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December 16, 2017 12:00 AM

Florida Keys providers lean on old-school medicine during Hurricane Irma

Matthew Weinstock
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    Cheryl Cotrell, at the podium, and Dr. Thomas Morrison, to her left, were effusive in their praise of clinicians who helped patients during Hurricane Irma.

    Despite operating out of a MASH-like unit, clinicians in the Florida Keys prove that old-school medicine can still result in quality care during Hurricane Irma.

    Cotrell: Because we are a coastal island, if a hurricane is a Category 2 storm or above, we will evacuate the Keys, which is different from other hospitals on the mainland.

    Irma was such a large storm, we knew that all of the Keys would be impacted.

    I did not plan on evacuating. I have a concrete house and it's 18 feet above sea level in high tide.

    D. Wayne Brackin, COO of Baptist Health, called and said, “I will be down to pick you up in half an hour and you will come with me.”

    OK. He's my boss. I will go, but I have (family here), so that was hard because you didn't always have communications.

    Healthcare Heroes

    Dr. Thomas Morrison

    Director of emergency medicine

    Cheryl Cotrell

    Chief nursing officer

    Mariners Hospital and Fishermen's Community Hospital, Florida Keys

    Baptist Health South Florida

    Morrison: We targeted Fishermen's for evacuation first because it was close to the impact.

    Cotrell: And all of the clinical staff stayed until the last patient was evacuated.

    Morrison: Even longer because we wanted to keep the ER open as long as possible.

    Cotrell: That's the hard part for people in the mainland to understand. When it's a mandatory evacuation, you cannot demand that your staff stay. Most of them do, but if they live in a mobile home, those are the ones who are always evacuated first and we have to figure out how to either provide them shelter until we can close the EDs, or let them go. We just rearrange schedules and people voluntarily shift and decide that they will cover for someone so they can secure their homes and then come back in and work.

    Morrison: We walked through Fishermen's that following Monday morning. You could see cracks in the hallway walls, and there was also some damage from underground. I understand it's an open debate whether that was water or sewage, but it doesn't matter, it's damage.

    We set up our own MASH unit, which is made up of containers that are attached to each other. It's better than a tent, but it is far from ideal.

    I'm really proud of my docs and nurses who worked there. They really rose to the occasion even though they were out of their element because they're normally medical-surgical or oncology or outpatient. Emergency medicine is very different, but they made it work.

    What really impresses me is the impact we've had. Lives were saved because of that facility.

    Cotrell: We saw a fair amount of heart attacks and strokes. We provided top-level care without a lot of extra things that doctors rely on now. We only had basic lab, basic X-ray, respiratory and EKG and we had the pharmacist there, which was helpful, but the physicians had to go back to being good clinical diagnosticians because they couldn't say I want a CAT scan or an MRI, because they weren't there.

    Morrison: We had a patient with a ruptured aortic aneurysm. We did not have any tools to make that diagnosis. When I sent him out via helicopter, I thought either he is bleeding out in his gut, or he has a kidney stone. I hoped I didn't overcall it, and we didn't. He was in the hospital for 47 days, had several repairs and came back to thank us.

    That kind of stuff makes it all worthwhile.

    Pastoral care really came forward too and they were there for people, not just in the setting of prayer, but in the setting of support. “Let me get you the FEMA number. No, let me get you the FEMA person and bring them to your house.” And they orchestrated cleanups where Baptist employees got together, loaded up a bus and would go to people's houses to clear them out.

    That was very impactful.

    Click here for more Healthcare Heroes' stories.

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