National Nurses United

C A L I F O R N I A N U R S E J A N U A R Y / F E B R U A R Y 2 0 0 6 11 I was usually greeted with a recording: "All circuits are busy now. Please try your call later. Zero-seven-zero-T." I had to try about six times for every time I got through. When I did dial through, I mostly got voicemail, but occasionally encountered a live per- son who took down our information. The states appeared to be actually mobilizing registered nurs- es, but in a completely disorganized and inconsistent fashion. In Mississippi, the state board of nursing was recruiting and plac- ing RN volunteers. In Louisiana, the Office of Emergency Pre- paredness was the one handling that task. In Texas, I was directed to the Texas Nurses Association, which was signing up RN vol- unteers through its website, but its program appeared to move slowly and involve a lot of waiting. I was fortunate to eventually find a woman who, as president of the Houston chapter of the Emergency Nurses Association, directed me to the person in charge of RN volunteers for the local healthcare district that was staffing the Astrodome complex's medical clinics. Besides just figuring out which agency was coordinating RN volunteers, figuring out license reciprocity proved to be anoth- er huge headache. The Mississippi Board of Nursing seemed to just want RN volunteers to fill out the state's temporary license form and fax it with a copy of their current state license to their offices to keep on file. The Louisiana State Board of Nursing had evacuated New Orleans and was desperately trying to set up offices in Baton Rouge. Because its website wasn't up and phone lines were down, it was difficult to determine whether it was granting emergency reciprocity to out-of-state nurses, and what paperwork it would need from volunteers even if it did so. In Texas, where the Astrodome clinics had said they could immediately use as many volunteers as we could send and had at one point been so short of nurses that they hired from a reg- istry, the State Board of Nurse Examiners told me that no emer- gency reciprocity was in place. Nurses wanting to practice there would need to complete the full endorsement process. The clerk there said the process took about 10 days, but that they would try to shorten it to five. But perhaps most astonishing was when she informed me that RN volunteers would still be required to pay the $200 application fee. "Are you serious?" I asked. She sounded apologetic, but replied yes. She then revealed to me that the Texas board was even making displaced Louisiana nurses who wanted to work in Texas, but who carried no cash, checks, or money since they evacuated so suddenly, sign promissory notes committing to pay the $200 later. Later that same day, that directive was fortunately overturned, but not before some CNA staff and California Board of Registered Nursing officials pushed Texas to be more accommodating. As CNA began sending out volunteers, I continued to research where RNs were needed. By this time, I was in touch with the Louisiana Office of Emergency Preparedness, which said it was coordinating statewide need for RNs. Though the agency gave us one assignment to help staff a special needs shelter in Lake Charles, the OEP said it actually had too many RN volunteers and not enough slots for them. We found it hard to believe, though, that Louisiana did not have greater need for medical per- sonnel to help care for victims of the worst natural disaster in the nation's recent memory. A colleague suggested I call hospitals directly and that's how we stumbled across Earl K. Long Memorial Hospital, the only pub- lic, charity hospital in Baton Rouge. Earl Long, nicknamed "Uncle Earl" or just "The Earl" by locals, is part of the Louisiana State University hospital system to which Charity Hospital, the huge public hospital in New Orleans that was evacuated, also belonged. When I talked to the nursing administration office, I learned that Earl Long's regular high-end census of 80 to 90 patients had doubled, and at one point almost tripled, after the hurricane. On top of people who would be regular patients at The Earl, patients from Charity and another LSU hospital in New Orleans, Univer- sity Hospital, had been evacuated there. Meanwhile, the popu- lation of Baton Rouge had almost doubled from about 400,000 to 800,000, and since the majority of New Orleans residents lacked health insurance, according to a recent Kaiser Family Foundation survey, The Earl bore the brunt of serving the city's additional patients. The numbers of supplemental RNs the nursing administra- tion staff said they could use was staggering: at least 30 medical- surgical RNs, more than a dozen ICU, and up to a dozen RNs in NICU, ER, OB, chemo infusion, and other specialties. Being a county facility, Earl Long had little funds to hire extra nurses. In fact, the county had talked for years about shutting the hospital down. CNA immediately got to work supplying Earl Long with RN volunteers, and our nurses were soon caring for at least half of the hospital's census. Eventually, from September to late De- cember, we would send Earl Long more than four waves of up to 30 volunteer RNs each.

• Cover