The 2011 Queensland floods: a dialysis clinical nurse manager's personal account.
Abstract: This paper describes the personal account of a nurse unit manager's four-day vigil working in the Wesley Hospital, which is situated on the Brisbane River and bore the brunt of the January 2011 Brisbane floods. Implications from this story are many and illustrate the resilience and commitment of renal staff in times of disaster.

Keywords

Dialysis, nursing, lood, disaster.
Article Type: Column
Subject: Floods (Influence)
Floods (Australia)
Hemodialysis patients (Care and treatment)
Nurses (Practice)
Nurses (Personal narratives)
Author: Moynahan, Lynda
Pub Date: 07/01/2011
Publication: Name: Renal Society of Australasia Journal Publisher: Renal Society of Australasia Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 Renal Society of Australasia ISSN: 1832-3804
Issue: Date: July, 2011 Source Volume: 7 Source Issue: 2
Topic: Event Code: 200 Management dynamics
Product: Product Code: 8043100 Nurses NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 265192669
Full Text: I had been locked down at the hospital now for three days and had no idea what was happening outside.

I came home from work on the Monday before the floods. Nothing was unusual. It was raining and the drive home was difficult. Driving to work the next day it was raining, but it had been raining for the last month so I did not think that was unusual. The drive to work was relative easy, but when I got to Indooroopilly the heavens opened. I could only drive at 40 kph because you could not see that well in front of you. I remember arriving at work and thinking how lucky I was to make it there safely. I had no idea what was to follow over the next four days.

My niece rang me from Mittagong in NSW at about 10 am on the Tuesday. She wanted to know how things were going in Brisbane because of the loods. I told her to stop being a drama queen as nothing was happening up here. It was raining but that had become the norm since Christmas. My niece tried to tell me that it was looding in Ipswich but at that point I did not believe her.

One hour later I was called to a code yellow meeting. We were told at the meeting to send our staff home if they could get home. Ipswich was looded and the water was headed for Brisbane. I live in Ipswich and asked if it was possible for me to go home but it was too late. The Ipswich motorway was looded as well as the Warrego Highway and the Centenary motorway. Colleges crossing had been under water for about two weeks so all of my possible routes homes were blocked. The hospital offered the staff that could not get home accommodation in empty wards and they were willing to supply us with meals at no cost. It was school holidays so most surgical cases had been cancelled because the doctors were on leave.

I had no option. I had to stay. I returned to the dialysis unit and allowed the nurses who could go home to go. I was left with four nurses and 14 patients. Two of the nurses left at about 6 pm as they were anxious to go home to find out what was happening to their property and were worried about their families. A nurse who lives up the road from the hospital came in to offer her help. The nurse and I stayed to finish the treatments for the day so everyone else could go home. We finished work at about 7.30 pm. I had been on duty since 6.30 am, so I was very tired by the end of the day.

The nephrologists decided to cancel the next day's treatment so the patients and staff could assess the situation and we would make a decision as to what to do the next day. I will never know if that was the right or wrong decision. I did not sleep well that night, mainly because the bed was uncomfortable and I was worried about my home being looded. I awoke early the next day and rang Ipswich City Council to see what was happening in my area. It was not good as the schools near me were looded and my street had been evacuated as the creek at the bottom of my street was rising. Some of the homes near my home were underwater but my home was safe for the moment.

I met the nurse who lives near the hospital for breakfast at 6.30 am the next day and we planned to have a quiet day doing some machine cleaning. On arrival to the unit the phones started ringing and they did not stop ringing until we left the unit at about 7.30 pm. Patients were worried where they would get their next dialysis treatment and other staff members were worried about us. The hospital was surrounded by water. The only way into and out of the hospital was via a railway crossing bridge. That bridge crossing became the lifeline for the hospital over the next four days.

It was the Gold Coast Hospital that gave me the idea to transfer patients out away from the lood waters. The nurse manager of the unit rang to see if she could help with the dialysis treatments. I sent two patients to her and one to John Flynn Hospital also at the Gold Coast. I had just transferred two patients to Logan Hospital when a nephrologist from the Princess Alexandra (PA) Hospital rang me to see if I needed help with the dialysis treatments. She was concerned about the patients and could dialyse some of my patients that day. I sent six patients to the PA Hospital. One patient was air evacuated to the hospital and admitted as his home was surrounded by water. Most of our patients lived on the north side of the river so I sent 12 patients to the private NephroCare dialysis unit at Chermside. At one point the nurse working with me asked what was the other nurse unit manager doing with all of the patients but I did not want to know the answer to that question. I later learnt that the nurses at Chermside were doing overtime to care for my patients. Some patients managed to find their way into the hospital, so we gave them a dialysis treatment. The first day of the loods we looked after seven patients and transferred 12 patients.

Only two nurses at the hospital could dialyse patients so we performed the dialysis treatments and prepared the paperwork for the transfers. Ambulance transport had to be booked and the patients needed to be notified. We were desperate for clerical support but no clerical staff were available. The workloads were heavy and by the end of the day both of us were very tired. Sleeping remained a problem. The bed was so hard and uncomfortable. I was also still worried about what was happening in Ipswich to my home. I watched the news reports at night but that only caused me more concern. I recognised many of the places now under water. I still had no idea what was happening to my home.

The next morning I awoke early and rang Ipswich City Council. I needed to know what was happening to my home. The person I spoke to could only say that my street was not on the looded list and really did not know about my home. A member of the pastoral care service could see how anxious I was and rang a friend in Ipswich to go and look at my home. Good news! My home was OK. The lood waters had not come near my home but were all around it. That gave me some peace of mind. Now I had to prepare myself for the next day of treatments.

Again the nurse and I met for breakfast at 6 am. There were three in-patients that required dialysis treatment that day and we commenced working in the unit at about 6.30 am. Two nurses from another ward agreed to help us. As soon as we walked into the dialysis unit the phones started ringing again. They did not stop until we left the unit at about 5.30 pm. Queensland ambulance service phoned regarding patients they could bring to the hospital for dialysis. We asked them to bring them but the only way into the hospital was across the railway bridge.

Bringing patients into and out of the hospital proved to be a major logistical task. These are mostly elderly people who find it hard to walk short distances and many of them have cardiac issues. However the orderlies' service at the hospital and the ambulance officers managed to bring the patients to us. That day we dialysed nine patients and transferred a further 16 to various dialysis units in Brisbane. For the two nurses who could dialyse the workload was very heavy. However, we did receive help from the two ward-based nurses with the transfers and general aspects of nursing care required for the patients.

I will never know how she did it, but a member of my staff appeared at about 11 am. The nurse could sense the desperation in our voices when she rang and set out with her son-in-law to come and help us. Towards the end of the journey a police escort was required but she managed to get through. I cried when I saw her. Now three nurses were available to give the dialysis treatments. With her help we finished our work about 5.30 pm and went for a walk around the hospital to assess the lood waters. It did not look good. I had been locked down at the hospital now for three days and had no idea what was happening outside. Water was all around us and it was moving down slowly. I could see now that the hospital had been surrounded by water for three days. We sat for a short period and watched the river low. The speed the river was lowing at was remarkable. I saw pontoons with boats attached to them speed past. The debris was plentiful and consisted of industrial waste disposable bins, boats, trees, restaurants and logs of wood, to name a few things. No traffic was on the roads and it was deadly quiet. All you could hear was the sound of the river and helicopters.

I did not sleep that well on Wednesday night and felt I was beginning to look like a bag lady. You must remember I left for work with only the clothes I had on. On the second day I changed to theatre scrubs but had no clean underwear or a change of clothes. We have a pharmacy on-site so I could get some toiletries and personal medications but that is all I had for five days. I did manage to wash my hair but had no hairdryer to make myself presentable. I was still concerned about my own home. I knew that it had not flooded but I wanted to see if for myself. The next morning I rang Ipswich City Council again. They could still only tell me that my street was not on the looded list. You would think I would stop worrying but I could not.

The nephrologists managed to get to the unit each day. I do not know how but somehow they managed to get through the lood waters to the hospital. I therefore had medical support through the looding and many doctors stayed at the hospital. Every day a member of the hospital executive came to see us. This was because I could not get to the daily code yellow meetings. Theatre nurses were giving out meals and the executive were delivering the meals to the wards. Laundry was being pushed up and down a hill to the railway bridge. Clean linen was not an issue. Everyone was doing what they could to care for the patients who could not be transferred to another hospital. At one point we thought the hospital would have to be evacuated.

The waters started to recede on the Thursday. So some staff members rang to say they could come in on the next day (Friday). That was wonderful to hear as I was starting to get fatigued due to the long days. One nurse asked me if she could bring anything in for me. I needed clean underwear. All I wanted was a clean pair of pants. My request was granted the next day. I felt as if I had won something special.

Friday came and so did the cavalry. Five nurses managed to get through. They arrived at about 7.30 am and we were very pleased to see them. The nurses took over the clinical workload and left the nurse working with me over the past two days to inform them what had happened so we could finalise our paperwork from the last three days. A very valuable receptionist came as well. I asked the receptionist to tidy up the files as we had made a mess of them and to confirm ambulance bookings for the patient to return to the unit over the next four days. We left them a busy workload. I left the unit at about 2 pm that day.

All I wanted to do now was go home but this was not possible. The roads were still blocked and some were too wet with mud to make driving safe. I still had to wait. It was starting to get hard now. I had been away from my home for four days now. I was not sleeping and the stress from the last four days was beginning to show. At one stage, the hospital chief executive officer asked me if I had managed to get home. My answer was no. I live at the Wesley Hospital now. Now that is what it was like: you live, work, eat and sleep at the hospital. I did this for four nights and five days.

I finally left the hospital on the Saturday morning at about 6 am. You could see the devastation from the loods everywhere. I still had to be diverted around various streets before I could get onto the Ipswich motorway towards home. I was never so pleased to get home and everything was fine.

Moynahan L (2011). The 2011 Queensland floods: a dialysis clinical nurse manager's personal account. Renal Society of Australasia Journal,7(3), 56-58.

Submitted February 2011. Accepted April 2011.

Author details: Lynda Moynahan, RN, MN, Clinical Nurse Manager (Dialysis), Wesley Hospital, Brisbane, QLD, Australia.

Correspondence to: Lynda Moynahan, 451 Coronation Drive, Auchenflower, QLD 4066, Australia. lynda.moynahan@uchealth.com.au
Gale Copyright: Copyright 2011 Gale, Cengage Learning. All rights reserved.