By Joyace G. Ussin, MSN, RN, BSBM, CCM
This year will commemorate the twentieth (20) year anniversary of Hurricane Katrina, the category three Hurricane that devastated New Orleans and the Mississippi Gulf coast on August 29, 2005. This topic hits home for me, being a native Louisianian, raised eight miles from New Orleans and living less than 5 miles away during the time. As an entrepreneur in New Orleans, I owned an office building, and my business partners and I were located across the street from Baptist Memorial Hospital on Magnolia Street. A building that took on more than seven (7) feet of water after the levees broke. This became relevant when the news reports began to break concerning the Medical Personnel and patients trapped in Baptist Memorial Hospital for days in the aftermath of the Hurricane without resources, including electricity, food, water, and the necessary elements to sustain life. So much chaos ensued, and hard decisions had to be made as medical personnel and patients pondered whether they would survive!
Thinking about Hurricane Katrina often fosters feelings of helplessness and despair, as dealing with such a large-scale natural disaster is something that we are not usually prepared for. In reviewing accounts of what happened at Baptist Memorial Hospital, several ethical issues arose from a personal standpoint and as a nursing professional. How should one react in this situation? Knowing that euthanasia of humans is not legal, should one question to administer the medications prescribed by the Doctor in charge? Considering all the devastation and the situation, what would you do as a nursing professional?
I pondered all these questions and read several accounts of what happened in those five days at Baptist Memorial Hospital, and honestly, I cannot say how, if I had been in that situation, I would have responded. Thankfully, as case managers, we are not responsible for administering medications, but we could be in a natural disaster. Regardless, I found myself empathizing on both sides when I read the accounts and statements from family members of the nine patients and the Healthcare personnel on the Lifecare floor. So often under the guise of Hospice Care or End of Life Care, decisions are made to “ease the suffering” of patients transitioning, and without question, life altering drugs are administered. Nevertheless, I know the difference is that we, the medical personnel, have the family or patient’s permission to “assist”. Does that make it ethical or any easier?
In the aftermath of Hurricane Katrina, research found that:
“971 Katrina-related deaths in Louisiana and 15 deaths among Katrina evacuees in other states. Drowning (40%), injury and trauma (25%), and heart conditions (11%) were the major causes of death among Louisiana victims. Forty-nine percent of victims were people 75 years old and older. Fifty-three percent of victims were men; 51% were black, and 42% were white. In Orleans Parish, the mortality rate among blacks was 1.7 to 4 times higher than that among whites for all people 18 years old and older. People 75 years old and older were significantly more likely to be storm victims.” (Brunkard, 2008)
However, the focus, out of all this devastation, landed on the nine patients that were euthanized at Baptist Memorial Hospital. The question we should all be asking is how can we be better prepared for natural disasters in order to minimize loss of life? What role should the Case Manager play in end-of-life care during natural disasters, if any?
As I write this blog, I am realizing that the post trauma suffered due to natural disasters is accurate and relevant. However, as a professional in our field of practice, we must continue to examine our motives and rationale for how, and why we function during disasters or events that are out of our ability to control. There are so many aspects to consider when reviewing behaviors during these crises, including what and how we believe; what values we esteem; and how we view life itself! Ethical considerations for end-of-life care during Natural Disasters should cause all of us to introspect, reflect and pause. How can we prepare for this, should be a question on all of our minds.
Dr. Pou and that team of professionals did what they thought was best at the time and given the situation. Some of the accounts were horrific and mentally anguishing, yet decisions were made. So, again, I pose the question, considering all the devastation and the situation, what would you do as a nursing professional?
2025 is your year. Join us for this upcoming webinar where we will:
Talk about how to prioritize self-care and overcome self-doubt in Case Management
Define your leadership style to inspire others
Build a personal brand that positions you as a leader
Featuring insights from distinguished speakers, this session offers 1 hour of RN and CCM credit.
Date: January 23, 2025
Time: 1:00 PM CST
CMSA Members: $0 | Non-Members: $40
Register Now: https://www.pathlms.com/cmsa/courses/89969
Bio: Joyace has over 40 years of nursing experience with tenure in multiple specialty nursing areas including but not limited to: case management, oncology, intensive care, post anesthesia care, orthopedics, geriatrics, and pediatrics. Masters-prepared, she has educated and mentored countless nurses throughout her career who have become valuable contributors to nursing in multiple institutions. In her current case management position, Joyace is a member of the Unit Practice Congress which develops, implements, and enforces guidelines that foster quality coordination and effective case management principles. She also participates in the Sunshine Committee which highlights individual contributions of Case managers; promotes health and wellness tactics; cultivates mental well-being, and nurtures self-care. She is a member of the Case Management Society of America where she serves on the Board of the Houston/Gulfcoast chapter as a Board Member at Large. She is celebrated among her peers and is often sought out for her ideas and problem- solving skills. Joyace is a published author of The Power of Positive Words (2019, Westbow Press) and has a published abstract in the Journal of PeriAnesthia Nursing, which she presented at ASPAN (2015).