Formerly St. John's hospital, Mercy Hospital Joplin took a large hit in the 2011 Joplin tornado. Most staff seem to remember what they were doing and how they helped evacuate their unit.
The catastrophic destruction led to the construction of a brand new Mercy hospital, which opened in March 2015. Hospital officials learned many lessons in the tornado and used those very lessons to rebuild a stronger, more prepared hospital. Other hospitals have taken note.
"We're home, we're not going anywhere for awhile. that's fantastic. so we can settle in, that's nice," unit secretary in the E.R., Nancy Nichols said.
Nichols explains a new triage process, developed by Mercy nurses upon moving into the new structure.
"It's just a way to keep as few people as possible in our waiting room, get as many people as we can into rooms as quickly as possible, to get care teams with them as quick as possible. So I think that's really improved our wait time, our patient flow, and as a whole I think just how people who come to the emergency room, see an emergency room visit," Nichols said.
When storms draws near and imminent danger is a risk, the hospital goes into "condition grey". This lets staff know to be prepared, and at that point, grab the "go bag".
"We have a Go Bag now. it's huge. It's this big duffel bag and we have them on every single unit. So that's something you pick up and you take with you wherever you're going," Kathy Cowley, manager of the birthing center, pediatrics and specialty surgery units said.
In the go bag is items like pry bars and work gloves, but also medical necessities like trauma shears and gauze pads.
"A lot of hospitals, we've not found any one that had a Go Bag and so now we even share the contents, so that's really big," Cowley said.
Cowley recalls her team of nurses evacuating the entire labor and delivery floor, which was on the eighth level. Strangely enough, the highest level evacuated first and no mothers or babies were lost in the hit.
One mother had a C-section birth the day of the tornado. Thankfully, the feeling in her legs returned but Cowley knows that's not always the case. Thus, a medical sled is now on every floor to help patients evacuate who may be unable to walk.
"All the floors have a sled and we can put our patients on that and it comes down the stairs in a controlled situation and that's how you get them down. so that's a new thing too, we shared that with other hospitals and people that have asked us," Cowley said.
Another policy change: footwear. When the storm hit, patients shoes scattered with the debris, forcing many nurses to give up their own shoes for their patients.
"We put their shoes on the end of their bed, so if we need to activate "condition grey" which is what we call it or to shelter in place for a storm, we have their shoes immediately available to put on their feet because we learned in trying to evacuate people from a building full of debris, you're not going to be able to find their shoes after the storm,” Dr. Timothy O’Keefe, hospitalist and chairman of hospital-based physician services said.
O’Keefe explained the structural changes made in hardening new Mercy, including the poured-in concrete roof and windows built into the structure itself.
“So we have specially-designed windows that are tornado-proof as best as can be done, so basically, the lower in the building, the more forceful is the debris. So the lower windows and the ICU windows and the windows in labor and delivery, are all rated for 240 mile per hour debris impact. Then we have other windows that are rated for 160 and 110 miles per hour,” O’Keefe said.
O’Keefe recalls hospital officials visiting hospitals as far as Alaska and teaching emergency-preparedness.
“One of the things we learned was the emergency operations center was destroyed, so we had a backup location. It was destroyed. And then we had a mobile emergency operations center and it was also destroyed. So one of the things we learned was having a geographically large enough system that you can get your hands on after a storm,”
The hospital has its own reverse osmosis system, so they can purify their own water if need be. They have also begun locating critical resources such as oxygen, fuel and natural gas far from the building. Building generators are located partially underground so they cannot be ripped from the earth in damaging winds and now a larger portion of the building is connected to its emergency power system.
"Very quickly you need to get the mindset that you are on your own. You have to utilize the resources you have available and when assistance can get to you it will get to you. If you spend a lot of energy trying to figure out how to get people to show up, you're probably wasting your time,” O’Keefe said.
While St. John’s went down with the storm, patients were transferred over to Freeman Health System. Freeman experienced a surge of patients that no hospital elsewhere in the U.S. has.
"We consider, if we lose the ability to provide services like St. John's did, what would have happened to this community? So there's nothing of more importance than we have of providing the best possible care. Even in the worst possible times,” Freeman health and safety officer, Skip Harper said.
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