A nurse is defined not simply by the medical knowledge he or she acquires. Personality traits—ambition, selflessness, courage—also characterize those in the field. Being a medical professional requires a level of giving that those in other occupations may not experience firsthand. There's a sole focus on the health of others, and a drive to set aside all personal matters for the well-being of complete strangers. For some nurses, the selflessness has taken them to another world, one where they step outside the confines of a hospital setting and into an area devastated by a natural disaster.
Over the past decade, there has been no shortage of disasters: Hurricane Katrina, the earthquake in Haiti, and the tsunami in Japan, to name a few. But through all of these events, one thing has remained certain: nurses and medical professionals act as steadfast caretakers to help victims physically and mentally recover from such disasters. Nurses act as the liaison between the devastation and the happy, healthy life the victims had before—and strive to have again.
These are the stories of the nurses that helped make that happen.
Eugenia Millender, Ph.D.(c), M.S., R.N., P.M.H.N.P., C.C.R.N., experienced multiple hurricanes as a Florida resident and Panama native, and knew firsthand what it was like to have such a major natural disaster strike. But even after the earthquake in Haiti, she couldn't begin to imagine how the quake could drastically change so many lives so quickly.
"As a human being, I couldn't imagine how a person could one day have their whole family, friends, and neighbors, and the next day, lose them all," she says. "Day after day, the stories I heard got worse to the point that I just couldn't watch anymore. I wanted to do more than pray."
Working full time as a critical care nurse, Millender was no stranger to sad situations. But she had experienced "nothing so massive," until she traveled to Haiti. And from the moment she got off the plane, it was pure chaos, she says.
"There were thousands of people walking with nowhere to go. Children were walking alone because now they were orphans," and on the way to the hospital, there were countless bodies on the side of the road, Millender says.
"Once I reached the hospital, there was no orientation, no introductions, no explanation of what to do, how to do it, or when to do it, because there were hundreds of people in the parking lot of the hospital waiting for care," Millender says. She adds that in the following days, there were many aftershocks, including one that was as high as a 7.0 on the Richter scale.
Millender remembers one patient she had, a 21-year-old woman with an arm that was almost dead and covered with flies and maggots. They didn't have the equipment for amputation, and even if they did surgery, she would likely die from infection. Millender made many phone calls to help the woman—even contacting hospitals in the United States—but ended up sending her to the Israeli Army on the island since they had more advanced medical equipment. Millender later received good news from the woman's brother: they amputated her arm and were taking excellent care of her.
After her work in Haiti, Millender moved away from acute care, and into community care and prevention, saying that she wanted to be an agent of change, not of treatment.
"I want to prevent, educate, and empower," she says. "I want to change policies to improve the health care of the underserved. This is a step I probably would not have taken before the earthquake."
Millender noted the resilience, perseverance, and hospitality of the Haitian people, saying they cared as much for her as she did them.
"Even when they did not have food or a place to eat, they made sure that I was cared for," she says. "Caring is a universal language. I did not have to speak French or Creole to show how much I cared."
For Norma Graciela Cuellar, D.S.N., R.N., F.A.A.N., her biggest moment of assurance for becoming a nurse was in her mother's last days.
"She said, 'I know what you do. You are a nurse. I know how much these nurses have done for me and I know what you do now. I am so proud of you,'" Cuellar says. "To this day, no one has ever reassured me that I made the right choice to go into nursing as those words from my mother did."
Having spent so much of her life along the Gulf Coast, and with family still there when she joined the faculty of the University of Pennsylvania's School of Nursing, her heart sank when she heard about the approach of Hurricane Katrina. Cuellar's family was living in New Orleans and Hattiesburg, Mississippi, and her sister owned a condo in Long Beach, Mississippi.
"That Monday, I went to work when I knew the hurricane was hitting. I could not concentrate. People at work acted as if nothing was happening," she says. "How could I be somewhere safe, being aware that people could actually be dying, fearful of survival?"
Feeling helpless, Cuellar volunteered with the Pennsylvania chapter of the American Red Cross. "I was sent to the Cajun Dome in Lafayette, Louisiana, for my assignment," she says, adding that there were 1,100 people there—mostly from New Orleans—that had to leave their homes.
Cuellar was assigned to be the charge nurse for the medical unit. The volunteers worked 12-hour shifts, but any time nurses left, there was always a chance they wouldn't come back. "Sometimes, I wanted to beg them to stay because we didn't know if we would get replacements for them," she says.
There was one story that stood out in her mind about a man who thought his life was coming to an end. "He was looking out his kitchen window and saw a wave of water coming towards him. This was when the levee broke," she says. "He couldn't get out fast enough, and the water was up to his waist." In tears, the man described how he was trying to get to safety while dead bodies were floating in the water around him.
Cuellar and her staff were so busy, it was often difficult to take the time to hear the victims' stories, but she says, "the most important thing is to listen. These people wanted to talk and they needed to talk. They needed reassurance."
Although working with these victims was the hardest thing she had ever done, she recommends that everyone volunteer with disaster victims at least once in their lifetime.
"You will get a different perspective of what is in your community and what the needs of the people were before the disaster hit," she says. "It is a challenge to yourself and it will make you more aware of who you are and how you will practice in the future."
When Joyce Hyatt, R.N., M.S., M.S.N., C.N.M., D.N.P., heard about the earthquake in Haiti, she fell asleep with horrific images in her head from the disaster. She woke up the next morning and told her husband that she had to go to Haiti to help the victims.
Born in Jamaica, Hyatt works as an assistant professor at the University of Medicine and Dentistry of New Jersey (UMDNJ). The desire to become a nurse came at an early age for her.
"I was inspired to become a nurse after watching my grandmother, a lay midwife in Jamaica, diligently perform her duties: delivering babies in the community," Hyatt says. "I knew she was doing something good. She was helping people, she was loved and respected, and I wanted to be like her."
She had initially planned on becoming an operating room nurse, but when she inadvertently assisted with the birth of a baby in a hospital elevator, she knew that was her calling.
"The overwhelming joy I experienced when the baby cried led me to realize this was my true calling," she says. The following week, she applied to the University of the West Indies School of Midwifery, where she received her degree in nursing and a certificate in midwifery.
Hyatt had the support of colleagues and her church when she decided to go to Haiti. She had also joined an organization called Midwives for Haiti, a group that was training traditional birth attendants to become skilled midwives and to offer compassionate care to women.
When she went to Haiti, Hyatt worked in a hospital in a village outside Port-au-Prince. Many of the patients, particularly women and children, went to the hospital to deliver their babies or to seek general medical care
She worked mostly with other volunteer midwives, resident nurses, doctors, and medical students from the area who had lost their medical school in the disaster. "Everyone was compassionate, kind, and caring, not only to the patients, but toward each other," she says.
Many visions of the disaster in Haiti remain with her. Even a few weeks after the earthquake, the effects were still evident: collapsed buildings, tents that housed victims, and organizations providing donated food. "[There were] people with missing limbs, some with burns or other injuries from the earthquake," she says, adding that there was "an air of sadness" in the affected areas.
Some of the challenges she encountered with patients were ambulating women in labor, promoting position change, and trying to provide comfort in the absence of pain medication. Hyatt also helped in an orphanage during her time in Haiti. And for the first time in over 30 years of being a nurse, she used her CPR/neonatal resuscitation skills.
Despite the challenges, Hyatt noted how volunteering time and resources can truly make a difference to victims of a natural disaster.
"Helping these patients was one of the most rewarding experiences of my life. The patients were very grateful for the help they received, and most were just grateful to be alive," she says. "I have become more aware of and more appreciative of what I have."
After hearing about the suffering caused by Hurricane Katrina, Cynthia J. Hickman, M.S.N./Ed., B.S.N., R.N., B.C.-C.V.N., C.M., broke into tears.
The news reported that buses were coming to Houston, Texas, with displaced families. After hearing requests for water, clothes, and other sustenance, Hickman wanted to do anything she could to help the victims. But local media outlets said to wait until "a true assessment could be made" of the situation.
"I thought to myself, what kind of assessment was needed with so much human suffering?" she says. "I was scared, afraid, and sad. The worst emotion of all was an overwhelming feeling of helplessness. It was at that point I cried."
For Hickman, a case manager at St. Luke's Episcopal Hospital in Houston, this was her first time helping victims of a natural disaster. She had always wanted to train, but just never had the time. "When Hurricane Katrina hit, I learned a lot of things fast. I knew I was not going to face people just within my specialty," she says.
The list of suffering was long: diabetics without insulin, infant dehydration, depression, and more. "The [hospital's] expectation of available staff and the roles we were to play would change based on instructions from the command station," Hickman says. "My role as a non-direct care member of the staff was more of ensuring that patient and family needs were met and to assist with medical equipment or community services if patients were hospitalized."
The stories of the victims brought back distressing memories for Hickman. The faces of the people and children wondering: What just happened? What do I do? Have I lost everything?
"I spoke to a lady who could not find her son, who was with a family member while...the levee collapsed," she says. "Still today, I don't know if she ever did."
Hickman says food hoarding was a frequent occurrence among the victims brought to the George R. Brown Convention Center. "Many had no idea what the following days would hold. Survival by any means possible was the behaviors of many," she says.
Most of the evacuees she worked with were African American (New Orleans' population is roughly 67% black). But Hickman notes that the hurricane didn't show any regard for ethnicity. "Disasters are unplanned and unwanted, but occur," she adds.
Hickman quickly realized there were lessons to learn before, during, and after a natural disaster. Though she often thinks about what she could have done differently, she believes that anyone in a community can help during a time of disaster.
"The natural disaster reminded me why I became a nurse: to mentor, teach, care, and support those needing a hand," she says. "My reason for volunteering was very simple. There was a need, and I wanted to meet the need to the best of my ability."
For Marie O. Etienne, D.N.P., A.R.N.P., P.L.N.C., the earthquake in Haiti was personal.
A native of Port-au-Prince, Etienne was in her office grading papers when a fellow professor came in and asked if she had heard about the quake.
"I was in a state of shock, feeling a sense of urgency to call my family to find out if everyone was safe," she says. Her family members in Port-au-Prince lost their homes. Another family member had a broken leg. And her cousin, who was attending medical school at the time, died as a result of the earthquake.
Currently a professor at Miami Dade College School of Nursing, Etienne traveled to Haiti a few days after the earthquake struck. There, she served as a nurse practitioner with Project Medishare, where she cared for amputees, children, and families who "felt powerless," she says.
"I felt so guilty that I was able to walk, breathe, and feel okay while so many people were crying in pain and suffering with either one or two limbs amputated," Etienne says. "I did everything I could to help the patients and families...giving them hope, hugs, and a little smile to keep them going."
One patient that stands out in her mind was a 26-year-old woman who was brought in with a GI bleed and elevated blood sugar, barely conscious. She held on to Etienne saying, "Please don't let me die." Although they did everything they could, the woman didn't make it.
"I could not control my tears and emotions, yet we had to remain focused to handle and care for other victims," she says.
One major lesson that stood out during her time in Haiti was Maslow's Hierarchy of Needs to prioritize patients' survival: airway, breathing, circulation (A, B, C). Etienne adds that providing culturally sensitive and compassionate care was essential.
"I had to remain strong, calm, and ready to serve at any given moment," she says. "During the recovery phase, I learned to appreciate the smallest things in life, because the victims were optimistic even when they had no reason to be hopeful."
Etienne speaks proudly of Miami Dade, saying that students took part in several vigils and helped raise funds for the victims. She also speaks highly of her colleagues who volunteered in Haiti, having worked with the Haitian American Professionals Coalition (HAPC) and members of the Black Nurses Association (BNA) Miami Chapter both before and after the earthquake. She also worked with the Haitian American Nurses Association (HANA), noting that 30 HANA volunteers, under the leadership of former President Guerna Blot, R.N., M.S.N., M.B.A./H.C.M., O.C.N., arrived to assist with the shortage of Creole translators and provide culturally competent care.
"The medical and nursing team were outstanding in terms of handling the pressure of saving lives," Etienne says. "When giving care, give it all you've got by being caring, compassionate, skillful, and a dedicated nurse."
In July 2010, Etienne received an Unsung Hero Award in recognition of her efforts in Haiti's earthquake recovery by the Haitian American Leadership Coalition. She continues to coordinate medical missions to Haiti with the HANA team.