross headquarters in Baton Rouge listening to academic banter over the wording of a needs assessment survey to be given to a sampling of evacuees in shelters, ostensibly with the purpose of identifying how well/not well their medical needs were being met so that problems could be remediated.  I say ostensibly, because in reality this study, which occupied the time and talents of more than a dozen RNs and MDs from around the country, was in reality an attempt for certain prestigious colleges to pull a plum from a pie of human suffering and loss. 

When I arrived in Baton Rouge, I was processed through the Red Cross.  I was assigned, along with 6 other nurses, to the ARC Public Health Division.  We joined 12 physicians who had also been processed as volunteers with the Red Cross, and we were set the task of conducting a needs assessment survey of evacuees in the shelters scattered around the state of Louisiana - the goal being to survey 30 shelters, 30 evacuees per shelter, according to an academically acceptable methodology that would allow for publication of the survey results.  Never mind that the methodology would be impossible to institute in the chaotic and ever-changing environment of a shelter.  Never mind that this survey could easily and readily be conducted by a layperson and in no way required the expertise and/or knowledge of a trained physician or nurse.  Never mind that the results were almost certain to fall short of the requirements for academic research (this not after all being an academic, but rather a disaster, situation). 

We all in our various ways made the best of our assignment, and used the survey data gathering as a door to initiating meaningful conversation with evacuees about their experiences, circumstances, and needs.  We then were able to intervene to meet some of these needs in an immediate way.  We also worked in shelter clinics in whatever capacity we were needed. Dutifully reporting to our "boss" at the Red Cross, we did whatever we could wherever we went.

After several days, we were divided into small teams in order to cover more shelters.  I had the great fortune to find myself on a team with a wonderful family practice doc (with previous disaster experience) and an advanced practice RN.  We were sent to Monroe, Louisiana, a city about 41/2 hours north of Baton Rouge, and home of a very large Red Cross Shelter.  This shelter has been widely publicized as a model shelter, complete with photo ops with the governor.  About 600 people were sheltering there when we arrived, with the population expected to grow as smaller shelters were being merged into it.  There was a great need for our services, and we quickly got our surveys out of the way and set to work.  The MD was busy seeing patients in the shelter clinic.  The advanced practice nurse set about setting up a much needed health outreach program to get health care services to the countless evacuees staying in motels and private homes in the Monroe and the surrounding communities.  And I went to work organizing the bags and boxes of donated meds and supplies into a workable pharmacy and supply room.  Our presence was welcomed and much needed, and we were all thrilled to be so useful at last.  Throughout our time there, we checked in many times daily with Red Cross Headquarters and were assured that as long as there was clinical work for us to do, we should make that our priority. 

And then the line from Red Cross Headquarters underwent an abrupt change.  Our boss made rumblings implying that we had defected - where were we and when were we planning on coming back?  Suddenly there was an urgent tone - we were needed back at Red Cross Headquarters immediately.  Why?  That was never made clear, but there were murky hints that all personnel were being rallied to prepare for the coming assault of Hurricane Rita, that we might be needed in New Orleans, that ……….whatever, but it was urgent!  Given that we three had already had the experience of wasting precious hours and days in Red Cross Headquarters, we were understandably reluctant to return.  I especially was very much against returning.  However, I did not want to do anything to endanger my co-workers' relationship with the Red Cross, especially the MD who was our team leader.  When I spoke to our boss about my concerns, he calmly but unequivocally make it clear to me that if I did not come back with the rest of the team, I might never be able to work with the Red Cross again, and that I might be damaging the reputation both of the MD I was traveling with, and the MD I would be working with if I stayed behind in Monroe.  There were also assurances that we were NOT being called out of situation where we were clearly needed just to sit uselessly at headquarters.

Well, bucking the system and taking the consequences on myself is one thing, but when faced with the threat of hurting professionals I respected and admired, I caved.  The three of us said our goodbyes and hopped in our rented car and headed back (4 ½ hours) to Baton Rouge.   What a sad crew we were, but trying to keep a positive view of things, and ready to do whatever was needed next.  We arrived back in Baton Rouge and went directly to Red Cross Headquarters.  There we found the section devoted to ARC Public Health completely vacant save for our boss Mike.  And what did Mike have to say for himself?  Why had we rushed back?  Uh………turns out, no reason!!!!!  He had NO REASON for demanding our return, NO WORK for us to do, NO URGENCY, NOTHING.  NOTHING AT ALL!  We had come back for no reason at all, none.  Was it a power play?  Making sure we would respond to orders like good little soldiers (Mike is a military man).  We will never know.  The MD was so frustrated and disgusted with this turn of events that he got back in his car and drove back to Monroe!  Anything to salvage some useful work after wasting an entire day for NO REASON.  The advanced practice nurse with us had the advantage of another week in Louisiana and found an assignment at another shelter.  Because I was scheduled to return to Madison the next day, there was no assignment for me, and it was only by serendipity that I was able to put in my last morning working at a non-Red Cross clinic in another town. 

Coming home from Louisiana as the Gulf, already reeling from Katrina, geared up for the expected fierce onslaught of Hurricane Rita was heart wrenching, and went against all the fibers of my sense of rightness.  To stay would put my job in jeopardy:  my hospital had been very unsupportive of those of us who chose to go, and had erected numerous obstacles for us to surmount.  They held out the promise that they would soon be setting up a field hospital of their own in the stricken region, a plan that had been shelved by the time I returned home - no need, the self-congratulatory letter from the CEO said.  There are no needs for us to meet, but isn't it great that we were theoretically willing to go??  This did not sit well with me, knowing as I did first hand just how great the need was, and is.

I met amazing people on my trip to Louisiana - volunteers and evacuees.  People of enormous grace and courage and warmth and humor and generosity and strength.  There are an abundance of good people in this world.  How is it then that so much power lies in the hands of  the power seekers, the greedy, the self-seeking, the ignorant, the close-minded and prejudiced, the entitled, and the just plain evil?  And how is that that these are the people who are directing the course of the world the live in?  On levels large and small. 

Acute Stress Disorder in my case came from the disconnect between what was and what should have been.  What is, and what should be.  It comes not from the disaster that Mother Nature has wrought, but from the failings of humans in their response to that disaster.  Thus creating a disaster that keeps on giving - in pain, suffering, waste and injustice.  Why were there hundreds of medical personnel unable to find places to use their skills, while at the same time there were clinics and shelters and hospitals that desperately needed doctors and nurses?  Why was there not a central registry of all the personnel available - their skills and their availability - that could be matched with the need?  Why not?  Because politics and power and territoriality and egos take precedence the saving of lives and the alleviation of suffering. 

Want to cause a health care professional acute stress - stand them in front of a need that they can meet, and tie their hands behind their back."

Lisa Fernandez
Registered Nurse
SEIU District 1199W/UP Member

Pat Klinke, RN, Meriter Hospital

"This is a synopsis of my one week volunteering in Thibodaux, La.  I was assigned to a Special Needs Shelter, which was located in a school of nursing, on the campus of Nicholls State University.  The Betsy Ayo Center (Nursing School) is a three floor building.  The first floor was used as a command post and triage center.  Second floor housed the patients in classrooms and skills labs. These patients were not sick enough to be in the hospital but had too many medical problem to be in the general shelters. The rooms held up to twelve patients-men, women and children, placed cot to cot.  The more acute patients were place in the skills labs which had regular hospital beds and privacy curtains and the less acute were assigned to a regular classroom without any privacy.  I have to give the people alot of credit because there was not much complaining about the accommodations. The general population of my patients were being treated for diabetes (dialysis), hypertension, asthma and alcohol issues.

We all worked twelve hour shifts.  I was fortunate enough to be on the night shift for five nights in a row!!! 

One of the rooms on the second floor was converted into a pharmacy.  This was run by different D-MAT teams (Disaster Medical Assistance Team). These consisted of pharmacists, paramedics, nurses and doctors.  They did alot of the triaging.

I loved the patients that I cared for and the nursing I did, but it was really frustrating to see how unorganized the whole game plan was put together.  Nurses not showing up for their shifts and no plans for replacements,  no drinking water on the floor for the patients unless the nurse went to the first floor to get it,  ice was kept in 5-gallon Home Depot buckets that we had to keep filled WHEN there was ice, no activities for the patients unless they went outside and stood in the humidity just to watch other people, etc.  One of the things I observed about the patients is that they slept in their street clothes and were up frequently during the night. 

I'm glad I had this experience and I thank the union for giving me the opportunity to help others in need."

Pat Klinke
Registered Nurse
SEIU District 1199W/UP Member

Louise Koshollek, RN, Meriter Hospital

"I was part of the 10 member team that flew out on Sept 14th.  Four of us were sent to replace other SEIU nurses at the special needs shelter in Thibodaux, La.  It was housed in the Betsy Ayo School of Nursing on the campus of Nicholls State University.

There were 8 evacuees in the classroom I was assigned to, along with 4 family members, who were allowed to stay as caregivers.  The evacuees in the "Pink Room" as it was labeled, were the lucky ones.  Theirs was a nursing arts classroom and they could sleep in hospital beds and not Coleman cots.  They had been placed at this shelter because they couldn't be in the general shelter because of medical needs.

They had come from all different walks of life, a plumber, retired postal employee, a lawyer and a bed bound elderly woman.  Katrina was the great equalizer.  She brought them all together in one classroom under the care of RN's and EMT's from Wisconsin, Indiana, Maine and Pennsylvania.

We worked 12 hr shifts and tried to refine the charts and systems put in place by the teams that came before us.  We came 2 weeks after the hurricane and some things were getting better.  For instance, the pharmacy and supply room was getting better stocked although staffing was still chaotic.

Some of the other teams slept on cots on the third floor.  Our team of 4 was fortunate to go home with David and Imogene Howell.  We were fed home-cooked southern meals each night before going off to work and we collapsed into REAL beds every morning.   We were well cared for so we had the energy to care for the evacuees.

I have many memories that I will cherish for the rest of my life.  Many involve fellow RN's.  We heard the story of how one of the shelter nurses hid an elderly woman so she wouldn't get sent back to the general shelter where conditions were less than ideal.  I saw fellow RN's spending their money to buy clothes and egg crate pads for the cots for the elderly in their classrooms and continuing to problem solve how to make life better for the people they were assigned to care for. We worked with a displaced RN from Tulane Hospital who had been on duty during the hurricane and the flooding that followed.  His stories were inspiring.

I am so grateful to SEIU for providing the planning and resources to allow me to go."

LOUISE  A. KOSHOLLEK
Registered Nurse
SEIU District 1199W/UP Member

Laura Nelson, RN, State of Wisconsin

"I am fiercely Patriotic, believe in our freedoms, our rights as Americans.  I was mortified at what was happening to American citizens in the coastal area. This is why I went. To do my part, to help my fellow Americans. To share the God given talent I have to comfort and heal physical and emotional wounds.
 
The spirit of the people came through. Despite the devastation and loss surrounding them. I received from people who had nothing left. I received hugs, thank yous, laughter and smiles. Gratitude in the form of a sigh of relief from someone who was tired ,weary and ill. All I had done was to sit and listen to their story. Stories of sitting in their homes, on their roofs, in their bedrooms watching their material belongings washing away wondering when someone was going to come for them.
 
I worked beside paramedics, nurses and doctors from Michigan, Maine, North Dakota, Florida, Minnesota, Indiana and Wisconsin. What a wonderful group of people!

Arriving into "organized chaos" very tired, we then worked a night shift. We cared for people who had not had insulin, with wounds from debris, rashes from being in the water, dialysis, post-op from cardiac surgery, severe hypertension, you name it!  We gathered supplies from a room filled with donated supplies. We asked and a volunteer found the item for us. The pharmacy was a room filled with boxes of medicine. Physicians came around every hour or so to see what we needed, to help with any physical developments as developing CHF, MI, unresolved infection. Our nursing judgment was respected and well received. I used every  skill I had developed in my 35 years of the profession. One patients caregiver pitched in and helped me make beds and get ice and water.

I cared for 12 people. I could tell you each and every ones "story" The 88 year old sun downer that kept everyone awake two night in a row singing Hymns and praying. On the 2nd night the room was in mutiny and we had to move her out into the hall. The man who soothed himself by care taking other patients. He was an ex New Orleans Policeman wounded in the line of duty 12 years ago and had contracted HIV from infected blood he received during his surgery. He was weak from being without food and water for 3 days. He thought his wife and son were in a shelter in Houston but he wasn't sure for several days as to where they were or what had happened to them. They had been separated when he needed to be hospitalized. Each person had a story. Each had their own disappointment. But I heard very little " woe is me". The spirit showed through.

We managed to find time for some fun. There was a Talent Show for all in which my ""sun downing Grandma" sang a hymn a Wisconsin nurse juggled and the Director of the shelter was Tina Turner along with other volunteer Tina's. There were donated trinkets for door prizes.

We ate Beans and rice, slept on very squeaky cots. I got homesick.There were volunteers in the "kitchen" that nurtured us by getting us coffee, finding Chocolate and a Turkey sandwich.

Although I gave I also received. I found a inner strength I forgot I had and I have a new personal respect for "the nurse in me"  I hope I don't lose that in the day to day nursing often encumbered by paperwork, regulations, personal power struggles and the rare Thank you, you did a good job.

It was a once in a lifetime opportunity. Thank You SEIU for making it happen. Hat's Off to the Wisconsin Nurses that accompanied me. I could not have survived without you."
  
Laura Nelson
Registered Nurse
SEIU District 1199W/UP Member

Sally Schlehlein, RN, UW Hospital and Clinics

"I was one of the SEIU members to volunteer to help the evacuees of Hurricane Katrina.  I wanted to tell everyone a little about the experience and to also express my appreciation to SEIU.  I am so proud to be a member of an organization that acted so quickly in the face of such a national natural disaster. SEIU had nurses on the ground by September 7th: I went with the second group leaving September 10th.  Bonnie Strauss worked tirelessly to make arrangements to get these groups on the ground. We didn't know our travel plans until late Friday afternoon for a 6am flight out of Milwaukee.  All the transportation was arranged, we were met at the other end in Baton Rouge by Vickie Baca, SEIU International Contact in Baton Rouge, who took care of our documentation and transportation to a special needs hospital in Thibodaux Louisiana.  The organization of SEIU was excellent and left our group of eight with a sense of safety and pride to be members.  I am pleased to be a member of a union, which is so proactive, andnot only works to protect us in our workplace, but also works to provide needed services to the community at large. Thanks to our union of workers we were able to take quick decisive action in an atmosphere of delayed response. Never again will question why I pay union dues!

In order to make our six am flight to Baton Rouge we had to leave Madison at 2:30 in the morning.  We each had a small carry on bag with our personal items so that our check on luggage would be made up of boxes of donated medical supplies collected by SEIU.  The airlines were very cooperative to get our 26 boxes and us onto the flight, it was quick and easy.  We arrived in Baton Rouge at about noon, were met by Vicki Baca, and taken by bus to be credentialed as RN's in the state of Louisiana.  We were fed with donated food from a local church and taken to Thibodaux where we were well received as indicated by the need.  Arriving at 6pm, we were told we were the night shift and after a 15 minute orientation began our first of six twelve hour night shifts.

We worked at the commandeered Nicholas State University Nursing School and campus.  Our duty as night shift nurses was to work in the special needs area with the evacuees who could not be in the general population with those in the two shelters on campus, which were in the gyms.  Our people were diabetics, on dialysis, with respiratory needs, wound care; psych needs, amputees, paraplegics, hurricane injuries and dysentery.  We were busy and well used.  No one ever had a second thought about why we were there. 
I am please to report that our group did very well, we worked together well, no complaints other than the difficulty of sleeping in the day for us daytime people. 

In short, I just want to thank SEIU for the opportunity and the fantastic organization."

Sally Schlehlein RN
Radiology

Mark Oddson, RN, State of Wisconsin  

"I'm currently "on the ground" in Baton Rouge, Louisiana. I deployed on Sept.27th and have spent most of my time helping the I.A.F.F. run a shelter for firefighters and they're families in the Port Arthur region. Firefighters in the area were working 24/7 so they had no time to take care of their own homes. They're families had been evacuated. We kept thestations supplied with food and water, immunized those that needed it andkept meals and the shelter going 24 hours a day for the firefighters who poured in from all over Texas and other parts of the country to temporarily repair the homes of the firefighters who remained on duty. Having been a paid on call firefighter for the last 29 years, it was a rare privilege for me to work with our union brother and sisiters in the firefighting service. We were able to finish our part of the work and close the shelters in Baton Rouge and Port Arthur. This does not mean they are fine in these areas. Itmeans they have the very minimal ability to begin the difficult task ofrebuiding. The only reason I'm able to send this letter is I am waiting to find where I'm going to assist New Orlean's firefighters. This is the first chance I've had to e-mail since I came down here. I was able to direct some of the medical supplies to local doctors who had given their supplies up to the shelters and now must open their offices without anything. It is important to get the local health care system as stable as possible and get local m.d.s working as quickly as possible. Just before I left, a visit to the emergency room had an average waiting time of 7-9 hours. This impedes health care for all in several different ways. It has been a very positive experience and I look forward to moving on to New Orleans."

Mark Oddson
Registered Nurse
Dodge Correctional Institute

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