When all hell breaks loose, do you know where your stethoscope and BP cuff are?

It did break loose as a wave of wildfires descended on North Central Washington Saturday and Sunday, Aug. 13 and 14, 2015. As TV and news articles so dramatically described, the town of Chelan was surrounded on three sides by flames and smoke, with active firefighting by tankers and helicopters creating the big show on the lake.

Early Saturday, major power lines feeding Chelan had been damaged, leaving 9,000 people without power, including cell service. NCW Emergency Management was issuing level 3 evacuation notices to those in the town, meaning, “Leave NOW with no time to pack!”

Managers of Lake Chelan Hospital, Regency Manor SNF, Heritage Heights Assisted Living made the decision to evacuate the patients and residents. The hospital can admit 30 patients, Heritage Heights has 35 ALF residents and the SNF 40 plus. Now what?!

Take a minute to think about the number of employees that would be on your shift, especially on a weekend when far fewer staff are working. Is there someone in charge in case of a sudden change in circumstances that put people at risk?

I heard a jaw dropping presentation about the evacuations by Ray Eickmeyer, EMS Operations Manager - Lake Chelan Community Hospital in October highlighting the challenges of evacuating people on such short notice. Many could help themselves and follow directions, but those with memory loss, O2, IV’s? Bariatric patients?

Emergency Managers had to make arrangements for evacuation to move people 45 miles to Wenatchee through smoke and without communication.

“Evacuation” means finding:

• Leaders to organize and direct the volunteers in a fluid situation
• Large open spaces with running water and electricity services to set up beds, such as hotel ballrooms and school gyms
• Volunteers to pack, load and unload beds, med carts, supplies, linens, water, food, etc. onto vehicles, including school buses and local transit
• Volunteers to set up beds and space to work at the shelter site
• Support staff to reassure scared and confused people
• Ways to prepare and deliver food and fluids to evacuees
• CNAs to help with the usual basic personal care: cleaning, feeding, assisting with incontinence care
• Creative ways to problem solve privacy with care and document records without EMRs
• Ability to provide quality care to patients without the equipment and supplies taken for granted
• Coordinating care with unfamiliar people and lack of routine in a high stress situation without knowing how long it will last or if there will be a home to return to
• Places for caregivers to stay while taking care of the evacuees

Surprisingly, there weren’t many stories in print or on TV of the enormous effort that went into this event. I think the lessons learned and questions raised during the fires have been a practice run, focused on a small community. But the response in a more populated part of the state should another catastrophic event, such as an earthquake or tsunami, occur has the potential to be very chaotic. The 2011 tornado that cut a swath in Joplin, Missouri, resulted in more than 1,100 people injured and 159 killed in 45 minutes.

When these events occur, people with medical skills want to DO something. As part of WSNA’s commitment to Emergency Management, links have been added on the WSNA website at under www.wsna.org/nursing-practice/emergency-preparedness. This is how you can volunteer to be part of the Washington State Rapid Response teams through the WaServe registry. In addition, it would be helpful to review the ANA white paper that outlines volunteering and your license, scope of practice, and responsibilities in case of disaster as you might be visiting out of your community, but could still be called up if needed.

As outlined above, all kinds of people are needed, not just those with licenses or certificates. As a nurse centered within your immediate health care systems, your ability to communicate with your neighbors and community contacts about responding to disasters would help to start swelling the rosters of volunteers in all parts of the state.

No one can predict where the next one will occur or the scope of the people and systems affected and getting enough of the right people to start assisting quickly is imperative. Please consider registering.