National Nurses United

12 J A N U A R Y / F E B R U A R Y 2 0 0 6 C A L I F O R N I A N U R S E We were glad to be able to help, but disturbed that the Louisiana OEP seemed to have no idea that Earl Long was in dire straits. If we had not called the hospital directly, who would have helped Earl Long? Later, I asked A.J. Varner, Earl Long's director of nursing, if FEMA or the state had ever called to ask whether the hospital needed assistance with RN staffing. Being the only public hospital in what was not only the state capital but also the closest large city to New Orleans, it wouldn't take a rocket scientist to suspect that Earl Long would be slammed with pa- tients. Varner laughed heartily be- fore she replied, "No, nobody's called, and if they have, they haven't talked to me, and I'd be the one to talk to." Clearly, none of the groups in- volved in providing medical care or emergency services was communi- cating with each other. The state had no idea that hospitals like Earl Long were desperate for RN volunteers. Local public health agencies and hospitals were so busy trying to keep their heads above water that they had little time to reach out for help. And nobody seemed to know what the feds were doing. I n the absence of government leadership, many nurses as- sumed the American Red Cross, which is chartered by the federal government to provide disaster relief and to which donations have topped $1.82 billion just for Katrina, would fill the role of coordinating and providing medical care, but quickly discovered that was not the case. Many who tried to vol- unteer through the Red Cross or ended up doing so said they were frustrated by the excruciatingly slow assignment process and then disappointed by how little nursing they actually did. Dianne VanOrder, an RN who works at Kaiser Permanente in Manteca, signed up to volunteer through the Red Cross imme- diately after the hurricane hit. A pediatrics and OB/GYN RN with a background in emergency nursing, VanOrder had volunteered before in many disasters through several relief groups. She had treated survivors of major earthquakes in El Salvador, Turkey, and Mexico City. She had gone to Indonesia after the Asian tsuna- mi. She had gone to help during a famine in Ethiopia. In those cases, she had worked in make-shift clinic situations, cleaning wounds, triaging patients, or helping prescribe drugs to lower out-of-control hypertension. When she went through the Red Cross training, VanOrder said the instructors warned the RNs that they'd be doing less hands-on nursing than they were used to, but said she never ac- tually expected her duties to be reduced to handing out bandag- es and aspirin since the healthcare needs of the survivors were so acute. "I would have preferred to be in a place where we could do more direct care," said VanOrder, who reported that she spent her time at a Red Cross shelter at Texas A&M University hand- ing out supplies and over-the-counter medicine. When a shelter resident needed more urgent or emergency care, the medical volunteers would pass out vouchers and make referrals. "It was- n't what I thought we'd be doing. I thought we'd be working in a hospital or triaging people in a tent someplace. Had I known what it really was, I would have volunteered somewhere else." The Red Cross attributes experiences like VanOrder's to in- appropriate and unrealistic expectations by RNs. "If you're an emergency ward nurse and you think you're going to do that, you're naturally going to be disappointed," said Dee Yeater, RN and senior associate for disaster health services with the Amer- ican Red Cross. "We don't run hospitals. We're not a clinic. We don't replace the healthcare system. We set up and operate shelters." Yeater said that for liability reasons, Red Cross RNs only pro- vide basic first aid. Sometimes during a public health emergency, a local public health department will ask the Red Cross to "co- locate" and supply RN and MD volunteers, but in those instances, the volunteer "takes off her Red Cross hat" and officially moves over to working for the public health department. Asked whether the Red Cross has received complaints that it should do more direct medical care, Yeater replied, "We get let- ters, and we answer them. I'll leave it at that." In recent months, the Red Cross has been criticized for a va- riety of failures in response to Katrina, from imposing a some- times insurmountable amount of bureaucratic red tape for survivors to receive help, to providing toll-free help numbers that are never answered, to a lack of cultural sensitivity when helping

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