Wake of the Storm
RNRN nurse volunteers provided all types of healing in Asheville, N.C. after Hurricane Helene
By Michelle Morris
National Nurse magazine - Oct | Nov | Dec 2024 Issue
When Barbara O’Neill got the call from Registered Nurse Response Network (RNRN) to deploy to Asheville, N.C. to support the Hurricane Helene recovery efforts, she was thrilled. Now an emergency department nurse at Kaiser Permanente’s Oakland Medical Center, she had been a nurse at a New York City hospital when Hurricane Sandy hit.
“Because I had lived through Hurricane Sandy … it was important to me to volunteer with RNRN. So it was an immediate yes when RNRN called to ask me if I could go to Asheville.”
Asheville was one of the regions most impacted by Hurricane Helene, which swept through the Gulf Coast and southeastern United States, killing more than 200 people and leaving billions of dollars in damage.
For Carlton Purvis, an emergency department nurse from Memphis, Tenn., the call to deploy to Asheville was a personal one. He had spent many happy times in his youth there. “When I saw the pictures on the news and on social media, I knew exactly where they were taken. Those were places I had stood, and places I had spent time in.”
Purvis and O’Neill were among 14 nurses who were deployed with RNRN as part of a response mounted and led by International Medical Corps. What united all of the nurses—who travelled from Tennessee, Arizona, New York, California, Minnesota, and Florida— was a desire to connect and serve humanity.
Venessa Soldo-Jones, an emergency department nurse from Minneapolis, Minn., served as a team lead for the first group of seven nurses that went to Asheville on Oct. 11.
“I’m a retired firefighter. I’m a paramedic. I’m a nurse. That’s my job and my skillset,” said Soldo-Jones. “When there are survivors who need our help, I’m always honored to see the RNRN phone number show up.”
The second deployment, which left for Asheville on Oct. 23, was led by Sandy Reding, an operating room nurse from Bakersfield, Calif. and a president of California Nurses Association/National Nurses Organizing Committee. She agreed that it’s the inherent value system of the nursing profession to be on the front lines of disaster response.
“It’s just what we nurses do,” said Reding. “We have the skill set and the values and the mindset—and the RNRN vehicle—to help communities heal.”
Nurses were sent to different shelters and placed at mobile medical units across the Asheville area where people from all walks of life were staying. There were elderly folks. There were veterans. There were young families. There were recent immigrants. All were welcomed. All were served.
From their seat at the windowed booth area, day shift nurses would start at 9 a.m. seeing residents who had been waiting in a long line before the clinic even opened, hearing their concerns and administering over-the-counter medications, like Tylenol and Day- Quil, for aches, pains, and cold and cough symptoms. They ensured people got their medications and had help managing their medications for pre-existing conditions. They assessed and cleaned wounds. They tested for Covid and flu.
If further check-ups were needed, there were spaces set aside to take vital signs and more private areas set up for further examinations. In more serious situations, nurses would refer the resident to the emergency department or mental health providers.
Basic nursing work continued into the evenings, and night shift nurses soon found that their main task was helping people sleep, according to Mary-Jane Perry, a perianesthesia care nurse from Sacramento, Calif.
“Imagine the trauma of the sudden disruption to your life, as well as the anxiety about the future, after your people, your home, and your job have all been washed away,” said Perry. “And then consider that you’re sleeping in an auditorium with so many strangers. So during the night shifts, we handed out a lot of melatonin and a lot of Benadryl because people could not—and understandably—sleep in that environment comfortably.”
Just like in their nursing jobs, nurses had to be flexible and quick to solve problems.
When residents needed private examination areas, at one shelter, nurses worked with paramedics to heat an emergency transport vehicle; the back of the vehicle then became a private examination area that ensured patients’ privacy.
In another instance, elderly residents were refusing to drink water because they didn’t want to venture into the freezing and wet outdoors to use the bathrooms. So nurses and other staff at the shelter set up indoor portapotties, including establishing a workflow to remove the waste. The elderly residents who were at risk of dehydration started drinking water again.
As with so many disaster responses, nurses were called to deliver not just medical care, but also empathy and compassion, recalled Joy Bessinger, an early childhood health and nutrition coordinator from Dutchess County, New York.
“Not all wounds are physical, especially after a natural disaster of this magnitude. People had been through very scary situations just to survive and make it to us. A lot of our time was spent listening to people and giving them the space to process their trauma,” said Bessinger.
For the most part, nurses stayed at the same shelter over the course of their deployment, which allowed them to grow connection, understanding, and trust with the residents. They played cards at night. They shared stories. They entertained children, held babies, and took care of residents’ dogs. They even celebrated birthdays and Halloween together.
“When you’re recovering from a disaster of this magnitude, when you have no consistency or stability of any kind, even just having the same staff who knows your name, and says hello to you, and asks you how you’re doing, it brings back people’s humanity and encourages them to take positive steps forward,” observed Perry.
And as they do in their hospital shifts, RNRN volunteers worked together as a team, even across the two deployments, to ensure continuity of care. There was one victory that multiple RNRN volunteers celebrated. Perry, who was on the first deployment, gave the second deployment a heads up about a resident she was concerned about, who had been refusing treatment and avoided the nursing staff.
“We knew from the update Mary-Jane had given us that we would have to gain her trust first before she would even make eye contact with any of us,” recalled Michele Van Wyk from Vero Beach, Fla. “After a few days, we were able to have a conversation with her and she was able to communicate her needs. It truly was a team effort from one RNRN deployment to the next to support this woman.”
“A few days after that, she began to trust us enough to allow us to treat her wound. We were all high-fiving after that,” said Bessinger with a laugh. “After that, she also trusted the RNRN team to help her shower and give her clean clothes.”
Reding noted, “We knew it was outside our job expectations to take care of the woman’s daily needs but we knew it was an essential part of the healing. It took time, rapport, and trust, and we got the job done!”
RNRN nurses acted as advocates on multiple fronts for the residents they came to know and grow attached to—often going above and beyond their nursing duties. Nurses became resources for residents who needed guidance on where to access immediate and long-term support.
“People would ask, ‘When you guys are gone, how can I get help?’” recalled Kathy Shimada, a retired nurse who divides her time between Arizona and Minnesota. “So it was important that we do whatever we could to educate our residents and connect them to resources they could access even after we left.”
For O’Neill, in collaboration with other concerned health care staff at the shelter, that meant advocating for the area hospital to readmit a resident with cancer who she felt had been prematurely discharged without a sufficient plan to manage his condition. She personally spoke to the admitting doctor and social services to ensure he was served appropriately.
For Katie Purdy, a nurse from Oakland, Calif., that meant flagging for the social work team at International Medical Corps, the leader of this deployment, that one of the frequent visitors to the mobile medical unit had become unhoused. They then connected this resident to housing resources and free veterinary care for his dog.
For Van Wyk, that meant earning the trust of residents who confided in her that, because of the uncertainty of their futures, their substance abuse was worsening. Pulling on her own personal experience of having a loved one struggle through substance abuse, she helped successfully connect several residents to the medical and mental health care they required.
The nurses marvelled at the resilience and solidarity of the Asheville community, even as the scale of the recovery was just coming into focus. Asheville has long been known for its art scene, and on the last day of the second RNRN deployment, some nurses had the chance to attend a street fair in support of local artists whose livelihoods were at risk. The fair’s positive spirit was a reminder that the city, despite the destruction, will continue.
“Having the time to listen to our residents’ stories was so important to them, but looking back, it was just as important to me. I will remember to be a better listener and give patients my undivided attention,” said Van Wyk.
For O’Neill, who deployed with RNRN for the first time, the experience was life-altering: “It’s given me big perspective about what I want to do moving forward. I got to meet great people and made great connections with patients, nurses, and other health care providers—doctors, social workers, and medics who go to disasters. It’s changed how I approach my future as a nurse.”
Michelle Morris is a communications specialist with National Nurses United.