A Nurses experience in Christchurch - February 22 2011

Written by: Marianne Wilson
Nurse Specialist
Christchurch Diabetes Centre

At 12.51pm on Tuesday 22nd February, I had just come back from my lunch-time walk and was on the second floor of the Diabetes Centre when the building started shaking and shelves, books and filing cabinets flew across the room. It was immediately evident that it wasn’t just another aftershock. It was impossible to move and all I could do was stand in the doorway which I happened to be close to, hang on to a room divider and wait for the shaking to stop. Once it did, people were shouting to get out of the building and the instruction to evacuate and the siren blared repeatedly over the intercom. I don’t remember seeing anyone remaining on the floor and went down the stairs to the first floor where the clinical rooms are situated and helped other staff already there, check that everyone was out of the building. Some people recall feeling frightened, but my mind was a blank.

Everyone congregated outside in the same area we stand when we have a fire drill. A staff member and a patient who were injured were tended to and an ambulance called for the patient. Some people were aware that the area we were standing in wasn’t safe if the building collapsed, but trying to persuade people to shift was like herding cats. Most people were in shock and trying to make sense of what had happened. I just remember trying to comfort a friend and to figure out what to do next when my partner who works a couple of streets away arrived. The relief was indescribable and I was able to start thinking again and to text my father who replied that he was alright and my sister who works in the central city and who didn’t reply. There were stories coming through about buildings collapsing and the realisation dawned that we weren’t going to get away as lightly as we did in the first earthquake in September. As the aftershocks continued and people started to think about finding family members and making their way home and to drift off, I decided to go into town to look for my sister.

Traffic was bumper to bumper and crawling so my partner and I walked. The streets were flooded, full of silt and cracks and for the most part deserted, and it felt as if we were walking on the surface of the moon. As we got closer to the main street, there were groups of people standing round talking, people walking and cars lined up the length of the road. We could see that the multi-storey car park at my sister’s workplace had collapsed and there were cars hanging over the edge of the building. The minutes until my sister answered her cell phone were an eternity and some of the most frightening I have ever experienced. She had taken an injured friend to be treated at a first aid station about a hundred metres from where we were standing. The tears we shed when we found each other were the first of many. The rest of the day we spent transporting people, checking on family and friends, watching the horrific news footage on television, praying for the people who’d been buried in collapsing buildings and trying not to panic with each aftershock.

After a sleepless night, a friend and I decided to go into the hospital to see if we could help. There were cars queuing along the road waiting to get into petrol stations and we had to go through a cordon manned by army personnel to get to the hospital. Apart from the presence of security staff on the main door, the hospital seemed to be functioning much the same as usual and we weren’t required, but gave our names to be contacted if necessary. While there, we got a call from our Unit Manager and arranged to meet him at the hospital. He was able to persuade security to let us go into our building which was yellow-stickered (damaged, but accessible) for 15 minutes to retrieve some supplies. We were so focussed on getting what we needed and getting out that there wasn’t time to be frightened, but being in the building felt very surreal.
It would have been easy for the people making contingency plans to dismiss diabetes as being unimportant at that time, but we have a consultant who was excellent at promoting the welfare of people with diabetes and ensuring their requirements were included in the planning. We were given two rooms in the Outpatients Department and from two days after the earthquake, our podiatrists used one room to arrange appointments and to treat people with acute diabetic foot problems. I contacted all of our nurses and arranged a roster so that we had two nurses working from 8.30am – 5.00pm manning a cell phone to which all diabetes related calls coming through the hospital switch board were directed. The hospital telephonists and each ward were informed that there were doctors and nurses available to take calls from medical staff and to see any inpatients who required assistance and any person who called in to the hospital with diabetes related problems. We had enough equipment to start and when we contacted companies they were very helpful and couriered equipment to the hospital so we had ample supplies. Our Diabetes Christchurch manager worked with us each day and delivered supplies to the Relief Centres and to patients who weren’t able to come into the hospital. Our Maori Diabetes Nurse Specialist and Maori Health Worker worked out in the community assisting their patients. One of our secretaries and the nurses contacted patients to explain the situation and to cancel their prebooked appointments.

During the second week after the earthquake, we continued the service initiated the first week and arranged appointments for one physician clinic each day of the third week. We were able to enter the Diabetes Centre to retrieve education material and additional supplies. Our medical staff and manager continued to push for the resumption of normal diabetes services and repairs to our building were started on 7th March. On 10th March some staff continued to run the emergency service in the hospital and the remainder started cleaning up our building despite not having any running water or toilet facilities.

On 16th March we resumed our usual clinics at the Diabetes Centre. A week later our attendance rates were about the same as they were pre-earthquake and we were gradually becoming less nervous about the continuing aftershocks.

During the nine days we ran the emergency service, we saw 130 patients and took 120 phone calls.
In my opinion, the most important lesson we learnt was that, during a disaster, hospital managers don’t view diabetes care as a priority and it is vital to have a strong advocate for patients’ welfare and for diabetes services. It was also important to maintain a high profile and to ensure hospital staff, Medical Centres and Relief Centres were aware that we were available to assist with any diabetes related problems. Some patients left messages on telephones at the Diabetes Centre, but we were able to retrieve those and to ring the patients. Patient referrals faxed to the Diabetes Centre were a problem as we weren’t able to retrieve them until we were allowed to enter the building, although we had been contacted in some other way about all the urgent referrals. Having one cell phone number with all calls put through to that number worked well except where there were ‘missed calls’ with no record of the caller’s phone number.

We were fortunate that we were able to gain access to our building and to get some equipment out, but I believe that if the building hadn’t been accessible we could have had sufficient stock to meet patient’s needs within two days. We now have a small stock of equipment and education material in one of the hospital wards and that would be enough to start with if we weren’t able to access our building in the future.

Our most valuable resource is our staff and we were really lucky that only one person was injured. Despite people having homes badly damaged or destroyed, having no transport and having to relocate their families, most staff members wanted to come to work, and to help and support each other and our patients. Talking about our experiences with each other was (and continues to be) an important part of dealing with and recovering from the horror we shared on 22nd February.