Florence and Michael. Katrina and Rita. Ike and Sandy. The names have become synonymous with destruction, displacement, and loss. Despite growing preparation, hurricanes remain a major threat to coastal and inland communities in the U.S. They’re complex and totally unpredictable, shifting in size and direction as they approach landfall. They also carry a lot of second-hand problems — from storm surges to flooding to infrastructure damage.

As a travel nurse, if you’re on assignment near the Atlantic seaboard or Gulf of Mexico, there’s a fair chance you could be on duty when the next big storm hits. It can be a really scary situation.

• During Hurricane Katrina, a full two dozen hospitals were evacuated due to loss of power and water and sewage failure. 11 hospitals were directly touched by floods, affecting 1,700 patients and thousands of staff members. Brave personnel who stayed to help had to resort to using IV fluids for sustenance when food supplies were depleted.
• In Hurricane Sandy, more than 6,400 patients were evacuated, and six hospitals and 26 residential care facilities were closed. In a survey of hospitals, 18% were affected by the loss of power and 8% experienced flooding.

Hospitals have improved their response protocols and learned from these past tragedies. Still, when a hurricane hits, the challenges can be demanding and grueling.

So what can you do if a hurricane’s coming? Make sure you’re prepared. Here’s how.

Protect and prepare yourself first

Think of it like the warning you get from flight attendants on an airplane: put on your own mask before assisting anyone else. If you’re not ready for the challenges of functioning in disaster mode, you can’t fully help those around you.

If you know a hurricane is coming, and you’re concerned about your safety, contact your agency. Ask for guidance and advice. Your safety is the most important matter. And if you feel your hospital is asking for unreasonable assistance, make sure you express your concerns to your agency. It may be best to leave the assignment.

Make sure you’re personally prepared for a hurricane. These instructions from the CDC will help you make sure you’ve got everything you need. (Similarly, the CDC offers advice for how to respond after you’ve been affected by a hurricane.)

Here are some items to keep on hand in the event of a hurricane or other natural disaster, either in your apartment or the trunk of your car:

• Heavy gloves for handling and broken glass or debris related to the hurricane.
• A portable LED flashlight.
• An emergency USB charger.
• Water and non-perishable snacks.
• A blanket.

Consider downloading a disaster response app. FEMA’s app provides emergency alerts and information regarding what to do before, during, and after disasters.

Study your hospital’s Emergency Operations Plan

Whether or not you anticipate a natural disaster, it’s always wise to become familiar with your hospital’s Emergency Operations Plan (EOP). Though permanent staff will likely run operations in the event of an emergency, it’s still crucial for you to be in the know — this will help you to help others as effectively as possible. The EOP will provide essential details about what to do, where to go, and how to communicate in the event of a major natural disaster. Plans include:

• Communications. This includes who is responsible for the communication command center and for developing and sharing messages. It will also outline standards for communicating with external agencies regarding needs (supplies, etc.).
• Resources. This section will give you information on the hospital’s resources and assets you’ll need in an emergency situation, including where to find and how to operate generators.
• Safety and security. Here you’ll find procedures related to safety and coordinating with outside agencies, like the National Guard, for the purpose of ensuring safety.
• Staff responsibilities. This section will clearly outline who’s in charge of what — from communications to dealing with vendors, and more.
• Utilities. Hurricanes and other natural disasters often compromise electricity and water. This section will have maps and explanations for how to identify and address utility infrastructure failures.
• Patient and clinical support activities. This section will address how to plan for clinical services in reaction to emergencies, as well as how to anticipate the impact they’ll have on your facility and patients.

Educate yourself

Beyond reviewing your hospital’s Emergency Operations Plan, you’ll also want to educate yourself with other resources. Here are a few guides that can really help you out:

• FEMA offers dozens of self-paced courses within their Emergency Management Institute covering a broad range of topics. (Also check out FEMA’s index of Emergency Management Agencies.)
• If you’re in pediatrics, see the CDC’s guide on Caring for Children in a Disaster. It illustrates the different ways children process and respond to disasters, physically, mentally, and emotionally.
• This information from the Centers for Medicaid and Medicare Services explains some changes in regulations and rules that occur during emergency situations to accommodate the needs of affected patients.
• The American Red Cross provides information on how to become a disaster volunteer. As a nurse, you’ll bring a wealth of expertise (and a confident attitude) as a volunteer.

Interestingly enough, if you’re on assignment for a while following a hurricane, you can expect an uptick in your number of patients. According to a recent study, natural disasters set off a chain reaction of medical issues, e.g.:

• patients require mental health assistance resulting from the trauma, or
• patients have increased symptoms of asthma or diabetes from not having access to medications during the event.

The study found that in the thirty days following one tornado, hospital admissions increased by 4% for older adults.

It’s definitely scary to think about the potential harm of hurricanes. But there are good reasons nurses are known for their toughness during a crisis. In response to Hurricane Harvey, over 300 nurses flew to Houston to lend a hand. And as a travel nurse, your experiences make you uniquely prepared to adapt in new situations.

Looking for more emergency prep tips? Check out our article on Gypsy Nurse on what to do when disaster strikes when you’re travel nursing.

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