Stories from Haiti: A Very Different Kind of Travel Nursing
By Debra Wood, RN, contributor
General chaos, a shortage of medical supplies and medicines, outdoor clinics, emergency triage, and meager accommodations don't sound like the kinds of things that would attract nurses to a short-term travel nursing assignment. But scores of RNs have gone anyway, to do what they could in the wake of Haiti's recent tragedy that has killed approximately 230,000 people and injured countless more.
Televised scenes of earthquake victims suffering moved nurses and other health professionals to pack a bag and head to Haiti within days of the January 12, 7.0-magnitude earthquake that struck the nation. Most found the aftermath heartbreaking and their patients' resilience remarkable.
"You know you are doing something, maybe not as much as you want," said Adrian Mesa, RN, BSN, an American Mobile Healthcare travel nurse assigned to the pediatric intensive care unit at Plantation General Hospital in Plantation, Fla. Although stressful, Mesa found his experience rewarding.
Mesa traded shifts with fellow nurses at Plantation General so he could spend five days in Haiti with the University of Miami Global Institute's Project Medishare at the Port-au-Prince airport. He arrived six days after the earthquake and began providing wound care at the project's hospital. He soon realized there were more people in the surrounding area with crush injuries needing access to medical care, and, with two paramedics, ventured out of the compound in a bread truck, which served as an ambulance.
"We triaged patients as we went along," Mesa said. "We didn't have much equipment. It was basic assessments."
When they brought patients to some of the makeshift hospitals in town, they often were required to take a discharged patient "home," sometimes leaving the person on the side of the street, including one 8-year-old, with pins holding his fracture in place.
"I could cry," Mesa said. "We go and treat patients but don't have the facilities to do things like rehabbing them, finding prosthetics."
Mesa urges his fellow health care workers and other Americans not to forget about the Haitian people, because their needs will continue for a long time.
Beverly Kram, RN, a cardiac intensive care nurse at Miami Children's Hospital, also volunteered and traveled to Haiti with a medical team mobilized by her hospital to assist Project Medishare.
"I wanted to contribute, and speak French and a little bit of Creole," said Kram about her motivation for going. She stayed for five days in a tent, but found it difficult to sleep.
"There were a lot of children by themselves, and that shocked me the most," Kram said.
The children had lost or become separated their parents. One 14-year-old girl, now on her own, experienced crush injuries to both legs, yet she always expressed thanks for the comfort and nursing care she received.
"The hardest thing about leaving was not knowing the outcome of your patients," Kram said. "It was for me, as a nurse, one of the best experiences of my life, and I would do it again."
A group of nurses from Holy Cross Hospital in Fort Lauderdale, Fla., also traveled to Haiti with Project Medishare. Marjorie May, RN, CCRN, assistant nurse manager of the cardiac care unit; Jacqueline Pennant, RN; and Anna Morrison, RN, BSN, spent five days on the ground, caring for more than 40 burn and orthopedic patients each, hanging IV antibiotics and administering pain medications nonstop.
"It was almost like being in a war zone, with helicopters overhead," May said. "But I wanted to be there so badly I didn't care. I was driven to go, to help, to give back."
May felt at times the needs far exceeded what she was able to do. She wants to return.
"It was probably the hardest I ever worked in my nursing career," May said. "But it was a great feeling to be at the bedside and take care of these patients."
Morrison, who has made two trips to Haiti since the earthquake, initially found the needs overwhelming but was amazed when physicians pitched in to assist with traditional nursing tasks, such as emptying bedpans, passing medications and taking vital signs.
"They jumped to come and help us," Morrison recalled. "Senior nurses said to me you will never see this again. It was a beautiful coming together of the professions for the sake of the patient."
The nurses worked 24- to 36-hour shifts, without showers or complaints.
"Just because we were tired didn't mean the helicopters stopped bringing patients," said Morrison, who found the Haitian people remarkable.
"They lost everything but still found the strength to smile at you," Morrison said. "They wanted hugs. They wanted affection and love and were happy you were there. A lot of times, as nurses, we can go for weeks without people saying thank you, but it was incredible [in Haiti]. Everything you did, there was a thank you that followed. It made it rewarding to be there."
Barbara McLean, MN, RN, CCRN, CCNP, FCCM, a nurse consultant from Atlanta, also has traveled twice to Port-au-Prince with Project Medishare and plans to return. She cared for one patient who had been pulled from the rubble 27 days after the earthquake. She wrote orders for Benadryl to help patients sleep and enlisted emergency medical technicians to hang IVs and provide other care.
"The cooperative framework and the feeling you are really able to do something is highlighted," McLean said. "You use all of your skills and knowledge."
McLean urged nurses to only proceed to Haiti prepared for the worst-possible conditions and with a well-supplied organization or health system. Project Medishare is one of the many nonprofit endeavors aimed at meeting Haitians' need for medical care. Nurses with U.S. government teams also have stepped up.
Most facilities supported their employees' and travel nurses' desire to help in Haiti. The nurses with understanding employers were most grateful for the opportunities, and it likely will benefit the hospitals in the long run.
"Miami Children's was awesome," Kram said. The Miami Children's Foundation, in concert with the United Nations and Incident Command Team, coordinated and shipped a plane load of medicine and medical supplies to Port-au-Prince. It has helped secure aircraft to transport volunteers, gathered supplies and paid for fuel and vaccinations for hospital personnel providing aid.
Such generosity may have its paybacks. While in Haiti, Kram carried a caseload of 27 patients. She says now, home again, she doubts she will ever complain about her patient load again.
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