Inpatient Nursing
Alicia Bechtel RN, MSHA, CNML
How I Heard
Early that Sunday morning around 2:30 am, my cell phone began ringing. As I went into the kitchen to answer it, I thought to myself, This can’t be good when it goes off in the middle of the night. On the other end of the line was Mark Jones, the president of Orlando Health Orlando Regional Medical Center (ORMC), who said there had been a shooting. I replied in a sleepy, raspy voice that I would be on my way. I jumped in the shower hoping to wake up and 20 minutes later I was out my front door. I took my normal drive into work, but when I got to Orange Avenue and Michigan Street, it was blocked off and there was a huge police presence. Turning down a small side street, I noticed every side road was blocked and officers were on every corner. It was a very weird feeling. I had the radio on and even switched stations to see if I could hear what had happened. After parking my car in the dark, quiet parking garage, I walked briskly through the front door of the hospital, heading straight for our main conference room and incident command.
Synopsis
The ED looked like a war zone, but everyone there had trained diligently for what was put in front of them. The hospital census was around 450, which is typical on a Sunday. In a very grim moment, the only good news was we had inpatient beds available.
Response
As soon as I entered the conference room, I could tell from my colleagues’ eyes that they were unusually stressed. They briefed me on the horrible tragedy that had just occurred, and as part of the Hospital Incident Command System team (HICS), I was assigned the role of operations chief. I was briefed by the administrative supervisors who were busy moving all appropriate patients out of the ED to prepare for a mass intake. When the victims started arriving, they came by ambulance, police cars, pickup trucks and some were even carried by other survivors. The nurses and doctors in the ED were busy triaging patients outside the ambulance bay.
After an hour, we went upstairs to prepare the inpatient floors and ease some of the fear that was spreading through the hospital. A colleague and I decided to divide and conquer. We each took half of the hospital and went to the nursing units, updating them on the current status and assuring them we could handle this situation. After rounding on the nursing units, I stopped in the administrative supervisor’s office and noticed the team was being flooded with phone calls. I knew they needed my help, so I stayed to triage phone calls. After assisting there, I focused on staffing for the day shift. We were going to need all hands on deck.
Just as the sun was rising, concerned family and friends started streaming into our lobby and hallways. We opened our largest conference room for the families to gather. We also needed to secure our facility as reporters were trying to make their way into the hospital. The surgeons continued working to save lives, while we began the task of matching names to the victims. Most of the victims arrived without any identification, so this became one of the hardest tasks of the event.
With victims still being taken to the OR, the nursing units were asked to take care of both the physical and emotional states of the victims. Here’s what Shirley, an RN on one of the surgical floors, said: “The patients were in a state of shock, and as a nurse I felt a sense of honor to take care of these victims. The primary goal for me was to help them feel safe and protected. There were feelings of sadness and remorse for victims and families.”
The orthopedic unit, which is one of ORMC’s largest units with 48 beds, received several victims all covered in blood. Adam, an RN there, said: “We responded as a team. Every one of the nurses on our unit that day took care of a victim, and some took care of more than one. We cleaned the patients and helped to provide emotional comfort for them. It was also important to connect with their loved ones as soon as possible. This was very emotional when the family was notified and came rushing to the hospital because they learned their loved one was alive.”
Emotions were high, and the media started setting up camp in front of the hospital and their trucks lined the street. Well-wishers from across the country were sending food and gifts, and the outpouring became overwhelming. We continued to keep security at a high level.
Lessons Learned
Through tragedy, we learned that we had great teamwork across departments. Each one worked at its highest capacity to make sure we saved as many lives as we could. Preparation was also key to our high performance. Drills throughout the year prepare us for disastrous situations, and I believe we all will take them more seriously after this event. We also learned we needed to tighten security in our facilities. After the incident, we reduced our entry points and added metal detectors to our front doors.
Conclusion
This will be a day I won’t forget for the rest of my life. Tragedy can happen on any given day. What defined ORMC is how we responded as a team and how we saved so many lives. In this day and every day since, I am proud of our team and proud to be a leader at this organization.David, you and Orlando Health have just had milestone days.” The caller was right.
The events that surround June 12th will never be forgotten and have been life-changing for many of us. What happened has become a part of our organization and now is a part of our lives. I couldn’t be more proud of the people who represent Orlando Health and create milestone memories and experiences for patients and each other on a daily basis. I am saddened, humbled and honored to have been a part of the Pulse experience.