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AJN On the Cover

Szulecki, Diane, Editor

AJN The American Journal of Nursing: May 2019 - Volume 119 - Issue 5 - p 19
doi: 10.1097/01.NAJ.0000557906.59162.95
AJN On the Cover
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On this month's cover, a medical team evacuates a patient from the Kaiser Permanente Santa Rosa Medical Center in Santa Rosa, California, during the October 2017 Tubbs Fire. This medical center was one of two in Santa Rosa evacuated because of the wildfire, which killed 22 people. The Tubbs Fire was, at the time, the most destructive wildfire in California's history. But now that title belongs to the Camp Fire—which, just one year later, decimated the town of Paradise about 100 miles away, killed 85 people, and destroyed nearly 14,000 homes.

On the morning of November 8, 2018, the day the Camp Fire started, staff at the Adventist Health Feather River hospital in Paradise found themselves racing against the clock to evacuate as fast-moving flames approached. All of the hospital's patients and staff made it out, some staff narrowly escaping with their lives—only to return to the shuttered hospital to help community members who had sought refuge there. In a new podcast series, Nurses’ Stories, AJN editor-in-chief Shawn Kennedy speaks with two of these staff members, RNs Allyn Pierce and Nichole Jolly (go to http://links.lww.com/AJN/A134 to listen). Their stories, while nightmarish, are a testament to nurses providing extraordinary care in the face of overwhelming danger.

Early into their shifts that autumn morning, both Pierce, an ICU nurse manager, and Jolly, a medical–surgical nurse, smelled smoke in the hospital. The wildfire was burning across a nearby canyon. Hospital leaders gathered to assess the situation, and within a matter of minutes, decided to evacuate. The fire quickly jumped the canyon and encroached upon the hospital grounds.

“All I was thinking about at the time was, ‘My patients need blood pressure meds. My patients need these cardiac meds before I evacuate them,’” recalls Jolly. “You're not thinking that you're going to be stuck in a firestorm, fighting for your life.”

Staff rushed to move the hospital's 76 patients out. Forty minutes later, the entire hospital was cleared. Jolly did a final check of her unit, making sure no one was left behind, and Pierce helped tag rooms as “evacuated” so firefighters wouldn't have to check them. But that was just the first hurdle. By the time Jolly, Pierce, and other hospital staff—among the last to leave—got into their cars, nearly every escape route was blocked by flames. “You're not going to be able to get out without touching fire,” a sheriff cautioned.

His warning proved accurate. They soon ended up in bumper-to-bumper traffic after being diverted off of a main road. Stuck in gridlock and surrounded by fire, their cars filling with thick black smoke, Jolly and Pierce feared they wouldn't make it out alive. “I recorded a message to my family telling them I loved them, just in case,” says Pierce.

Jolly called her husband and told him she didn't see a way to escape the flames. He urged her to run. She left her car and sprinted up a hill, barely able to see or breathe, as hot ash from the wind-driven fire rained down on her. Mercifully, she reached a fire engine, but it was also trapped in gridlock. The firefighters helped her inside and extinguished flames from her burning pants. She listened as they radioed for air assistance but were told it would be impossible. Their fate seemed grim.

Pierce, meanwhile, had remained in his truck, preparing for the worst. The car to his left was on fire, blocking him in. But then a bulldozer appeared. It pushed the car out of the way, allowing him to escape the inferno. He drove through the forest and returned to the hospital. The fire engine with Jolly on board also made its way out thanks to a bulldozer; it, too, returned to the hospital.

There, reunited staff members hugged and shared stories, then got right back to work. Local residents, Jolly describes, “were just walking in off the street, their cars burned, their houses burned,” seeking assistance. Numerous hospital employees—themselves suffering from burns and smoke inhalation—began triaging patients and gathering supplies. When the hospital itself caught on fire, they moved their makeshift triage area to the hospital's helipad. They spent approximately eight hours working there as nearly everything around them burned: parts of the hospital building, its campus, the valley in front of it, and the surrounding town.

The patients and staff were evacuated for good later that day once a road was safely cleared. The hospital, however, sustained too much damage to continue operating. More than 1,300 employees lost their jobs as a result. At this time, there are no plans to reopen.

The two nurses say they were just doing their jobs. “It's nice talking to nurses about this, because they get it,” Pierce told AJN. “There's no explaining why we would do something that seems dangerous or scary. We take care of people and that's what we do. We're responsible for them.”—Diane Szulecki, editor

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