March 2, 2015
Running a hospital emergency department exposes nurses to a lot of urgent situations, but nothing like the dirty bombs, earthquake, smallpox and chemical plant explosions Marshall Medical Center nurses had to handle during a hi-tech training exercise. “It was very intense,” said Audra Ford, director of the emergency department at Marshall North. “We were all exhausted after it was over.” Mrs. Ford, along with charge nurses Joanne Ray, Shelia Blackmon and Renee Jordan, director of the emergency department at Marshall South, went through the intensive training at the Center for Domestic Preparedness in Anniston last week. The CDP is located on former Fort McClellan property. In 1999, Noble Army Hospital was converted into a training site for health and medical education in disasters, including both acts of terrorism and manmade disasters. The Noble Training Facility is the only hospital in the nation dedicated solely to training. The facility includes classrooms, exercise/simulation areas, a computer lab and two prototype mass casualty decontamination training lanes. Mrs. Ford, Mrs. Jordan and Mrs. Blackmon were part of the Healthcare Leadership for All-Hazards Incidents course, where they learned about decision-making during mass casualties, communicating with the media and public as well as managing medical supplies. The 45 people in the class acted different roles in disaster scenarios with mass casualties. Trainers threw almost everything at their students. “In the middle of all that we had to deliver a baby,” Mrs. Ford said. Mrs. Jordan called the training “a very eye-opening experience” that taught her the need to practice the hospital’s emergency plan so that everyone knows how to prepare, who the other players in the county are and how to contact them. “Overall it was a good exercise that trained us to see where our weaknesses are and how we can improve on them,” she said. The same fast-paced triage required with a large number of patients - some with special needs like hearing loss - can be applied to tornadoes, she said. It was also helpful to be challenged with new scenarios, like the drill they did Friday that involved poisonous sarin gas, she said. The students arrived on the scene of that exercise to find bleeding bodies everywhere. They had to think through how to begin and then walk through the mock disaster. “It makes you think, ‘What I will do if it happens in my hospital,’’’ she said. Mrs. Ray was part of a team charged with ‘protecting the house’, which required decontaminating patients before they were brought inside the hospital. Practical information also was covered, such as how to keep a hospital running during a disaster. Mrs. Ford said the best thing about the training was that it was hands-on. “This is the worst case scenario, yet it’s in a controlled environment so you can learn from it and bring it back to your staff.” Disaster triage is very different from what nurses do every day in the hospital, she said. That’s why training is so important. MMC already has plans to add active shooter drills to their ongoing training schedule in order to lessen the risk if the worst does happen. The week-long training session culminated with an Integrated Capstone Event (ICE) where all the students worked together on a massive incident. Mrs. Ford said it was a very helpful part of the training. “We all had to work together,” she said. More than 100 healthcare workers from all over Alabama participated in one of three courses depending on their jobs. They included emergency managers, physicians, nurses, public health officials and emergency medical technicians. In addition to students, as many as 40 role players portrayed survivors and patients, along with mannequins that pushed the casualty toll to around 200. The CDP is a resident training facility run by FEMA. The Department of Homeland Security funds the training, lodging, travel and meals for state and local responders, including all of those who trained there last week.