By Nancy Cook
Living in southeast Texas on the Gulf of Mexico for the past six years has given me an acute appreciation for hurricane disaster preparation. I am told that each hurricane is different in its manner and aftereffects. In 2005 Hurricane Rita dropped about 8 inches of rain; in 2008 Hurricane Ike dropped 18.9 inches of rain. Both caused billions of dollars of damage. In 2017 Hurricane Harvey dropped between 40 and 60 inches of rain, with about $180 billion in damages. In all cases some residual loss is felt and held in the collective memory of the community.
Harvey was extreme in that it hit southeast Texas as a hurricane, went back into the gulf and returned as a tropical storm. It was the flooding that took the biggest toll on the community. Some residents could not flee the flood fast enough and perished. Others were boatlifted by volunteers before a federal disaster response was established. Many areas flooded over the rooftops of homes.
As the hurricane approached, CHRISTUS Southeast Texas Health System opened its command center. Arrangements were made to fly in nurses, supplies, and water. Neonatal intensive care babies and renal dialysis patients were airlifted to CHRISTUS hospitals in Louisiana. The hospital did a “compression,” discharging patients who could be discharged and moving patients on the sixth and fifth floors to the fourth, third, and second floors. A temporary lounge was set up for discharged patients who could not get back into their homes. Nurses flown in from other CHRISTUS hospitals lived on the upper floors and were restricted to the campus.
Disasters have phases that foster certain emotions and feelings (Zunin and Myers, 2008). In the threat and warning or pre-disaster stage, communication and preparation can lessen the impact of the potential disaster. Knowing the hurricane was 48 hours away allowed for mobilizing our facilities and strategizing needs. The next stage is impact. Again, hit by Harvey as both a hurricane and a tropical storm, the impact phase lasted about five days. For survivors, this can be a time of intense fear and panic. The rescue or heroic phase is the time after the disaster where adrenaline flows. This is a time of intense action. In my hospital, it involved hyperactivity with the assumption of irregular assignments and tasks. For example, the chaplains were responsible to maintain and manage a semitrailer of portable showers.
The honeymoon phase can be experienced when outside agencies such as the Federal Emergency Management Agency and the American Red Cross come to help. The collective consciousness might have a sense of relief that the worst is over. However, the disillusionment and reconstruction stages can happen in the aftermath. Outside agencies pull out of the area, people resume their normal routines, and life seems to get back to normal. But not all families ease back into normal. Families that have lost their homes find that they must pay a mortgage and rent an apartment at the same time — for those lucky enough to secure an apartment at all. Families that have lost their cars find the same scarcity of low inventory and high demand.
The spiritual care team was active with our patients and employees through all these stages, serving the greatest and most acute needs. We mobilized pre-disaster, assessing who could serve as essential staff and who had to attend to their own homes in preparation for the hurricane. With essential staff, chaplain representation at every emergency management meeting allowed for continually assessing the spiritual and emotional needs of patients and staff.
We were able to maintain regular spiritual care services, including daily Mass, initial visits, overhead prayer, family care and ethics consults. The team assessed additional needs in the care of employees working, living, and confined to the campus. A lounge and game room was established so people coming off their shift had a place, other than their sleeping room, to go, debrief, and socialize. We named this venue the Hurricane Harvey Lounge. We maintained this service until the reconstruction phase.
The team also was mindful that in the reconstruction phase, not all employees and members of the community were getting back to normal. Some were left grieving the loss of loved ones, of home, of pets, and of any sense of stability. In preparation for this phase, the chaplain team set up opportunities of defusing, debriefing, and counseling through a series of venues and options. The team developed a needs list via the directors. We found that it was better stewardship to target resources to identified employees. These employees benefited from the offering of scrubs, pillows, blankets, and towels. Additionally, CHRISTUS Health gave a bonus to CHRISTUS employees who worked during the disaster. The system also gave money to those employees dramatically affected by the disaster.
Nancy Cook, BCC, is regional director of spiritual care at CHRISTUS Southeast Texas Health System.
