Ventilators and Tornados: Lessons Learned at CDP

As many of you know I had the chance to go to Aniston Alabama to take a class called Healthcare Leadership for Mass Casualty incidents.  It was sponsored by the Federal Emergency Management System, which is part of Homeland security.  It was an awesome and many times overwhelming experience, but I learned a lot! 

Here are a few things I learned:
Lesson #1 Our government likes to give things fancy names so there are a lot of acronyms, more than a lot, in fact our book had several pages explaining nothing but the acronyms used, it's a whole different language.

Lesson #2 I always thought I could never live where there were tornados, and since this was tornado season and there were tornados in the area the previous week, I was a little apprehensive.  That is, until I got there.  Everywhere you go there are signs telling you where the tornado shelters are, and the weather is predicted very specifically, up to the minute.  There was an enormous thunderstorm one of the nights we were there, being nervous I turned on the tv to make sure there were no tornado watches or warnings.  There weren't but what I found out was that the thunderstorms were going to stop at 1256am. not 1am, but 1256...I watched the clock and they did stop....at 1256.  It was amazing, our weather people cannot even tell us if there are going to be thunderstorms, let alone the exact minute they will stop!  Obviosly they have developed incredible weather tracking abilities there, so I stopped worrying about tornados.  Although I do have to admit that when I was out running I was constantly looking around to determine where I could escape to if I did see signs of one.

Lesson #3 it is always important to be prepared and have a plan, but you have to know that plan, just having it on paper doesn't do much good when you are in the middle of chaos, because you can look through books, but when you are stressed it is really hard to find information, even when you know exactly where it is.

Lesson #4 When you are in an exercise and the people running the exercise don't want you to have enough ventilators, you are not going to be able to locate them, no matter what you do.  How can you learn if you always have what you need when  you need it?  In real life you never have everything you needed right when you need it.  Sometimes you need the stress of NOT being able to have or do something in order to learn  how to deal with that. 

Lesson #5  When going in to a stressful situation it is always good to have friends around.  This week was incredibly stressful and phone service was sketchy.  I had people I knew, but no true friends with me and that made what I went through much more difficult than it had to be. There were a lot of friendly people around, but there is no substitute for true friends or family.   I am very blessed with a large family and a lot of supportive friends, it made me appreciate them much more, and it made me a lot more sensitive to what those that don't have that must deal with every day of their life.  

Final take away.  Amidst all the chaos one of the other participatns said "people think I am a b**** and I am not really like that" someone else replied  "you are what others percieve you to be".   It made me wonder what others perceive me to be, but then again, it is not important what "others" perceive me to be, it is only important what my Father in Heaven percieves me to be, and I want that to be good. 

ps.  Our command center determined this week that when you are in a disaster you need a S***load of ventilators!!!!


The Center for Domestic preparedness offers many classes to help first responders and healthcare leadership prepare for a disaster.  All classes are free for people at the local level, that means all transportation, lodging food and supplies are provided, you just need to be there.  If you would like more information, or to register go to cdp.gov and check it out. I highly recommend it.

Awesome and Awkward Thursday

Time for a little awkward and awesome Thursday!

Awkward
Standing in the elevator with someone you don't know who doesn't even aknowledge your presence.  Usually people smile and say Hi, not this time.  He didn't say hi to me, and I got the feeling that if I said anything he was going to think I was hitting on him, so I acted like I didn't see him either. 

Having a conversation with a friend, thinking you are on the same page, then realizing that she REALLY wants a position you have been thinking about applying for, and that position might be created in such a way that she wouldn't be qualified, but you probably would be.  For the record, I haven't found a job that I want bad enough to risk a friendship over yet, so I would be more than happy for her to take it.

Old men patients that think it is ok to make sexually inappropriate comments and hit on me. I guess old lady patients doing the same thing would be even more awkward.

Going to church by yourself and sitting in the row with all the single women, There really isn't a good place for married people whose spouses are out of town to sit.

Awesome!
Singing with the multi-stake choir, I said it before, but the talent in that room is amazing, very humbling, but amazing.  I keep thinking someone is going to discover I am not in their league and kick me out, but they haven't and it is almost showtime, so that is awesome!

Being able to check off a whole bunch of things that have been on your to do list forever.

Working hard on something and having it come out just the way you wanted it to! 

medsled training....AWKWARD

We had medsled training this week, for those of you that don't know, a medsled is a device used to evacuate people that are unable to walk in an emergency, down the stairs.  I don't know what I was thinking when I volunteered to be the patient,  noone else was volunteering, I should have taken a moment to consider why they were not volunteering before I stepped up, but I didn't, I just volunteered.  My first clue that this situation might be a little awkward was when I had to climb up on the bed, which was in it's highest position, with everyone watching me, not the most graceful move I have ever done, but I was in pants, so I didn't flash anything.  The medsled is a great big flexible piece of hard plastic with ropes and buckles on it.  To get me on this sled they needed to  roll me to the side.  I didn't realize  how close I was to the side until I found myself looking at the floor.  It was at that moment that I realized that my 4 nurse friends, that do this kind of thing all day everyday safely, were standing against a wall watching, and the guy that passes out the dinner trays and the pharmacy tech, that never actually touch people, were the ones there to keep me from falling off.  It was a little unsetltling, and I called out a little to ask my  nurse friends to help, but they were unable to get close enough to help me. I think they were having too much fun laughing at me.  Thankfully I made it onto the sled safely.  Those of you that know me well know that I am rather claustrophobic, and I really, really hate having my arms tied down.  When I volunteered I was envisioning something open, like the thing they lift people  up into helicopters with.  Imaging how I felt when the instructor then told the people to pad the sides of the sled and buckle it up tight, like a taco or a burrito.  I considered bolting at this point, however they quickly had me strapped in to the sled, buckled tight like a papoose, with my arms inside, so I had no choice but to deal with the situation, and try to not let everyone see me freak out, which would be terribly embarassing in front of my coworkers.  Once I was buckled in it was time to roll the bed onto the elevator, as we were going around the corner I heard a voice from the back say something like "watch out, she's falling off", the instructor stepped up and said "yes she is" then he proceeded to try and adjust me inside my cocoon,  thinking that I was somehow not laying in the medsled right, as he tried to shift me I tried to help, but when you are wrapped up tight how do you help with something like that?  awkward.  When he realized that the voice was trying to tell him I was falling off the bed he saved the day by pushing me back on the bed.  Noone, in the room full of healthcare workers, including myself considered the basic safety princple of having the side rales up when transporting a patient on a bed. duh..  My vision was limited by the medsled buckled tight around my head, with only my face sticking out I was only able to see the ceiling, which for some reason was dirtywith handprints in places, I have a whole new perspective on what my patients see when I transport them. 
When we made it to the first floor by the stairwell it was time to move me to the floor, we needed the bed in the lowest position to do this safely, but there were no outlets,and without power to lower the bed,  the decision was made to just lift me from the bed where it was, high in the air, to the floor.  The inner fat person in me came out, and inside my head all I could hear was myself screaming "oh no, they are going to lift my weight, they are going to know  how heavy I am!!!!"  for some reason, the fact that they were going to have to actually lift and move my weight hadn't occurred to me prior to that.  I was comforted by the fact that I no longer weight almost 300lbs, but I was mortified nonetheless.  To get me to the floor they slid my feet off first and kind of let me fall, at that point I was fully prepared for my head to hit the floor, hard, thankfully the instructor had a hold of the top of the sled so that didn't happen.  They then proceeded to drag me in my medsled papoose to the top of the stairwell so they could use a rope and a repel me down the stairs,the rope was hooked to a big bolt in the wall.  The problem was that the bolt was behind the door and it was challenging to get me into the right position, I felt huge as one person struggled to drag me around to the right position.

  Finally I was in the right position and the rope was attached.  People were lined up the stairway to the second floor looking down at me.  I lay there wondering if they realized how terrified I was, and thinking "how bad could I really get hurt anyway, if the sled took a freefall to the bottom of the stairs?"  I looked up to see the woman that had volunteered to control the ropes as I made my descent.  I didn't recognize her, but she looked to be about 50# soaking wet, OK so maybe that's an exageration, but she looked very small and weak, Dee must have read my mind, because she stepped up and said, I will hold the end of the rope so that if something doesn't go right you won't freefall to the bottom.  I thought, wait a minute, you mean there is possibility, that might actually happen?  With that I started down the stairs, at that point I realized that a quick decent was not what I needed to worry about, as I started over the top step, oh so slowly, I felt the pressure of the cement stairs pressing against my vertebrae, one by one as I went over them, I kind of arched to get away from the pressure, but that didn't help much, I once again looked up in the faces of my coworkers who were still lined up on the stairwell to the 2nd floor, my face must have shown what I was feeling, because they had a look of concern on their face and someone said "does that hurt?"  The instructor told the lady in control of the ropes "you need to let her go a little faster, and with that I was at the landing at the bottom of the first set of stairs.  Now it became the task of the one scrawny little pharmacy tech (who is actually very strong, but at that moment he looked scrawny) to drag, push and pull me around into position to decend the second portion of the stairs.  Again I felt like I weighed 300 lbs as I looked at him grunting and struggling to maneuver me around.  The second decent was much quicker and much smoother.  I swear, when I made it to the bottom and he started unbuckling me I heard a chorus of angels singing "AAAAHHHHH"  safe, and free at last.  I stood up quickly, only to notice that I must have been hyperventilating while in the sled, as I was very dizzy and lightheaded, thankfully I didn't faint, that would have been so uncool.  It occurred to me that if I fainted they would most likely call a rapid resonse, which would only add to the entire awkward procedure, this thought steadied me, and I was able to head back up the stairs for the second part of the training, how to use the evacuation chair.   I cannot imagine doing this with a 400# person, or a little lady with an osteoporitic spine, one can only pray we never have to find out what that is like.

I learned a valuable lesson from this experience, never volunteer when everyone else is holding back, there is probably a good reason for that, one that I should take a moment to try and discover.  OK, so I turned around and volunteered for the chair too, so maybe I didn't really learn anything after all!