AJN received this guest post last week, when the effects of Hurricane Irma were still in the headlines, from Kathryn Jackman-Murphy, EdD, MSN, RN, professor of nursing at Naugatuck Valley Community College in Connecticut. The challenges she describes here are not specific to Hurricane Irma—they are faced again and again by those forced from their homes and communities by storms and other natural disasters, and they often happen out of sight of the media.
Right after Hurricane Irma began to hit Florida, I checked in with one of my son’s adult friends. He was searching for a safe landing site for himself and his elderly parents, as his initial plans to stay had been compromised by the hurricane. He was now in Tennessee, with no idea of where they would be able to stay until it was safe to return home. The dad is a Vietnam-era veteran with PTSD, hypertension, and diabetes. The mom also has diabetes and some limitations with mobility related to arthritis and walks with a cane.
How can nurses help?
Watching the devastation in Florida and Texas, I was searching for something to do to help. That’s what nurses do—we help. Being so far away in the Northeast, I felt not only helpless but acutely aware that my world was still intact while so many others had nothing left.
As it became clearer that Hurricane Irma might have a significant impact on Florida, many residents heeded the warning and left their homes, friends, and family behind. There was only one direction to go—north, but to where? Many had friends or family in neighboring areas that were thought to not be in the path of the storm. Unfortunately, as these people began to travel, they needed to alter plans as the storm changed its course and continued to widen and affect areas initially considered secure.
As those fleeing the storm sought safe refuge, they tried to connect with others further away from the storm’s impact in order to make secondary arrangements. Many concerns loomed: How long would they be gone? Would the storm affect their home? How would their friends and neighbors make out? What would they go home to?
You are supposed to feel fortunate because you made it out safe, but you worry about what you have left behind. Every thought and concern is a stressor.
Those on the road with health issues face special challenges.
Families left home with as much as they could fit into their vehicles and uncertainty about their plans. Supplies, including medical supplies, ran low. Day-to-day survival became the focus rather than the modifications made to accommodate health concerns such as diabetes or hypertension. For example, more readily available fast foods became the staple of the daily diet and concerns related to sodium or sugar content were forgotten.
Being far from home presents further challenges for those with medical concerns, such as gaps in needed evaluations by providers or difficulty obtaining refills for medications. In many cases, pharmacies and medical providers’ offices damaged by the storm were closed and calls were not answered. Some patients couldn’t get medical records or prescriptions refilled, making adherence to their plan of care difficult. Proper preservation of medications such as insulin became a constant challenge.
Financial concerns affected travel plans as well, as people considered sources for food, gas, and lodging. Campgrounds offered a budget-friendly option, but many were filled to capacity and some travelers were turned away. Some campgrounds were also closing for the season.
Time to return home?
As the storm passed, finding information about their homes, family, and friends became the focus of attention. Many learned that grocery store shelves were empty and flooding had affected the water table and could influence the quality of their tap water and the function of their septic system. Cell phones enable contact, but may not provide specific updates about electricity, damage to houses, availability of resources, or flooding into one’s home. Attempts to get word about those who were unable to leave, the elderly without family, the medically fragile, or those with limited resources becomes an obsession.
Plans to return begin to form. The financial costs of the return journey are now a matter of concern. There are many anxious hopes—hope that those who’ve already returned are well, that the sense of community you once had will still exist, that you have not lost everything, and that you can find ways to begin again.
The car is packed, the trip is mapped, and you hope . . .
I’m wishing my visitors goodbye in a few days and hoping they are able to find fuel along the way and have safe, affordable, and comfortable lodging as they travel home. I am hopeful that they’ll find their home intact and with minimal damage, their friends there to greet them . . . and life can return to its “new normal.”
(Kathryn Jackman-Murphy describes herself as ‘very concerned about the effect of the environment on our health’; she works with nurses across the United States and internationally as a member of the Alliance of Nurses for Healthy Environments, www.envirn.org.)