The Orlando Police Department called and notified the charge nurse about multiple trauma alert patients. The staff that was going home at 03:00 stayed and the charge nurse called me. The staff then began readying the trauma area by lining up stretchers in the bay and outside in the drive so that we could triage patients. Then we all started calling colleagues whose numbers were in our cell phones. These were people we knew would come in, that past experience told us we could count on. Finding their numbers in our cell phone contacts list was easier than digging in the book or online with the phone list.  

As the patients started arriving in police vehicles, physicians determined who was alive and should go into the trauma bay, and who already was deceased. The trauma team also was triaging in the trauma bay, assessing who needed to go immediately to surgery. The critical care physicians came down to help as well. Patients who seemed a little more stable were moved into the department to make room in the trauma bay for more critically injured patients. The decisions made at this time were very difficult for everyone involved. We had never before worked a real disaster where we classified people as red, yellow and black. The team had trouble not being able to do everything for everyone.

When I arrived, I saw patients everywhere — on stretchers in hallways, in the nurses’ stations and all over the trauma bay. I walked the department to survey the area and figure out where to start. One of the assistant nurse managers tried to give me the charge nurse radio. I told her to keep it so I could manage flow and handle unusual situations like I do during the drill. I called another assistant nurse manager to come and work the waiting room. I realized that I needed another secretary to come in and help with patient tracking. I went outside to the decontamination area and saw the nine deceased patients who had arrived to us with no signs of life. Their shoes stuck out from under the sheets. Back inside, patients were moving in and out of the trauma bay. I helped nurses transfuse blood, give meds and comfort patients.

Information came to us in bits and pieces, which made it difficult to formulate a clear picture of what was actually happening. We received word that the gunman was locked in a bathroom at the club, so we prepared for a second wave of patients. Then we heard on the radio that there was a gunman in the hospital.  A Code Silver was activated and law enforcement officers came into the Emergency Department and told us to get down on the ground. Law enforcement officers also were sitting with some patients who were considered suspects. There was a lot of confusion with the combination of severely injured patients, some who were intoxicated and others who did not speak English. The stress of a possible gunman in the building added to the confusion and chaos.

Eventually, the Code Silver was resolved with no gunman located, and the shooter at the club was neutralized. We heard we were receiving more patients and that a police officer had been shot. Injuries for the second wave of patients were not as critical as the first, and the officer had been shot in his helmet! He walked to CT and we saw that he had a very minor injury to his head. He actually high fived me on the way out!

Once we heard we were not receiving any more patients, I walked outside. As the sun was coming up, I remember thinking that families were going to wake up to the worst news of their lives. While outside, I met a family frantically searching for their daughter. We did not know any patients’ names because they had all been registered as Doe patients. A nursing assistant and I went room to room and found their daughter. We were on lockdown, but I brought her mother back to see her. The patient was crying hysterically about being in the bathroom with the shooter. She was injured and went to the operating room. 

By this time, the dayshift had arrived and the night shift was leaving. I gathered them in the break room and thanked them for their heroic work. I told them we would all be processing this event together in the days ahead. I was never more proud to work with this team of professionals than that night.