IceStorm 98 Study

Ann says that the storm really hit Wednesday night. She lives in what used to be called "Kingston Township" out near the airport. She is surrounded by a lot of trees on the water. She was scheduled to work on the Thursday. She managed to get to work because she and her husband have a 4 by 4 vehicle and he works downtown. She felt that she had to get to work because if other nurses have to be at the hospital to look after patients then she as a nurse manager should be there even though she doesn't provide care to the patients.

She had no power in her own home. She did have phone service and a cellular phone so she had no trouble getting in touch with people. Having no children at home anymore, she says that she was in a very good position to leave her home. The hospital was very quiet when she arrived. As the reports came in, she and her staff were starting to appreciate how long they were going to be out (of power).

The "crunch" really didn't hit for her right away. She actually managed to get some office work done. The power was back on in addition to the emergency power. Her computer was up and running, internal phones were working, lights were on. There were still a lot of concerns about whether the whole grid would go down again so she had to make sure that certain things were in place--primarily staff. There are approximately 1,000 nurses on staff at K.G.H. When the storm hit there were some that couldn't get home and some that couldn't get to work. One of the first things that to be done was to set up a temporary "residence" or sleeping quarters for the staff. Fortunately, the former psychiatric unit was empty. The "dormitory" was set up here. She says that at times there were about 40 nurses using this dorm. She believes there may even have been more.

Ann says, "it was phenomenal" how good the staff were at staying and working extra hours. She says they worked and slept and worked and slept. This enabled the hospital to continue to look after their "in" patients which was their prime responsibility. There may have been as many as 350-400 patients in the hospital at this time. Surgery had been cancelled as well as any ambulatory clinics.

Ann says that it wasn't just nurses that stayed overnight. She says residents, cleaning staff, interns, nutrition services staff, etc. also stayed. She says there were enough nurses working at all times. It was a little tight at some times but it worked out. They called in to see if they were needed even when they weren't on duty. This is part of the disaster plan of the K.G.H. Gay says it was at the discretion of the managers as to whether people who did not make it into work would get penalized and those who worked extras shifts would get compensation. She says days lost could be taken as vacation or time in lieu so that money wasn't lost.

Patients were still coming into emergency but there were no patients being discharged. Post-operative patients couldn't be sent home to houses with no power and no available home care. All of a sudden the hospital was full of "bed blockers". Gay explains that these are people who are in beds that didn't need to be in the beds but didn't have another place to go. She says this is a serious problem with acute care hospitals. Acute care hospitals are also the most expensive. This lack of beds became a problem on Friday. Alternate arrangements were starting to be made.

Gay became "duty administrator" on Friday morning. This was above and beyond her regular role as co-ordinator. She became back up for the senior nursing co-ordinator. Gay explains that the duty administrator carries a pager for a week. She must stay within telephone contact of the hospital at any given time so if there is a problem she is accessible. The emergency department was starting to get backed up because of the lack of beds. The Hotel Dieu was taking all kinds of people in off the streets.

On Saturday Ann got the word from her boss that the K.G.H. was going to have to set up a hostel. It would be a very specific hostel for those who needed to have some medical/surgical type care above and beyond seniors. In the afternoon a hostel was put together in the old cancer wing. The physiotherapy department got moved to St. Mary's to create more space at the K.G.H. Beds and food had to be gathered together in a couple of hours.

Ann says the meals were really good. The hospital put on a huge buffet for these people--breakfast and lunch. A dining room was created and a lounge. Positive comments were received from those that ate there. The beds were to come from the base hospital. They were to bring the K.G.H. some cots but they turned out to actually be "litters". These are little canvas stretchers that sit very close to the floor with pokey handles sticking out of the ends. Gay says these were sent back as they would be impossible for most patients to use. Gay and her boss didn't know what to do because they had told the Hotel Dieu that they could send over the people and they would have beds. She and her boss raided the hospital for the best treatment stretchers. These go up and down and have sides on them. They are very much like beds. "It was a parade of stretchers". She says they did get some very satisfactory beds. The Cancer Clinic was very helpful in providing treatment stretchers.

These people had to be carefully registered so that family members could find them. Phones were down and there were panicky family members trying to find people. As they were registered a brief assessment was being done. Registration staff greeted people at the door. People were listed on the computer. A running tally was kept track of at all times. People were assigned to beds. A drawing was done of who was assigned to what bed so that staff could keep track of them as well. These people came from the Dieu and their homes. They were not called patients because they weren't being admitted for care. They were referred to as "guests". After being registered the next person they met was a professional nurse who did their assessment.

Gay says the volunteers rose above and beyond the call of duty during the ice storm. The volunteers oriented the guests to their beds and got them settled in. Volunteers took the guests for their meals, oriented them to the dayroom, the bathrooms. They kept people who were scared and lonely company. Gay says their support was "incredible". Nurses who weren't on duty and weren't needed in the "hospital" were invited to volunteer at the hostel and they did. Retired staff even came back to help in the hostel. They knew all the people (staff) and knew who to call if something broke. Approximately 48 guests could be accommodated in this space.

Because so many of the guests were fragile and under a lot of stress, the Department of Medicine provided the hostel with a senior resident for the group. Standard medications were kept on hand and the pharmacy provided whatever else was needed. Medications were available 24 hours a day. Extra support equipment was needed--wheelchairs, commodes, etc.

The housekeeping department provided all of the housekeeping. They cleaned regularly and provided all of the linens. Security was at the main door. They brought in extra people. Ann says the staff and volunteers at the hospital were "warm and fed". "They could be clean and be productive rather than sitting at home and accomplishing nothing".

Sunday and Monday, things carried on the same. She says that by January 12th there were still people in the hostel. Sometime between Monday and Wednesday the hostel was closed. On the Monday plans were made for a 10 bed home-care unit. This was set up on Tuesday. The K.G.H. provided the "physical" base for this unit. Any of the other hostel patients had gone home or had been sent elsewhere (i.e. K.P.H.).

Peter Glynn and the Vice-President were in the position to make the decisions. Gay's role was as a co-ordinator/support person. She works with architects, engineers, maintenance, and computer people to try to make sure that patient care, environment, equipment, and facilities are as good as K.G.H. can possibly afford to make them. She spends all of her time doing plans (i.e. blueprints). Patient care environment is her concern. Gay says that there are times when it is her responsibility to speak with the press. This would happen when she is taking her turn as duty administrator. This was not necessary during the ice storm because the heads of the hospital were in contact with the press and regular meetings were held to keep the press informed.

Gay says that during the ice storm, she did not feel stressed herself because her job is "change". She says that she lives with change. She is a change agent. "Without change she becomes stressed." She is sure that some of their "guests" in the hostel were stressed. The major stress for these people was worrying about whether their homes would be safe. They hated to leave their homes. They feared they wouldn't get back to them. In a couple of cases they were worried about their pets or whether their families would find them.

She thinks that among the team they were having a good time. She says that she would much rather have spent her time at the hospital during the storm that being at home "stuffing wood into the wood stove". She said that she got to work along side people that she normally wouldn't have had the opportunity to work with. She says that it didn't matter whether you were "a vice-president or a floor cleaner, you were all in it together".

Ann says at the time of the ice storm the hospital was very fortunate to have extra space, however, if they continue to move forward with their current restructuring plan, there won't be any space left over. This will present a problem, should another storm of this size occur again.