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22 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G O C T O B E R | N O V E M B E R | D E C E M B E R 2 0 2 4 Just like in their nursing jobs, nurses had to be flexible and quick to solve problems. When residents needed private examination areas, at one shelter, nurses worked with paramedics to heat an emergency transport vehicle; the back of the vehicle then became a private examination area that ensured patients' privacy. In another instance, elderly residents were refusing to drink water because they didn't want to venture into the freezing and wet outdoors to use the bathrooms. So nurses and other staff at the shelter set up indoor portapotties, including establishing a workflow to remove the waste. The elderly residents who were at risk of dehy- dration started drinking water again. As with so many disaster responses, nurses were called to deliver not just medical care, but also empathy and compassion, recalled Joy Bessinger, an early childhood health and nutrition coordinator from Dutchess County, New York. "Not all wounds are physical, especially after a natural disaster of this magnitude. People had been through very scary situations just to survive and make it to us. A lot of our time was spent listening to people and giving them the space to process their trauma," said Bessinger. For the most part, nurses stayed at the same shelter over the course of their deployment, which allowed them to grow connection, understanding, and trust with the residents. They played cards at night. They shared stories. They entertained children, held babies, and took care of residents' dogs. They even celebrated birthdays and Halloween together. "When you're recovering from a disaster of this magnitude, when you have no consistency or stability of any kind, even just having the same staff who knows your name, and says hello to you, and asks you how you're doing, it brings back people's humanity and encour- ages them to take positive steps forward," observed Perry. And as they do in their hospital shifts, RNRN volunteers worked together as a team, even across the two deployments, to ensure continuity of care. There was one victory that multiple RNRN volunteers celebrated. Perry, who was on the first deploy- ment, gave the second deployment a heads up about a resident she was concerned about, who had been refusing treatment and avoided the nursing staff. "We knew from the update Mary-Jane had given us that we would have to gain her trust first before she would even make eye contact with any of us," recalled Michele Van Wyk from Vero Beach, Fla. "After a few days, we were able to have a conversa- tion with her and she was able to communicate her needs. It truly was a team effort from one RNRN deployment to the next to support this woman." "A few days after that, she began to trust us enough to allow us to treat her wound. We were all high-fiving after that," said Bessinger with a laugh. "After that, she also trusted the RNRN team to help her shower and give her clean clothes." Reding noted, "We knew it was outside our job expectations to take care of the woman's daily needs but we knew it was an essential part of the healing. It took time, rapport, and trust, and we got the job done!" RNRN nurses acted as advocates on multiple fronts for the res- idents they came to know and grow attached to—often going above and beyond their nursing duties. Nurses became resources for res- idents who needed guidance on where to access immediate and long-term support. "People would ask, 'When you guys are gone, how can I get help?'" recalled Kathy Shimada, a retired nurse who divides her time between Arizona and Minnesota. "So it was important that we do whatever we could to educate our residents and connect them to resources they could access even after we left." For O'Neill, in collaboration with other concerned health care staff at the shelter, that meant advocating for the area hospital to readmit a resident with cancer who she felt had been prematurely discharged without a sufficient plan to manage his condition. She personally spoke to the admitting doctor and social services to ensure he was served appropriately. For Katie Purdy, a nurse from Oakland, Calif., that meant flagging for the social work team at International Medical Corps, the leader of this deployment, that one of the frequent visitors to the mobile medi- cal unit had become unhoused. They then connected this resident to housing resources and free veterinary care for his dog. For Van Wyk, that meant earning the trust of residents who con- fided in her that, because of the uncertainty of their futures, their substance abuse was worsening. Pulling on her own personal experi- ence of having a loved one struggle through substance abuse, she helped successfully connect several residents to the medical and mental health care they required. The nurses marvelled at the resilience and solidarity of the Ashe- ville community, even as the scale of the recovery was just coming into focus. Asheville has long been known for its art scene, and on the last day of the second RNRN deployment, some nurses had the chance to attend a street fair in support of local artists whose liveli- hoods were at risk. The fair's positive spirit was a reminder that the city, despite the destruction, will continue. "Having the time to listen to our residents' stories was so impor- tant to them, but looking back, it was just as important to me. I will remember to be a better listener and give patients my undivided attention," said Van Wyk. For O'Neill, who deployed with RNRN for the first time, the experience was life-altering: "It's given me big perspective about what I want to do moving forward. I got to meet great people and made great connections with patients, nurses, and other health care providers—doctors, social workers, and medics who go to disasters. It's changed how I approach my future as a nurse." Michelle Morris is a communications specialist with National Nurses United.