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Post Katrina: the story of the LSUHSC School of Nursing.

LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER (LSUHSC) SCHOOL OF NURSING HAS A REMARKABLE STORY TO TELL. Hurricane Katrina blew through New Orleans in August 2005, followed by a breach in the levees that effectively destroyed 80 percent of our beloved, zany city. As the world watched in horror, people abandoned their homes, their work, and all that constituted normal life. * Post Katrina, it has taken extraordinary effort by many people to regain some elements of normalcy for a city that is by no means repaired and restored. This article tells how, in those early days after the hurricane, nursing education kept on course within the LSUHSC system and how, surprisingly, the catastrophe provided a unique opportunity to plan a refashioned school of nursing.

Making Do in Baton Rouge Although all LSUHSC buildings in New Orleans were forced to close for repairs, the six schools of the health sciences centers reopened on September 26, 2005, at our Baton Rouge flagship campus. Ninety-six percent of our students showed up. In efforts to educate our students in Baton Rouge and on other campuses across the state, logistics were daunting. LSU set up a telephone call-in service and established a website that had 2.5 millions hits within days. The Pete Maravich basketball stadium on the Baton Rouge campus was converted into a MASH unit. Staffed almost entirely by volunteers, it briefly became the largest acute care hospital in the country, processing 6,000 patients and triaging 15,000 others with special needs.

Faculty slowly trickled into Baton Rouge, and it became possible to begin the process of organizing temporary structures for classrooms and housing. Housing was the most critical issue. Funds from FEMA allowed LSUHSC to hire a recently refurbished Finnish ferry, that normally crossed the Baltic Sea, as home for faculty, staff, and students. Buses were arranged to take students to class, and two meals each day, dinner and breakfast, were provided from the moored, stationary ship, where one could watch the Mississippi River roll inexorably downstream.

Finding classroom space and clinical sites presented a major challenge. For an entire academic year, undergraduates had all their lectures before 11 am in a movie theatre where the aroma of popcorn was pervasive, the air was stuffy and stale, and the LCD player perched precariously on a seat in the back row. It was an odd experience to teach in a movie theater. We felt dwarfed by our PowerPoints, which loomed overhead on a huge screen, while with no place to put material we did an odd sort of juggling dance to follow our own notes, manage the PowerPoint, and ensure that our students remained engaged.

Fortunately, Southeastern Louisiana University (SLU) lent us space for monthly Friday evening and Saturday classes for our graduate students. SLU also provided lab space, allowed us to place a librarian in their library, and made space available for a few faculty meetings. We were made to feel welcome, but it wasn't our home.

Clinical sites were a different story. With scrambling, and the willingness to drive considerable distances and use both evening and night shifts, we were able to patch together sufficient sites. Nurse practitioners in various agencies helped us out, offering to become temporary part-time faculty for clinical supervision.

The senior administration determined that all our health disciplines would continue to provide education to our student body. We had been undergoing undergraduate curriculum revision for some time and had just initiated a second-degree, accelerated baccalaureate program. Plus, we had begun development of a doctor of nursing practice program. The disruption provided the impetus to look at things in new ways. We had to be creative and willing to do things differently. We brought all changes to the Louisiana State Board of Nursing. The board, which also had to relocate to Baton Rouge and understood our difficulties and our needs, was willing to work with us, provided we kept them informed.

When the storm hit in 2005, the fall semester had begun and students knew the course requirements. But so many students, faculty, and staff had lost everything. They had no uniforms, equipment, and textbooks, and they had lost their dearest personal possessions. In many instances they were homeless, except for the ferry or other temporary residence. With such complete dislocation, many of us who taught in the graduate program reviewed our course loads carefully to determine how we could adjust requirements to make courses manageable and still meet standards. In the master's health care management course, for example, we reduced the web component slightly, cut the number of papers due, and maintained group presentations. In addition, we allowed for classes via conference call for some students who were still scattered across the country. These students found clinical sites and preceptors wherever they landed.

The Internet enabled LSUHCS to continue functioning from the first week on. But, even as we carried on during that first year, we discovered the loneliness of not having a formal organization and a building to go to on a regular basis. We had not appreciated the function of the ordinary socialization that happens when colleagues gather. There was no regular place for student advising, faculty committee meetings, and the myriad other gatherings that constitute a school's academic life.

When we were able to start having faculty meetings, the first half hour provided the opportunity to chat. Everyone had a story and wanted to share it. For example, many of our faculty and graduate students practiced nursing during the acute aftermath of Katrina. The hours they worked were mind numbing, and their own safety was on the line. One CRNA student who worked in Charity Hospital lost eight pounds in about 10 days because available food had to be reserved for patients.

The graduate council began to meet monthly in a conference room in a condominium in downtown New Orleans where one faculty member lived. These meetings were essential as we continued our plans for a DNP program and reexamined our master's and doctor of nursing science programs. They gave us a direction and hope that there really was a future for the school and the city. Hope had become a critical component of our daily lives.

Locally, in Baton Rouge, a coffee shop and bookstore became the meeting place for faculty and students, our de facto school office. There, one was sure to run into groups of people who were doing nursing work, whether advising, reviewing care plans and papers, or conducting postclinical conferences.

We managed to complete the fall 2005 semester and graduate our December students, not in New Orleans, as usual, but in the Pete Maravich stadium in Baton Rouge. We held a moving ceremony to acknowledge the remarkable achievements of our faculty, as well as our students. We recognized those who arrived in Baton Rouge immediately after the storm and kept the school alive, and presented the Caring Teacher of the Year award to Patricia Kimball, a long-standing faculty member whose efforts after the storm and throughout the semester were particularly heroic.

The experience had taken a toll, and several faculty, who were near or past retirement, decided that it was now time to leave the school. However, while we started the fall 2006 semester with a deficit of 12 faculty, we recovered, calling on nurse educators who had previously worked in the school and relying on master's-prepared clinical nurses to provide the oversight needed in clinicals. A number of new part-time faculty are expert practitioners--what is the national trend has become our modus operandi--and students report that they enjoy working with them. Now we are thinking about how to retool our programs and refashion our traditional faculty roles to optimize the skills of an aging faculty and take advantage of these younger experts.

Returning to New Orleans Gradually, over the course of 2006, repairs were completed, or at least initiated, in many homes, and more and more people returned to New Orleans. The school of nursing building reopened in late May with the first floors sealed off until remediation was complete and the nerve centers moved to a higher floor. Access was by a series of second-floor bridges from the parking garage, where the elevators remained out of action.

At first our school was eerily quiet. A number of faculty, concerned about mold and mold spores, were unwilling to come back for significant periods of time. But the building was thoroughly cleaned and now bustles with the noise of students and faculty. The usual rhythms of academic life are returning: the apprehension of seniors with NCLEX looming, sophomores worrying about their first exposure to patients, the stress of exams. Among faculty, there is excitement and apprehension about major curriculum changes that will happen in the next two years.

Finding clinical sites has remained a problem. The famous old Charity Hospital, where countless generations of health care professionals learned their trade, will never reopen; the building was deteriorating before the storm. And the Veterans Hospital, located near Charity, and several private facilities will remain closed as well. We find ourselves competing with other local schools of nursing for a considerably reduced number of sites, and once again we are using evening and night shifts with clinical part-time faculty. But we are managing, and the students are gaining excellent experience. They are learning, in a very direct way, the flexibility, adaptability, and agility needed for practice in nursing today.

The students have been remarkable. At a recent convention of the Louisiana Student Nurses Association (LSNA), six new officers were from the LSUHSC School of Nursing, including the president, secretary, and treasurer. Our students have been active in community projects, winning awards for the Best Community Health Project as well as the Most Community Health Projects. Our NCLEX results have remained consistent with previous years, and our certified registered nurse anesthetist and nurse practitioner students have continued to pass their specialist certification exams. We have hooded some doctoral students too, and feel justly proud of those accomplishments.

New Orleans is slowly righting itself. What was a gloomy, silent, brownish gray, empty, ghostly city now has mail and newspaper deliveries and the trash is picked up fairly regularly. The lights are on, we are told the air is safe, and businesses are reopening. Housing remains a problem and there were no department stores open downtown for a year, but the port is busier than ever, the supermarket shelves are full, and the tourists are trickling in. Some of the normal bustle of the city has returned with the nightlife, music, and food for which we are justly famous. As New Orleanians, we are hopeful and trying to be optimistic, cheering with every slight improvement. It is the same in the school. We are determined we are going to be much better than before.

Our one-year anniversary post Katrina was celebrated solemnly. Faculty, staff, and students stood for two minutes of silence outside the school. We listened to the ringing of the little Katrina bells we had been given, and an associate dean gave a speech of encouragement. Soon the rebuilt Superdome, symbol of so much tragedy and destruction, reopened; the Saints football team actually won their first hometown game; and we celebrated with a city-wide block party, which was exhilarating. We have lived this past year with a roller coaster of emotions, but this is exciting and real. We are truly coming back.

All of us appreciate the efforts of the volunteers who came to help us, the many schools of nursing that took in Louisiana students or sent books or equipment, and your heart-warming messages of support. It has been an incredible experience to participate in this national effort of repair and renewal.

LSUHSC School of Nursing is a fine place to be right now. It is exciting but challenging to be planning our next few years and ensuring that we are producing graduates who are outstanding practitioners of their art. Our undergraduates are returning as graduate students, which speaks volumes, and we want them back.

The story of Hurricane Katrina has become a critical thread in the saga of our school. It is a story of dogged determination and enduring courage. It is our story.

Jane Sumner, PhD, RN, APRN, BC, a member of the NLN Board of Governors, is associate professor and acting associate dean for undergraduate programs at the Louisiana State University Health Sciences Center School of Nursing in New Orleans. Contact Dr. Sumner at
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Title Annotation:Quick Reads; Louisiana State University Health Sciences Center
Author:Sumner, Jane
Publication:Nursing Education Perspectives
Geographic Code:1USA
Date:Jul 1, 2007
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