Helping in Baton Rouge in the Aftermath of Hurricane Katrina 
Written by September Brown, RN 

August 29, 2005 Katrina, a category 5 hurricane, slammed into Louisiana.  At first, everyone expected it would make a direct hit on New Orleans, so the day before, mayor Ray Nagin, who had previously asked for voluntary evacuations, now called for mandatory evacuations.  Most left, but thousands stayed anyway.  They'd seen hurricanes before, and had had evacuations before, so despite the warnings that this hurricane was stronger than Betsy or Camille, some people just didn't see a reason to leave.  Those who had no way to evacuate were instructed to go to the Superdome.  About 10,000 people went to the 30,000 seat facility.  Just before sunrise, Katrina hit the Gulf Coast with a vengeance.  At the last minute, she had veered slightly to the east, and traveled in a north-northeast direction.  Though New Orleans would sustain strong winds on the west side of the storm, the eye went east to Slidell, sparing New Orleans from the stronger winds on the east side of the storm.  For awhile, it appeared the city had been spared once again.  Then, the worst case scenario happened; the levy broke.  Mayor Nagin, when calling for evacuations, had warned people that it wasn't built to withstand a hurricane above F3.

New Orleans is a bowl in the landscape, sitting 15 feet below sea level. 
Bordered by the Gulf of Mexico, Lake Pontchartrain, and the Mississippi river, they had been flooded before.  Previous floods had floated the caskets out of the ground, and now all bodies were placed above ground in tombs.  Two canals, built in the 1960s as part of the flood control measures, divide the city into sections.  Massive pumps help drain the rainwater back into Lake Pontchartrain.  Seventeen housing districts make up the city, with the historic French Quarter in the heart of it all.

As Katrina passed through Louisiana, then Mississippi and Alabama, it left behind mounds of mud, muck, and debris. Dead fish, cottonmouths, water moccasins, and nutria laid around by the thousands, not yet stinking in the sweltering summer heat.  Alligators, and large four-foot thick sections of swamp sod, were uprooted and landed on the highway.  Late in the day, one of the pumps on the New Orleans side failed.  As water continued to pour into Lake Pontchartrain, the main levy along the 17th Street canal failed, and a 700 foot long section was washed away.  It was soon followed by a second breach.  Water poured into the city over the next two days, turning Lake Pontchartrain into Lake New Orleans.  Trapped citizens climbed into their attics, some taking axes to escape through the roofs, only to have no place to go.  Many died when they were unable to climb high enough, they were dropped by people who couldn't hold on any longer, they fell through attic floors, or they were washed away by flood waters.  911 operators getting frantic call after call, broke down in tears as they heard people cry and beg for help, knowing there was nothing they could do.  They tried to remain calm, but as they broke down in tears themselves, they had to relieve each other every few calls, so they could recoup and at least try to sound calm.  Several sharks, including a ten footer and a hammerhead, were seen swimming inside the city.  Water moccasins and fire ants were washed out of their habitats and into the streets of "The Big Easy".  Rescuers arrived slowly, picking thousands of people up from all over the city, depositing them at the Superdome or convention center.  Power was out in the whole area, and it didn't take long for looting to begin, first taking guns, then TVs, shoes, and clothes, despite the flooding and lack of electricity.  They had to carry, cart, or drag whatever they took, as the roads were impassable, yet they took TVs anyway.  As rescuer helicopters attempted to pluck people from rooftops, they were fired upon by AK-47 assault rifles, possibly from looters who were trying out their new toys.  Hospitals in New Orleans were running on generators, which quickly gave out in the rising floodwaters.  Memorial Hospital, Charity, and University Hospital sustained the worst damage.  At one hospital, staff were asked to put on wristbands with their name, date of birth, and social security number.  At another, they were asked to write their name, social security number, and next-of-kin on their leg with a permanent marker.  Meanwhile, looters gathered outside Children's Hospital in uptown New Orleans on the west side of town, and were attempting to break in.  Workers were holed up with around 100 kids, and neither police nor the National Guard were able to respond, due to the rising flood waters.  Sewers couldn't drain, and toilets backed up in the hospitals and the Superdome, which now housed 20,000 evacuees. Inside the Superdome, one man jumped to his death.

Two days after Katrina hit, twenty-four of us went to Baton Rouge, where many of the evacuees went.  Baton Rouge is approximately 60 miles northwest of New Orleans, and is the closest "large" city, with a population of around 460,000.  Patients from New Orleans were being flown to the convention center in Baton Rouge, where they were triaged (sorted), then sent to area hospitals.  We were asked to go help one of our sister hospitals, whose staff was overwhelmed with the influx of patients. Sixteen staff members came from our Tulsa hospital, and eight from another sister hospital in Albuquerque.  Between us, we had seventeen nurses, one social worker, two x-ray techs, two respiratory therapists, and two maintenance workers.  When they asked us to go, we only had two or three hours to pack enough for ten days, and were allowed to bring no more than 30 lbs (just under 14 kg) of luggage.  Our hospital CEO, Director of Nursing, and our manager drove us to the airport, where we flew to Baton Rouge on an eight-seater plane.  The rest of the staff arrived the following day on separate eight-seater planes.  The main airport in New Orleans was closed, and the small planes were the only way to get us there quickly.  When we arrived, staff from our sister hospital picked us up and drove us back to the hospital.  We saw some trees down all along the way, and noticed the traffic was fairly congested, largely due to the evacuees from New Orleans.  Baton Rouge's population had doubled in size since the hurricane.  We had about an hour of some required hospital orientation, followed by dinner, and were finally shown to our rooms.  They put us up on a floor which had previously been gutted, and was now in the process of being remodeled, and was near completion.  They had bought all the folding cots from the nearby Wal-Mart for us to sleep on.  There were no pillows, because the evacuees who were staying in the hospital's old rehab gym, were using them all.  They asked us if we would mind going to Wal-Mart to get our own.  We didn't have a rental car, so we walked about half a mile to buy them.  Knowing we'd have to carry things back, we tried to keep our purchases light. We also bought towels and clock radios. It seems that in our quest to save on airplane weight, nobody brought an alarm clock along.  Since our rooms didn't have televisions, the radios would be our way to hear the news about the outside world.  Baton Rouge was under a boil order, and we were told not to drink the water or ice, and not to even brush our teeth in it. Wal-Mart didn't have any bottled water left, so we did without.  When we got back, we were able to scrounge two gallon-sized bottles from the hospital that we had to share, until they could get more delivered in the morning.  We found some old hospital beds without mattresses, and their headboards, laid across some chair seats, made dandy bedside tables, and were just the right height next to the folding cots.  Sheets and tape became our curtains, and later, some green surgery sheets helped our room be darker for daytime sleeping.  Most of the staff worked days, but my roommate and I worked nights, so we weren't expected to begin working until the following evening.  We finally got settled in and got to sleep around 1:00 am.  At 4:00, we were wakened with an apology, and asked to come and help.  The emergency room had been swamped all night.  My roommate was asked to help in the ER, and I was asked to turn the recovery room into a telemetry unit, and take five patients who were having chest pain.  Not being familiar with their equipment, paperwork, computer system, or locations of supplies, they agreed to let me wake up a day-shift nurse to come help me.  While we waited for beds to be found so they could send the patients (who were uncomfortable on the stretchers in the ER), we spent our time helping the incoming morning shift get some surgery patients ready for their operations.  They let me go around 8:00 am, and my roommate and I walked to the Waffle House, across the street from the Wal-Mart, only to find it closed due to an electrical outage.  We walked another block or two to a McDonalds, and waited in a long line to order.  All the breakfasts that included eggs weren't available, but nobody complained, they just seemed to understand, and ordered something else.  Walking back, I realized this was going to be a long week if we had to walk everywhere in the humid Louisiana sun.  That afternoon, they lifted the boil order when the water tested okay.  The following nights I worked in the ICU.  Most of us worked in the ICU or the ER, and a couple of people worked in the medical units.  This was the smallest hospital in Baton Rouge, with the capacity for 200 beds, but they had previously closed several areas down, and were only licensed for 105 beds at this time.  They normally had 30-50 patients, so their staff wasn't used to having an influx of patients.  I think I heard that we ended up admitting 125 patients.  They were feeling overwhelmed, and were already overworked when we arrived.  They really treated us well, and bent over backwards to make us feel welcome.  Our hospitals are much larger, and our staff is accustomed to having lots of admissions and sicker patients, so we were pretty comfortable with the work that we were given.  The third time I needed to go to Wal-Mart, I bought a cheap bike to share with everyone else.  I had planned to give it to one of the evacuees that was staying at the hospital's shelter, but by the time we left, they had all been sent to another shelter.  I decided to leave it for the next batch of nurses that was coming to replace us, but the hospital cancelled them when they didn't get the onslaught of patients that they were initially expecting.  Many of the patients in the convention center were now being sent out of state or to the temporary field hospital that was set up in the old K-Mart building that was vacant.  The hospital offered to send the bike home to me, but then one of the guys in the accounting office offered to buy it from me, so I got some of my money back.  When we left, the hospital and some of the nurses gave us gifts, there were lots of hugs, and tears.  It was hard to believe we had grown so close in so few days.  They were really nice, and we all felt so fortunate to have been allowed to go.

We saw lots of people and heard many sad stories.  The first few days were chaotic.  As people swarmed into the city from New Orleans, they were dazed and lost.  Most had no place to go, and few belongings.  The Wal-Mart was a mess, with 20 people in each line, ransacked shelves, and so many people it was very difficult to get around the store.  The baby aisle was totally empty, and there was no bottled water.  In the camping section, survival gear was disappearing fast.  Besides the evacuees, there were relief organizations that were buying up things in bulk.  The next day, we saw at least ten people trying to restock, but they couldn't get their pallets past the shopping carts, and the people couldn't get their carts past the pallets.  It was backing up on both sides.  The next day, they started shutting the store down at 10:00 pm so they could restock at night.  It was a little less ransacked looking the next day, but there were still a lot of people and long lines.

The second day we were there, we saw on TV a group of people leaving a building somewhere in Baton Rouge.  According to their story, there was a riot, and some building was being evacuated.  They asked a man (the mayor?) about it, and he tried to tell them that there was a "situation" that was "under control", and denied any reports of evacuations.  The camera continued to show people walking away, and insisted that there was a situation and that they would get to the bottom of the story.  Within a very short time, the rumors had grown to say that there was a riot with gunfire, police, a standoff, and that the city was out of control.  Later, the truth came out.  Two guys had gotten into a fist fight, nothing more.  People were just so "on edge", that it didn't take much to set of a wave of hysteria.  The next day, the local news was careful to try to remain calm and rational.  The radio talk shows were cutting off callers who were spreading rumors or hysteria. That seemed to help. Gas prices were rising as quickly as the flood waters had, and more rumors sprang up, this time about a gas shortage.  Gas lines became common, and cars were trailing out into the street by a block.  The panic caused some stations to actually run out of gas.  One local nurse said that on his way home the previous day, he had to stop at nine stations before he could find one that had fuel.  President Bush addressed the nation about the fuel situation, and over the next few days, gas prices began to fall, and the lines shortened.  Other than the traffic congestion, things seemed to settle down over the next week.

Several of the nurses were hired that week from New Orleans, and they had lost everything.  One lady didn't know where her husband was, and didn't know if he was alive or not.  "I just have to keep busy, I can't think about it or I'll go crazy."  One of the doctors also lost his home, and he was sleeping on the fifth floor, near our rooms.  The poor guy, they paged him overhead all the time, and I would see him making rounds late at night.  I don't think he got much sleep at all.  I think his wife and kids were staying someplace else, but at least they got out alive.  Another nurse's family had evacuated before the flood, and so did three other families that were related to her.  All four families were staying with another relative's family in Baton Rouge, which meant five households were all crammed together under one roof.  One patient was a homeless man who was unconscious when rescued from underneath an aqueduct.  An elderly lady had missed three dialysis treatments, and was near death. She was doing much better after having dialysis four days in a row.  Several had chest pain and/or heart attacks.  One lady had recently had a c-section when she had to wade into the water to rescue her kids.  Her incision got infected, she became septic, and wasn't expected to live.  A newborn baby was brought in, and they were able to locate the parents at another shelter.  They had lost everything. When the parents came, there was a happy, tearful reunion.  The nurse looked down, and saw that the father was wearing women's sandals.  She cried, and took off her own nursing shoes to give to him.  An elderly woman was brought in with cuts and scrapes all over the inside of her arms, her abdomen, and the inside of her legs.  She was trying to escape the flood waters with her family when they became separated.  She grabbed onto a tree, and hung on desperately for hours as the rising waters tried to wash her away.  She was picked up by one of the rescue boats, and was later reunited with her family, who thought she had died.  One lady only had a hospital gown, so one of our nurses gave her all of his scrub pants and shirts, because it was our last day, and he said he wasn't going to need them anymore.  A FEMA volunteer had chest pain, and was on the verge of having a heart attack.  When the hysteria grew on the TV, he heard about people turning against FEMA for responding too slow.  He had lost his home in the flood.  His family had died before the storm, so he was alone.  Now, all he had left was his van.  While making deliveries of food, he started having chest pain, and decided to drive to the hospital.  He was involved in a wreck, which damaged his front end.  After dealing with that, he drove on to the hospital, and was admitted to the ICU.  While he was there, he was watching the news about Katrina's aftermath, just as everyone else was doing.  Watching the people rebel against FEMA for being slow to respond, he became terrified that someone would destroy his van in anger, because he had FEMA signs in the windows.  "What they don't understand", he said, "is that's not FEMA's van, it's MY van, and it's the only thing I have left in this world."  I made him give me his keys, and I went down with a security guard and removed the signs from the windows for him.  I brought them back so he could see for himself, and he cried as he thanked me.  I didn't have the heart to tell him that his van was more damaged in the wreck than he was aware.  The inside smelled strongly of gasoline, so I'm sure there was a leak somewhere.  He was already so worked up, and his chest pain wasn't going away, so I couldn't tell him at that time.  Many people were turned away from the ER, because there just wasn't room to admit them all.  Only the very sickest were admitted. Many tried to be admitted just because they had no other place to go.  Some people knew the system, and tried to say they were suicidal, because normally, we'd have to admit them to protect themselves.  They didn't get admitted this time, though.  We would see helicopters all over the sky, like giant locusts buzzing everywhere.  Some were alone, some in groups of four.
Ambulances would drive into town in groups of four, whizzing down the highway in a small parade of flashing lights as the hospitals and Superdome were evacuated.  They would arrive at the assembly center in Baton Rouge, where they would be triaged before being sent to the various hospitals and shelters.  After the initial onslaught of patients, they started coming in with broken bones.  There were several instances of tree limbs falling onto people who were trying to cut them down.  One guy broke his back, another shattered his foot, and another shattered his ankle.  When we left, they were still expecting a wave of patients who would be sick with cholera, West Nile virus, tetanus, hepatitis A, and other diseases.  Some of us wanted to stay longer, but they couldn't guarantee they'd be able to get us back on a commercial flight, because the airport in New Orleans was closed, so we had to go with the group while they had a plane available.

When they first asked me to go, I said yes, and didn't even know if I would be paid or not.  After I arrived in Baton Rouge, I learned that we would indeed be paid our regular hourly salary.  The local nurses first thought we were high-paid agency staff, taking advantage of the opportunity.  Once they learned we were from a sister hospital, making our regular hourly wage, just as they were, they couldn't believe we'd come to help, and they thanked us over and over.  Some asked us how much of a bonus we were getting.  When we told them "none", they didn't believe us at first.  Some said we were crazy for coming.  Most of them just couldn't believe we'd come at all, with absolutely no idea of what we were getting into, and be willing to just roll up our sleeves and help out wherever they needed us.  They were really nice to us, and told us over and over how grateful they were that we'd come.  We felt like the lucky ones who should be grateful. We had families and homes and jobs.  Many of them didn't.

It was a sad but wonderful experience, and it's good to be home.  For us, the experience is over, but for the displaced citizens of New Orleans, their ordeal has just begun.

Here are some photos from my trip.  Each thumbnail will open in a separate window.

We flew to Baton Rouge on a Cessna Citation XL.

Some of the ICU staff who made my stay memorable.

My co-worker made a pretty good roommate.

Camera shy.

The hospital's surrounding property included a duck pond and forest areas.  The pond had a walking path around it.  The ducks were used to being fed, and would walk across the street, straight up to the front doors of the hospital, to beg for food.  Some would eat out of our hands.  

We took off one night and went out to dinner together.  

The housekeepers and others would walk into our rooms several times a day and wake us up, so we had to put a "night shift" sign on our door so we could get some sleep.

The hospital gave us a "thank you" reception, and gave us gift bags with Louisiana food and Cajun spices to take home.  

We flew home on a Cessna Citation Bravo.  There were 7 regular seats, and an 8th seat on the toilet.  Guess where I got to ride?  They all seemed pretty amused.  Good thing they went to the bathroom at the airport, cause I wasn't going to get up.