1. To understand the pressures doctors and nurses faced, can you imagine exactly what it felt like to be trapped in a sweltering hospital in a city that had descended into chaos? How do you believe you would have fared under the conditions at New Orleans' Memorial?
Insurmountable pressure and stress must have afflicted the staff of the Memorial in view of the legal, ethical and to some, religious dilemma that they found themselves in after the Katrina. There was loss of electrical power supply to the hospital, which left critical care patients who relied upon electrical machines stranded, and awaiting death. Additionally, this rendered most eviction routes using elevators unviable. This would have resulted in frustration on my part in addition to despair given the critical situation at hand, in addition to the extent of incapacity of the hospital and the relevant authorities to evacuate on time.
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Given the conditions at New Orleans Hospital, I would fare dismally given the high levels of stress and pressure the staff was exposed to in addition to the fatigue from having to evacuate persons through flights of stairs.
2. What do you think of the behavior and decisions made by the medical staff at Memorial? Where you shocked by the lethal injections of morphine? According to Dr. Ewing Cook, "It was actually to the point where you were considering that you couldn’t just leave them; the humane thing would be to “put em out.’’ What do you think?
The behavior of the medical staff at memorial hospital was professional and illustrated practice of the best standard of care in the midst of a seemingly unassailable challenge. The medical staff was organized and collaborative in their efforts to evacuate the patients and visitors from the premise (Fink, 2009). The decision to offer lethal doses of morphine was both shocking and nerve wrenching even though the rationale for taking such drastic actions was comprehensible. It was a considerate and a compassionate gesture by the medical staff to put the patients “out of their misery” given the fact that vital medical care and treatment could not be availed to the patients in time to prevent their demise (Fink, 2009).
3. What shocked, or disturbed, you the most? The actions of the staff? The unpreparedness (short-sightedness?) of the hospital? The horrific conditions everyone operated under?
While the actions of the staff could at first be shocking, it is the unpreparedness of the hospital to emergency situations that was of utmost shock to me. The situation of the emergency power central control at such a low level that it would be engulfed by flood waters seemed precarious and short sighted. Additionally, this was arguably, the advent of the woes of the hospital during the fateful events of the period following the Katrina.
4. What legal and ethical standards must health care personnel be expected to uphold in a disaster? Should they—or any professional—be held to the same standards that operate during normal conditions? In other words, is there a gray area in ethics when things go disastrously wrong?
While legal rules and ethical standards may seem stringent and subject to little variation and consideration during normal circumstances, this is not the case during disasters (Christian et al, 2006). Despite the fact that nurses are expected to uphold legal and ethical responsibility during disaster, it is apparent that extraordinary events may occur, which may call for out of the ordinary measures and judgment calls. It is therefore imperative for medical care givers to be careful and meticulous to ensure they adhere to ethical standards and requirements in the face of disaster, while working to achieve the greater good for everyone (Christian et al, 2006).
5. In such situations as occurred at Memorial, who should be saved first? Who should make those decisions?
Disaster management procedures outline up to nine recognized triages for priorities when it comes to the emergency evacuation of populations with limited resources (Christian et al, 2006). Common patterns delineate to the suggestion that the most vulnerable and critical survivors or victims should be evacuated first given their need for special attention and care, followed by less critical patients (Christian et al, 2006). Additionally, priority should be given to babies and children given the fact that they are vulnerable and most of them untrained for emergency response during disaster situations (Christian et al, 2006).
The decisions on who should be saved first lies with the senior most disaster management official in an institution and organization, given the fact that they are involved with disaster management plans preparations, and is therefore best suited to call shots in disaster situations.
6. Ultimately, who is most responsible for the tragedy at Memorial Hospital? The hospital owners? The staff? The local, state, or federal government? Explain your rationale.
Both the hospital owners and the government were responsible for the tragedy at Memorial hospital. This is in view of the fact that the hospital owners failed to have back-up evacuation plans for the hospital’s patients in case of disasters and emergency situations of such a magnitude. Additionally, despite frantic efforts delineating the lack of resources and personnel to perform evacuations, the owners did not respond with an actionable plan for evacuating the hospital. Additionally, the government would be blamed for the tragedy in view of the fact that it was ill prepared to tackle the evacuation of the hospital. Additionally, the government displayed ill capacity at handling civil unrest and the subsequent fulfilling of its protective role.
7. How did you think you would have fared under the conditions at New Orleans’ Memorial?
The conditions at New Orleans were harrowing and agonizing for both patients and staff, not to mention the distraught family members and visitors of the patients. The conditions at New Orlean’s Memorial were almost inhabitable given the moral, professional and ethical dilemmas that the staff was faced with. I would have survived the conditions at New Orleans, even though admittedly, it would make a mark in my memory as the most unfortunate day yet. Additionally, the ordeal would have been followed by fatigue and emotional unrest given the knowledge of what had happened in the midst of the despair and desperation of that fateful day.
8. What lessons were learned from the hospital disaster at Memorial from an organizational perspective and from a professional perspective?
From a professional perspective, it is in their best interest for professional medical care givers to acquaint themselves with the various laws and ethical considerations pertaining medical care. Additionally, practitioners should be ready to make intense and crucial judgment calls based on ethical and legal considerations during desperate times (Christian et al, 2006).
From an organizational perspective, organizations should ensure that disaster preparedness among its staff is prioritized to ensure that the staff can mobilize to provide emergency services in the event that rescue services are delayed. Additionally, organizations should ensure that contingency plans are made available to ensure that deaths resulting from disasters are either mitigated or all together curbed.
References
Fink, S. (2009). The Deadly Choices at Memorial. Retrieved from https://www.nytimes.com/2009/08/30/magazine/30doctors.html?pagewanted=1&_r=1
Christian, M. D., Hawryluck, L., Wax, R. S., Cook, T., Lazar, N. M., Herridge, M. S., ... & Burkle, F. M. (2006). Development of a triage protocol for critical care during an influenza pandemic. Canadian Medical Association Journal , 175 (11), 1377-1381.
