This is a different kind of story, because sometimes necessity requires the suspension of objectivity. It is difficult to maintain an emotional distance to events that have occurred in your own backyard, and even a month removed from Hurricane Sandy’s arrival, there are constant reminders of how the storm disrupted lives.
For many in this part of the United States, it took weeks for a semblance of normalcy to return. For others—including the nearly 2,000 people in New York and New Jersey who were still living in Red Cross shelters at the end of November—it will take years, and they may never fully reclaim what they lost in the storm. Tens of thousands lost homes and the entirety of their belongings; more than that, their peace of mind was taken from them.
“People who were directly affected by the storm are going to have issues with posttraumatic stress,” says Mark Zender, MPAS, PA-C, President of the New York State Society of Physician Assistants (NYSSPA). “That sense of certainty that home is safe—it’s unnerving when you’re forced to face that it may not be true.”
The stories from the height of the storm are so distressing that for many in and near the affected areas, it was a mercy not to have power and to therefore be temporarily insulated from the horrors that were occurring nearby. Children swam out of their homes to escape rising floodwaters. Pregnant women were rescued by boat. And more than 100 lives were lost.
“You hear all these stories and you’re thinking, ‘What can I do?’” says Pat Discenza, NP, President of the Staten Island Chapter of the Nurse Practitioner Association New York State (The NPA).
What people do in the wake of natural disasters is respond. It sometimes seems to take the worst of Mother Nature to shine a light on the best of human nature. Within days of the storm, teams and individuals from across the United States had come east, predominately to New York and New Jersey, to pitch in with the recovery effort.
Of course, local NPs and PAs also responded in a variety of capacities. Many went as health care professionals, others as members of military units, and some as private citizens who couldn’t sit by and watch their neighbors suffer. Here is just some of what they witnessed and experienced.
MARK
ZENDER, MPAS, PA-C
President, NYSSPA; Critical Care PA, John T. Mather Memorial Hospital, Port Jefferson, New York
Zender considers himself “very lucky” because he was in the minority of households that didn’t lose power during or
after the hurricane. But within blocks of his home in Sayville, level 1 flood zones were under mandatory evacuation and damage was apparent. As of the week of Thanksgiving, three of his friends were still homeless, and others were struggling to get needed repairs made
to their homes in the wake of high demand for furnaces and boilers.
“Just a few miles away, in the first precinct in Suffolk, there was a nighttime curfew because of looting,” he says. “We had gas-rationing, so to get to work you just hoped you had enough gas. I sat in a two-hour line one day.”
Zender worked the day the storm hit and was driving home at the height of it. “All the lights were out, and I saw tree limbs flying across the sky and not really landing anywhere,” he says.
Although the community hospital where Zender practices is a level 2 trauma center, most trauma patients are sent instead to nearby Stony Brook Hospital. While Zender’s facility didn’t have an influx of patients injured in the storm, there were cases related to its aftereffects.
“We had several people admitted for lack of medication, mainly elderly people who had no one to look after them because family or friends couldn’t get to their homes,” he says. “They ran out of medicine or couldn’t find a pharmacy that was able to fill a prescription. We also had several alcoholic individuals who presented with withdrawal because they couldn’t get out of their houses to get alcohol.”
Zender encourages his colleagues in affected areas to continue to monitor their patients for signs of posttraumatic stress. Furthermore, he says, “Just be a member of society. If you’re capable of helping, then provide either financial assistance or make food donations to organizations that can help the most.”
In fact, NYSSPA has been partnering with the Food Association of New York for many years as part of its annual President’s Charitable Endeavor. Zender says this is a particularly apt time to give, so the organization has been encouraging members to reach out to local food banks to provide assistance to those affected by Hurricane Sandy, as well as everyone else for whom hunger is an issue.
Despite the hardships, Zender chooses to focus on the positive. For example, stores in his community shut down their business activities and became drop-off centers, and then volunteers took food and clothing donations to more heavily affected areas such as Lindenhurst and Long Beach.
“We were very fortunate to see the outpouring coming from the public,” he notes. “The people who were less affected by the storm were looking for ways to help others. People were really willing to help one another.”
MAUREEN ROLLER, DNP, ANP-BC
Medical Reserve Corps, Nassau County (NY) Department of Health; Clinical Assistant Professor, School of Nursing, Adelphi University
Prior to Hurricane Sandy, Roller’s involvement with the Medical Reserve Corps had entailed operating flu clinics, vaccinating people for hepatitis, or visiting senior centers to explain the importance of the pneumonia vaccine. This storm radically altered her experience.
Roller was initially assigned to a shelter at Glen Cove High School that was being run by the Red Cross. She was the only medical provider there, aside from an ambulance crew from South Carolina and, 12 hours later, another from Ohio.
“Basically, I had to assess everybody that came in: Were they safe enough to come in, not infectious? Could we offer them a safe place to stay, or did they have to go to the hospital?” she says. Through the night, she did have to send people to the hospital if their blood sugar was out of control or they didn’t have their oxygen supply with them.
After three days, the Red Cross decided to consolidate the Glen Cove shelter with one at Manhasset High School, and Roller was no longer operating alone. The facility was stocked with medical supplies, and North Shore Hospital had asked any of its personnel who lived in the area and could get to the high school to pitch in. Roller was joined by a pediatrician, a psychiatrist, a physician specializing in respiratory issues, and a podiatrist.
“We took turns screening people, what did they need, and then we kind of pointed to who we thought would help them the most,” Roller says. “People wrote prescriptions, and we had someone who would go to the pharmacy that was two blocks away and get medicines for people. We were able to get insulin for those who needed it and cardiac medicine and asthma inhalers.”
While she was working, Roller was able to focus on keeping people safe and addressing their needs. But when she got home and processed what she’d seen, the magnitude hit her.
“In one section of Manhasset, there were families—four cots kind of in a little compound, all trying to huddle together and stay as a family,” she says. “That I found so difficult, how brave they were. They had no clothing; people were dropping off clothing and they were sorting through it. To see people sorting through bags of clothes to put something on their backs for the next couple of days or weeks or months … that’s not what you expect to see on Long Island.”
PAT
DISCENZA, NP
President, Staten Island Chapter
of The NPA; NP at North Shore-LIJ Staten Island University Hospital
So many people on Staten Island were personally affected by Hurricane Sandy that initially whoever could volunteer simply presented him/herself at shelters or FEMA sites. But as lines of communication opened and ongoing needs became apparent, Discenza says, “I wanted to coordinate that effort, so I reached out to the Red Cross.” As a result, she was able to mobilize a group of NPs to join the Red Cross for a “mass logistics push” over the weekend before Thanksgiving.
“We have a large contingent and can get a lot of people out there,” she says. “I expected a good response, but it was overwhelming. And people still want to help.”
The primary focus of the Red Cross mission was to distribute needed items—everything from cleaning supplies to warm jackets and diapers—to those in need. Cadets from West Point loaded supplies from the Red Cross warehouse into smaller trucks, which were then joined by carloads of civilian volunteers to deploy into affected neighborhoods. Discenza’s group brought in items such as glucometers and test kits, in case local residents had lost their supply in the storm or had run out and been unable to restock.
“Our mission was to provide health care; their mission was a little different. But we were able to mix the groups together,” Discenza says. “I would tell my group, ‘Identify a health care need and text it back to me’ and I would get that message to where it needed to go.”
If any volunteers identified a family in crisis, for example, the information was relayed to the command center. “Say FEMA came in and told someone their house was unlivable, that they had mold and needed to move to a shelter—imagine being told that,” Discenza says. “People were breaking down. So we were able to then say, ‘OK, there’s a psychologist in that neighborhood in this vehicle. Get somebody to pick her up and bring her over there.’”
Discenza has heard from other NPs who had already responded independently; many “came back from shelter sites crying after seeing the people out there. All this is going to take time to recover from. But in the interim, people are in warm places where there’s food and running water and heat.”
The widespread power outages made it tricky to coordinate volunteer efforts in the beginning—Discenza was only able to charge her cell phone in the car (and that, only because her neighborhood wasn’t underwater). But she says that shouldn’t deter anyone from pitching in when the need arises.
“In future, just initially, people could go out and be spontaneous volunteers,” she says. “That’s not a problem, because organizations like the Red Cross are ready, able, and equipped to set up sites. I would advise our group, in future, just to go and find these sites. You just respond—humanly.”
At the state level, The NPA collected donations for Hurricane Sandy victims through The NPA Cares Fund. Donations from individuals were matched by the organization, and a total of $13,590 was contributed to the Red Cross as a result.
STEPHEN MCKENZIE, MS, PA-C
President, New Jersey State Society of Physician Assistants (NJSSPA); Assistant Professor, PA Program, University of Medicine and Dentistry of New Jersey
McKenzie’s role in the Hurricane Sandy response began when his National Guard unit was mobilized. As the acting brigade surgeon—the senior medical officer—his first message to the medics and medical officers assigned to each battalion was, “What are your medical needs?”
“Essentially, our role is to protect the health of the soldiers who are deployed,” he explains. “We’re there to make sure that the soldiers have what they need to stay safe while they’re taking care of civilians and evacuating them.”
Members of McKenzie’s unit helped to evacuate more than 2,000 people from towns such as Moonachie and Little Ferry, as well as assisting residents stranded in Hoboken. They drove high-water vehicles into devastated areas and distributed food and clean clothes to those in need.
“When you arrive in some of these areas and see the devastation and realize how much longer their suffering will be,” McKenzie says, “it helps you keep perspective so that you’re able to do what you need to do to help.”
McKenzie commends the attitude of the citizens of New Jersey as “so positive. Universally, the soldiers said that was such a motivating factor for them to be able to push through the difficult times and continue to serve long hours.”
While he of course encourages interested individuals to join the National Guard, he adds that PAs who wish to serve in a civilian capacity should consider joining the NJ Disaster Medical Assistance Team. “And of course, the service you do as a medical provider at a local hospital or within your community is so critical,” he concludes, “because it helps your patients feel secure, knowing that you’re there to care for them.”
TRISH WESCH, APN, CEN
NP, Jersey Shore University Medical Center; Major
and Inspector General, Air
National Guard
The weekend prior to Sandy’s arrival was a drill weekend for Wesch’s Air National Guard unit, which was activated and sent to Monmouth County. Their primary mission was to set up and maintain a tracking system at a shelter based at Monmouth University—but on site, the situation rapidly evolved, because Wesch is a local.
While Wesch’s group maintained their mission—as people entered the shelter, they provided their name and contact information and were given a barcode for tracking purposes—the presence of the Monmouth County Health Department, one of Wesch’s part-time employers, expanded her focus. “They were like, ‘Trish, can you come help? We know you’re an NP,’” she says. “And though I couldn’t spend all of my time with them, because I was the troop commander for the Guard, I was trying to help. We were all trying to help out medically.”
There were two available gymnasiums at the shelter; one, the Boylan Gym, was designated for people with specific needs. If someone came in with an oxygen dependency, a psychiatric issue, diabetes, or even a shortage of medication, that individual was stationed closer to the health department’s area.
“It was really interesting, being there on an Air National Guard mission, but the nurse in you still pulls you back into ‘How are you feeling? Have you eaten? Did you get your medication?’” Wesch says. “It just became so intertwined. If it wasn’t with the health department, it was with the Red Cross. If it wasn’t with the Red Cross, it was with the sheriff’s department.”
Wesch credits her years as a nurse in the “organized chaos” of the emergency department with helping her juggle the overlapping demands on her time and attention. She also praises the cooperation between differing groups that were staffing the shelter—everyone from local law enforcement to the Red Cross to AmeriCorps, which sent a contingent of volunteers.
“I was shocked at how well it went, and how willing all these departments and organizations were to work together,” she says. “Nobody was territorial. Everybody just started to do things that normally they wouldn’t do.”
After nearly a week at Monmouth University, Wesch was able to return home for about a day before being sent with her unit to Brick Township. Their experience the previous week informed their decisions as to how to set up the new shelter. One of the elementary schools had a generator, so it filled the role that Boylan Gym had the week before; those with particular health considerations were assigned to that facility. “Everyone else was at the middle school, because they would be able to tolerate the no-power situation better,” Wesch says.
Once again, roles were blurred as all the volunteers pitched in however they could. “We couldn’t just say, ‘We’re here to track people,’ just like the police couldn’t say ‘We’re here to police,’” Wesch says. “Before you know it, they’re pushing people in wheelchairs to the bathroom.”
In Brick, Wesch also witnessed the kindness of strangers. A group from a Southern Baptist congregation in Virginia sent up a “shower truck” for use by people at the shelter. “This man, Frank, volunteers his time,” Wesch says. “He drove up from Virginia and spent almost a week in Brick with this trailer that had four showers in it.”
Since Wesch’s team arrived at the Monmouth shelter before the storm hit, and the power subsequently went out, they had no idea of the extent of the devastation for several days. “We had no clue what had really happened; we only knew what we could see looking around campus—what branches had fallen, what trees were laying across driveways,” she says. “We couldn’t see the ocean or the boardwalk, and we only got information from people who lived in the community, like the police officers who were changing shifts.”
Despite 20-hour days and the constant on-the-go, Wesch considers herself better off than a lot of folks were during and after the storm. “There was no heat or power at my house, but I wasn’t there,” she says. “The days were long and it was stressful not knowing what was going on, but I was probably safer and warmer, and I had the ability to take showers and be fed.”
DEBBIE
PARELLA, FNP-C
Private two-physician practice, Rockville Center, New York
“It’s really a horrible situation; it’s unfathomable. You can’t even imagine until you see it,” Parrella says of Hurricane Sandy’s impact on Long Island. Her own community was hit hard with fallen trees and wires and no electricity for two weeks, but about 30% of the patients she sees come from coastal towns that were devastated. “One after the other, they’re coming in and telling me stories about how they don’t have homes left,” she says. “It’s very, very sad.”
Parrella grew up in West Hempstead, which has a strong connection to the heavily affected town of Island Park; the two share a school system. “We got involved in an effort through my former high school to provide whatever relief we could—collecting water and cleaning supplies, canned food and clothing and blankets, and bringing them down to the train station so that people could come by and get what they needed,” she says. She and her husband also drove around with a chainsaw, stopping to help people remove fallen trees from their lawn “and just whatever random little things we could do to help.”
At work, much of Parrella’s appointment time since the storm has been spent listening to patients who just seem to need a sympathetic ear. “Many of them aren’t even really having a specific issue,” she says. “They’re just coming in because they feel they need a check-up after being through so much.”
One such patient was a man employed as a home inspector who told her he hadn’t stopped working since the hurricane. “He actually fell through a floor and somehow, miraculously, didn’t get hurt,” she says. “He just needed to come in and get that off his chest. He hasn’t been sleeping. Medically, he was fine, but I think he just needed to validate everything he was feeling with someone that he sees as a professional.”
Her customary “Hi, how are you?” as patients walk into the exam room has changed to “How did you make out in the storm?” Losing a home, and the sense of security along with it, is stress enough. But Parrella points out other sources of anxiety for displaced persons: “Many people are staying with family who they ordinarily wouldn’t spend that much time with or don’t get along with. People feel like they have no choice; they’re lacking control in their lives.”
Parrella is making notes in patient charts so she can follow up. “You just have to hope the support is going to continue to be there,” she says. “Once it’s not news anymore, and the acute phase is over, these people are still going to be faced with empty houses and relocations and things they never thought they’d have to deal with.”
Parrella describes arriving in devastated areas and seeing, for the first time in person instead of on the news, “everything piled outside of these people’s homes—photo albums and furniture and appliances and carpet and toys. You have to think about the emotions they must be going through, putting their lives out on the curb and waiting for it to be picked up by the sanitation men. I think there’s going to be a lot of posttrauma from this storm for a long time.”
Even so, the outpouring of help was uplifting. “There are truckloads of supplies and people from New Orleans, survivors of Katrina, coming up here now to help us,” she says. “And fire departments from around the country are donating ambulances and fire trucks to our departments who lost everything. I think it’s given all of this area a new perspective on life in general. It’s a very humbling experience.”
A FINAL MESSAGE
So to you, Hurricane Sandy, the people of the tri-state area say this: You came, you saw, you inflicted misery and devastation. But there is one way in which you failed. You did not conquer.
“The local outreach and the willingness of the general public to band together and help one another, despite such a terrible storm—it’s heartwarming to see the community come together,” Zender says. “It’s quite remarkable. The human spirit is indomitable.”