An image that shows items for emergency preparedness.

Before you blow over this post thinking it’s not for you—think again. While you might not live or work in Hurricane Alley, are you sure you have nothing to worry about? Never say never because the only hurricane I’ve experienced came farther inland than anyone ever thought possible.

Did you know that hurricanes can track up the coast as far as Maine and into Canada, and you can feel the force of their winds up to 150 miles inland?

My city lost power, gas stations and banks closed, and the hospital generators took over for a few days. Nurses scrambled to provide adequate care to patients in rooms that weren’t well-lit and without amenities. How prepared would you be if this happened in your neck of the woods?

An image that lists the top 10 states for hurricanes.

The Centers for Medicare and Medicaid Services (CMS) established the Emergency Preparedness Rule in 2017 to ensure the readiness of healthcare facilities for unexpected emergencies. However, they failed to address a key component of patient safety—how the security and welfare of vulnerable patients largely rest on nurses' preparedness. Despite fulfilling CMS contingency criteria, a lack of emergency training for nurses and other healthcare staff remains.

In 2018, Spectrum Health surveyed more than 5,000 nurses within its health system, and more than half said they had little or no familiarity with emergency preparedness and disaster response.

Despite the lack of emergency training for healthcare professionals, fierce nurses like us can do plenty of things to prepare ourselves and keep patients safe.

What Happens When Your Hospital Loses Power

Do you know what happens during a power outage in a hospital? Usually, the generators kick in, and the loss of power is merely an annoyance that doesn't affect nursing care. However, a study revealed that 78% of nurses are ill-prepared for a complete loss of electricity during a hurricane.

If you haven't done so already, you should become familiar with how your facility handles the following systems and equipment during power outages:

  • Communication system: Communication is crucial for the safety and care of patients. During a power outage, the generator continues to support the internet for some computers. Corded phones will continue to operate, but cordless phones won’t. Cell service may be interrupted. The pneumatic tube system will not be functional.

  • Critical medical equipment: Hospitals have designated generator outlets connected to emergency backup power. All critical equipment, such as ventilators and infant incubators, should be plugged into these outlets. In a complete power failure, manual bagging of the intubated patient will be needed.

  • Oxygen delivery: Hospitals use liquid oxygen delivered by trucks as needed. Oxygen delivery doesn't require electricity, so patients will continue receiving oxygen through wall outlets. Most hospitals have enough oxygen to last as long as two weeks.

  • Vacuum suction: Hospitals use a pump system to create a vacuum suction accessible through wall outlets. Generators will support suction during a power outage, but a complete loss of power will result in a loss of suction, which can be life-threatening for some patients.

  • Water and sewage: Hospital water and sewage connect to the city’s water and sewage system. An electrical failure at a hospital may mean reduced water pressure, but a complete power outage in a water and sewage plant will disrupt water delivery and waste disposal. Either way, it’s best to assume tap water is unsafe to drink.

  • Air conditioners: Most healthcare facilities in warmer climates have some air conditioners linked to their generators, as this is a patient safety issue.

What you do during the hours before, during, and after a hurricane impacts the lives of your patients.

What You Should Do Before Hurricane Season

The best way to plan for hurricane season is to review your healthcare facility's emergency and evacuation plan during orientation hours. Knowing these policies and protocols will give you a baseline knowledge of shelter-in-place or evacuation policies and protocols.

If a hurricane threatens your facility, attend the planning meetings, and ask questions so you know what to do during a catastrophic power failure.

Staff Safety Impacts on Patient Safety

Patient safety is more than just looking after the patients. It's also looking after you. Nurses are more apt to work during a hurricane if they know their families and pets are safe. Here are some things to consider if your facility asks you to work during a hurricane:

  • Sleeping arrangements. You may have to spend the night at your facility before the hurricane makes landfall so that you are available to work your day shift. It also might be unsafe for you to go home afterward. Ask your manager what accommodations, including meals, have been prepared for the staff.

  • Company policy on family and pets. Ask your manager or administrators about the protocol for bringing your family members or pets to stay in the hospital with you. Ensure that any dependents have someone to watch them during your shift and while sleeping.

  • Items to bring. Charge your phones and bring power banks with you for catastrophic power outages. Bring enough medication to last several days, and don’t forget your pet’s medications. Bring a flashlight and snacks to enjoy.

When It Gets Down to the Nitty-Gritty

In the hours before a hurricane and after it makes landfall, the safety of the patients lies in the hands of the nurses looking after them. Here are 15 nitty-gritty practical suggestions that will make a difference:

  1. Go to work: One of the main issues during hurricanes is a lack of staffing. One of the best ways to keep patients safe is to go to work.

  2. Batteries and flashlights: Know where the batteries and flashlights are stored. Ask for a headlamp or bring one from home.

  3. Generator outlets: Plug the essential medical equipment, including the fax machine, into the generator outlets. Find extension cords so that you can use hall outlets. 

  4. Battery suction: Ensure that battery suctions units are charged up before the storm. Check for extra battery packs and ensure they're fully charged.

  5. Oxygen: Although your hospital should have an adequate oxygen reserve, ensure that the regulators are off to conserve the supply.

  6. Bag-valve masks: Make sure bag-valve masks are nearby for patients in intensive care and emergency rooms.

  7. Flying glass: Be ready to move patients away from windows and into hallways.

  8. Pneumatic tube runners: Assign runners to take specimens to the lab and pick up supplies.

  9. Water: Know where bottled water is for patient consumption.

  10. Communication: Designate one person per shift to liaison with the emergency team. Nurse leaders should make themselves visible.

  11. Paper documentation: Make pens and paper available if electronic documentation is unavailable.

  12. Medication delivery system: Ensure your locked medication cabinet is connected to a generator-designated outlet. Know how to access it if there's a complete power outage. 

  13. Pharmacy cheat sheets: Ask the pharmacy for updated cheat sheets for mixing medications if you are in an intensive care unit.

  14. Emotional support: Provide emotional support for patients and other staff members who may be struggling.

  15. Hand sanitizers: Ensure that hand sanitizer containers are filled and available.

After the hurricane passes, ask for a debriefing. Discuss what worked and what needs more planning. Ask if you can be on the planning team for future storms and emergencies.

Nurses are critical to the delivery of safe and effective care during hurricanes. Lean into the excitement of the storm, take care of yourself, and help the patients remember the exemplary care they received during the difficult and scary hours.

Alice Blackmore, MN, RN, Content Writer

Alice is a registered nurse and healthcare writer. She has more than 20 years of nursing experience, which ranges from labor and delivery to long-term care, with pediatrics, community nursing, and critical care sandwiched in the middle.