Disaster Relief: A Paramedic Turned RN Shares Her Story
By Sherry Jones Mayo, RN, EMTP, DAAETS
Diplomate, American Academy of Experts in Traumatic Stress
Whenever there is a disaster somewhere, at least a dozen e-mails find their way to my inbox from all over the country with the same question: “So … you going?”
It isn’t that I’m a master of disaster (relief), but having deployed to Jackson, MS after Katrina, national disasters have become part of my portfolio. I’ve also responded many times at a moment’s notice after planes fell unceremoniously out of the sky. Something about people in emotional pain tugs at this old trauma nurse’s heart, and whether pain is relieved with medications, hand-holding, or simply talking to someone who is hurting and has had their entire world-view changed in a moment, I’m often there.
My own world-view changed after Katrina. I had been training for years to respond in a number of ways: I could be part of a ground crew, air crew, medical team, or crisis response (Critical Incident Stress Management) team. Whatever the hat, and sometimes those hats changed in the middle of the game, I was ready (I thought). Anyone who has responded to mass disaster will probably tell you it is not what they expected, but responders prepare to the best of their ability, and the rest is as unpredictable as the winds.
When Katrina’s hurricane winds whipped into frenzy, I began assembling my crisis response crew with the aid of my second in command, Chaplain Don Brown (an ex-flight medic). We considered the logistical challenges, the limitations of how many folks we would deploy, where our responders lived, how long it would take to get to the disaster site (and by what method of travel), how long folks could stay, and how many checkboxes each candidate filled (in terms of qualifications) so that we might get the most ‘bang for our buck’ with each person sent. I wore at least five hats: National Director for the department, Team Leader once on site, Interventionalist at my assigned base, Nurse (advising ground teams in the field), and go-fer when not wearing the other four hats. All the ducks were in a row.
Getting Back To The Basics Of Life...
Preparation guidelines dictated that responders deploy with a ‘go-bag’ ready for a week’s assignment. We had everything from bed rolls to food, water, and toilet paper. I cut 24” off my waist-length hair, knowing that hair care was not a priority on a disaster site. There were no showers, many of my team mates lived under the stars, and were it not for MRE’s (military Meals Ready to Eat), only sun-warmed meals made the menu. We returned to a much simpler way of life, and our priorities shifted wildly back to basics.
In nursing school, as with many collegiate programs, we learned about Maslow’s Hierarchy of Needs. Most folks who respond to disasters, who leave home and creature comforts behind, are usually personally and emotionally developed to a point that leans toward the top of Maslow’s needs scale. Self-actualization and following one’s destiny comes crashing down off the top of the needs pyramid as the focus on food, water, and safety take precedence over fulfilling one’s destiny. Those of us restricted to the compound’s headquarters felt a sense of guilt at not being ‘out there’ with the ground teams, or flying above with air crews who witnessed a massive sense of the destruction (and the smell of death). The overwhelming personal internal questionings of “why weren’t we here sooner?” and “why couldn’t we do more?” were consistent among rescuers. We were frustrated at not being able to do more; isn’t that why rescuers go to disaster sites, to make a difference?
Even Little Things Make A Difference
But we did make a difference. Sometimes working with the rescuers meant lending an ear to hear rescuers expressed frustrations about not doing enough to help folks devastated by the loss and destruction. Sometimes, as a nurse, I was able to pull rescuer’s shoulders out of their ears with massages (please, if you are a professional masseuse, offer your chair and services when possible). Sometimes we made coffee or shared rations. Sometimes there were medical evaluations made to determine who needed to have care expedited and who could wait for standard ground transport. What we did on scene was comparatively small in terms of a disaster, but it is amazing how great an impact the small things can have in inordinately large circumstances. There is no small effort when you come to the aid of others, because the heart speaks volumes in immeasurable ways.
So you do the small things, and the things others may consider not so small, but you continue on tirelessly into the night that blends into the next day and the next, and before you realize it a week has passed. You are exhausted, but you keep pushing to do more because there is just so much to do, so many people affected, so much that cannot be fixed or forgotten. When you leave all of the creature comforts of home to enter a place that literally holds nothing to support life, you become someone else. When the devastation is only a relatively short distance from home, as with Katrina, it might as well be a war zone on another continent, because you temporarily lose the reality of the place you left behind. The homes and conveniences we knew were gone, and seeing the impact of a hurricane’s fury left some with a new reality. We formed new connections, adopted new families, adjusted to a new structure, all in a very short time. When the time came to return home, many of us didn’t want to go. Helping people through a disaster situation can be addicting to the rescuers and those who offer much needed emotional support.
Reevaluating Values And Choices
So am I going to Haiti? No; but I gave it a great deal of thought before having to pass on the opportunity. I see pictures that friends have sent home, and the images pull at my heartstrings for those who have suffered such loss, and for the responders who are there to help them. I hope that when the workers get home, their families understand there will be a time of transition necessary to acclimate back to ‘normal’ American living; our lifestyle can seem terribly excessive and wasteful when you’ve come from a place without the most basic creature comforts, a place of nothing.
And that is where my world view was most changed; my family background stressed gratitude for the simple things in life, but coming back from that place of nothing cemented those perceptions even deeper into my emotional psyche. Look around; you have food, water, electricity, clean clothes, the people you love, pets. Things are relatively sanitary and neat, manicured yards are the norm, and you talk to those you know and love simply by reaching for a telephone. You make plans for tomorrow and next week and next summer because the fair expectation is that everything is going to happen as designed, and those days will come and go without incident.
As you ponder and prepare for those future plans, there may be some type of distraction (TV, radio) nearby. Sometimes a lack of silence defers introspection about incidents like disasters and tragedies. It is easy to change a channel or turn one’s head and think, “That is awful, I feel for those people, but I can’t deal with what they are going through.” Maybe you can’t, and that is a fair choice made by each individual asked to respond. If you have the opportunity to go, if you have the skills and flexibility to leave your home and job and family, prepare for a life-changing experience. Responding to a disaster is not what the average Joe imagines if he envisions going to a disaster site as a totally selfless service to humanity. I suppose you could look at it that way, but personally, I see just the opposite, as the probability is that you will receive far more than you could ever possibly give.
About Sherry Jones Mayo, RN, EMTP, DAAETS: Author of Confessions of a Trauma Junkie: My Life as a Nurse Paramedic, a registered nurse and a licensed paramedic with over two decades of experience in emergency medicine, including 14 years as a trauma nurse and 10 years on the road in rural and urban areas. Sherry is a member of, and Approved Instructor for the International Critical Incident Stress Foundation (ICISF), and a Diplomate with the American Academy of Experts in Traumatic Stress. Visit her website to read an excerpt from Confessions.