Food & Nutrition Services

How I Heard

On June 12, 2016, I was the supervisor for the third shift in the Food and Nutrition Department of Orlando Health Orlando Regional Medical Center (ORMC). I remember having a normal third shift until about 2:00 am. On a normal night, we serve between 100 and 130 customers plus the typical patient meal requests. I was preparing for the usual 2:00 am to 3:00 am rush before we close at 3:30 to clean and prep for breakfast. Around 2:30 am, the head of security came through and told us something was going on and we needed to prepare to close. Not five minutes later, he returned and told us to close immediately. I watched as a flood of administrators came in, and I started feeling uneasy. Something was definitely up. The COO of ORMC came through to check on us, and then security instructed my team and I to wait in the lobby while the building was “cleared.” As we waited in the lobby, someone mentioned there had been a shooting at Pulse nightclub. This was gut-wrenching news and hit close to home. My family and I had owned and operated Lorenzo’s Pizzeria in that same building for more than 20 years.

Response

Once ORMC was cleared, we loaded cases of water for the ER. When we delivered the water, the gravity of the situation was apparent. We set up a conference room for families and put together an incident command cart. The team and I passed out countless bottles of water to those gathered outside the hospital’s north tower entrance. We set up an ER refreshment center. And, we brewed and delivered lots of coffee. I cannot give an honest accounting of the requests we processed and completed, but we all just kept busy and did not dwell on the tragedy that had befallen our town. Every food and nutrition team member did their utmost. They selflessly did whatever was asked and often times what wasn’t asked. They anticipated needs before they became apparent. Patients were fed. Staff was fueled to serve patients. Doctors only came down when they were famished. Victims’ families and friends got coffee and sat in the dining room to cry somewhere other than a waiting room. I was only able to make brief eye contact with anyone for fear I would break down.

Lessons Learned

More administrative help: Although clinical help flocks in, we also needed more administrative help. Because the administrative supervisor was in the ED and the ED charge nurse was calling staff in, there was a delay in activating the MCI alert. The patients came in so quickly that no one thought to activate the mass casualty alert right away. This delayed notification of the event to the rest of the hospital and made it difficult to initially get blood products because the blood bank was not aware of the magnitude of the event at first.

I also learned that we needed a better way to track patients.  I assigned a secretary to log in each patient and document where they went.  Incident command was preparing their press releases and needed accurate counts of deceased, patients who went to the OR and those in the ICU. 

Another administrative person is needed to track patient belongings.  We had cell phones ringing in the trauma bay, which was very upsetting to staff as we knew families were trying to reach their loved ones.

And a leader needs to coordinate with Law Enforcement.  We had many different agencies investigating, and they all needed workspace and help navigating the system. 

Time to decompress: As the night shift was leaving at 0700, I did not consider the same team was scheduled to work again that evening. I stayed all day at the hospital helping reunite families and put the department back together, but did not consider giving the team the night off.  There were plenty of other staff who did not get called in and could have covered for them. 

Staying in touch with the staff: I also learned how important it is for the leadership team to continually check in with staff.  Four days after the event, a nurse let us know that the team was not okay. We arranged a big debriefing that evening with our Employee Assistance Counselors and quickly shuffled schedules and coverage for the department so everyone who needed to could attend.  The team was surprised at how quickly we pulled this together and commented on how comforting it was to be together and share.  

Starting the healing process: In the Emergency Department, we usually do not know the outcome for our patients.  It was not until I was in a debriefing with a Trauma ICU Nurse that I realized all the patients we sent upstairs survived.  The injuries were so severe and there was so much blood loss, I did not think there would be many good outcomes.  I spent the week after visiting patients with front-line staff so they could see the results of their hard work.  This made it real for us and refueled us.  The patients were thanking us, but I had to tell them that seeing them was a gift for us.  I believe this started the healing for the team. 

Conclusion

I have always felt privileged to work at ORMC. This organization is an asset to our community. Nineteen years ago, my brother-in-law passed away in the ICU due to complications of AIDS. He received first-class compassionate care and was able to quietly slip away holding his mother’s hand. He was my best friend. I am eternally grateful to Orlando Health for the excellent care he received. When the opportunity arose to work for Orlando Health, I was excited to be part of something so much bigger than myself and be part of a great team. I used to make pizza and breadsticks for lots of hospital staff at Lorenzo’s. I still am fortunate to serve our staff as a supervisor with ORMC’s food and nutrition team.