Aiming for a 'Smoother Chaos'

Sep 15, 2011, 11:59 AM, Posted by

Sharon Stanley, PhD, RN, a new Robert Wood Johnson Foundation Executive Nurse Fellow, the chief nurse for the American Red Cross, and a recently retired leader in the U.S. Army Reserves after 34 years of service, discusses the role nurses can play in disaster relief.


Human Capital Blog: Congratulations on your selection for the Executive Nurse Fellows (ENF) program. The news broke amidst earthquakes and hurricanes – not your easy season! But your work with the Red Cross is related to your plans for the fellowship. Tell us about that, please.

Sharon Stanley: It’s absolutely related. What I’d like to focus on with the fellowship is the role of nurses in disaster planning and relief at the American Red Cross. So it’s very timely! We rely greatly on nurses in disaster recovery. They’re really the “care” component of what we do. But it’s not just after the disaster strikes where nurses need to play a role. Our preparedness efforts go on all year, across the organization. We’re working to educate our various communities and lay the foundation for preparedness and recovery. Nurses are already involved in that, and I’m hoping that as a result of my work with the ENF program they’ll become even more fully integrated and take a bigger role in the leadership of our efforts.

One thing we’re doing already to help accomplish that is the addition of a new volunteer component to disaster response – the certified nursing assistant (CNA). Red Cross has been providing nurse assistant training for a while now. In disaster situations, when people are displaced, it’s important to have trained volunteers who can help care for people who live with access and functional needs at shelters. Those needs don’t go away in a disaster; if anything, those needs become more acute in such circumstances, in the midst of the chaos. So we’re ramping up our training for CNAs and, of course, that training is of use to the community not just in disaster circumstances or even just in preparation for disaster, but all year round.

HCB: Give us a sense of how you prepare for disasters.

Stanley: I think one of the biggest misconceptions about our work is that we pop up when hurricanes roll into town and then recede when the storm passes. In fact, we’re very busy making sure that needed resources are both available and in place before the storm hits, and we’re still there long after the winds stop blowing or the ground stops shaking.

So in the weeks and months leading up to hurricane season, we put our leadership teams in place, and make sure our rosters of volunteers have been refreshed. After all, it’s a largely volunteer workforce we rely on, and these are men and women who are usually employed elsewhere, have families, are members of the community, have a lot going on in their lives, sometimes move or get ill, and so on. We strive to stay on top of that. And I should add that it’s not always a question of sending volunteers from one state to another or one community to another. Often the volunteers come from the affected community. That’s really the strength of the Red Cross response. In the case of Hurricane Irene, we deployed some 4,200 volunteers from North Carolina through Maine.

And we need to plan for the likelihood that there will be more than one storm, too. We can’t exhaust our volunteers on the first storm of the season, no matter how much hype it gets. Neither can we rely on the media’s judgment for when the “all clear” can be sounded. In the case of Irene, for example, 24 hours after the storm had left New York, a lot of the media were saying we’d “dodged a bullet.” The problem was that the floodwaters were rising in New Jersey and Vermont, and much of the damage and distress was yet to be suffered.

HCB: You’ve said nurses play a vital role in disaster relief work. Tell us a little more.

Stanley: Sure. The real gift that nurses bring to the task is that, from experience, they understand chaos and how to function in it. Nurses deal with it on a daily basis in acute care settings or in the context of other emergency situations in their communities. So they’ve got valuable experience, put the client at the center of their efforts, and they’re pretty resilient volunteers. That’s a powerful combination. That skill set is what makes them such an asset, and not just in emergency settings. It’s why I think we need to integrate nurses even more deeply into the work of the Red Cross, across all the work the organization does.

HCB: You served for 34 years in the military before coming to the Red Cross. How did that help prepare you for what you’re doing now?

Stanley: I’ve got to thank the military for all of the leadership training and advanced education that it provided me. The Army sent me off to nursing school where I got my nursing degree at a program that operated in conjunction with Walter Reed Army Hospital. It was a setting that emphasized both leadership and a multi-disciplinary approach. When I went on the floor as a baby lieutenant in my first assignment for the military, there was no mistaking that I was junior, but it was equally clear to me that as a nurse I was a part of a team that was going to provide the best in client care. Those are the lessons I try to bring with me to the Red Cross. We need the whole multi-disciplinary team at work in order to care for our clients – nurses, physicians, mental health professionals, certified nursing assistants, emergency medical technicians, everybody. It takes all of us.

And another important thing I took from my military experience is that I learned how to manage in disordered times. My first experience with a disaster was a flu epidemic, local to my particular post. I was on an evening shift at the hospital, and suddenly I was moving clients (including post-op patients) to other hospital areas and to home very quickly to make space for soldiers who had to be housed separately from the rest of their barracks in order to prevent further spread of the epidemic. It was my first disaster experience and it’s served me well.

Of course, when I came to the Red Cross, I was happy to find that it draws a lot of military retirees and volunteers – many of them nurses. I think the organization feels comfortable to them. They find that same kind of mission-first mentality, and people who lead by example, putting their all into it.

HCB: You’ve mentioned your hope that the Executive Nurse Fellow program will help you in your work to better integrate nurses into the Red Cross’s work. What else attracts you to the program?

Stanley: Well, the networking aspect of the ENF programs is extremely important to me, too. You know, Red Cross doesn’t do anything by itself! We’re absolutely in partnership with the community, the public and our other partner agencies, working to make preparedness and response happen on the ground. A lot of that goes back to the networking that occurs not in disaster, but on a day-to-day basis when you have a Red Cross chapter somewhere that’s reaching out to the community. They know their local hospital, they know the community and they’re building relationships. It all combines to produce a smoother chaos than you might have found otherwise. So a major part of what made me apply for ENF – and I’m grateful that the Red Cross is enabling me to do this – is that networking component that’s so strong in the ENF program. I know I’m going to find opportunities for partnerships in RWJF and ENF circles. I’m really looking forward to that.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.