CODE WHITE: Spotlight On Nursing Staff at Children’s Healthcare of Atlanta
by Matt Skoufalos
“Rain in Atlanta is not good for traffic,” said Steven Wagner, Chief Development Officer for Children’s Healthcare of Atlanta (CHOA).
Which explains, somewhat, how fewer than three inches of snow could have been responsible for thousands of stranded schoolchildren, hundreds of vehicle accidents, and a panic that locked down the major metro area for a harrowing two-day period at the end of January.
Atlanta doesn’t have a strong infrastructure to deal with the accumulation of either ice or snow, Wagner said, and when local school districts elected to hold classes as normal on January 28, a die was cast that eventually led to one of the biggest logistical nightmares the city had seen in years.
By 11 a.m., the public schools saw the writing on the wall, as the roadways were icing up and the accumulation continued to mount, and “all at the same time, decided that they had to send the kids home early,” Wagner said
When that announcement broke, he said, “every single parent that works in Atlanta jumped in their cars at the same time” and headed out on the roads — ahead of the salt and plow trucks.
“If somebody could get in their car and drive, they did,” Wagner said. “And on top of that, people started panicking. Then everything was blocked. So you now have a snow and ice problem and a traffic problem.
“The result of all of that globally was people spent hours to go two miles.”
The scenario was an exercise in how the best of intentions nonetheless resulted in widespread panic, Wagner said. He recounted story after story of the travel woes of colleagues who spent literally a full day traveling to go fewer than 30 miles. People abandoned their cars on the Interstate. Students bunkered down in their schools; others were eventually sent home on buses that either hit the same travel snags or broke down on the ice.
Wagner’s wife spent 10 hours collecting their three school-aged children, a feat in which she was assisted by friends, neighbors, and some helpful high-schoolers who were ferrying stranded passengers on four-wheeled ATVs.
At Children’s Healthcare of Atlanta, however, a “Code White” emergency was in effect, meaning staff were under special orders due to the weather. Non-essential personnel were dismissed, off to join the press of humanity on the highways, while staffers scheduled to arrive later were ordered to report immediately in support of those who remained to care for the vulnerable patients at one of the busiest pediatric facilities in the nation.
Just as the travel plans for those parents collecting their children were harrowing, Wagner “heard story after story of people doing whatever it took” to get in to work at CHOA. Nurses parked on side streets and walked two or more miles to reach the facility; one called four different family members to get her where she had to go in stages.
At the same time, Wagner said, hospital staff made similar preparations as their homebound counterparts, arranging caregivers for children and pets for a minimum of two nights.
“Internally, they’re taking care of patients,” he said; “they’re dealing with the stress of a pediatric hospital, and they’re taking time to make those four or five different phone calls. All the stress that they were feeling, they’re feeling on top of the obligation that they have to the kids at the hospital. Those same nurses are having to scramble to get coverage for their families, get coverage for their units, [and] get coverage for the kids in their care.”
The nurses at CHOA live by a “how-do-we-get-it-done, what-do-we-need-to-do attitude” that describes their level of dedication to the children in their care, their colleagues at the facility, and the people who are depending on them at home as well, Wagner said.
The staff who were called in to relieve their counterparts were no less deserving of acclaim, he said, because in addition to meeting their obligations at home, they “really took some risks to see about getting down there.”
“They’re really dedicated to the mission of what we do,” Wagner said.
Inside the facility, nursing and hospital staff were transforming the building into an emergency shelter. Although a majority of the patient rooms are designed to be private, so that families can stay with their children, he said, there were no such accommodations made for the staff who would be bedding down for the night there. Environmental services workers started rolling out cots, creating sleep spaces in conference rooms and offices.
“Any non-patient area they could find that was dark and fairly quiet became bedrooms,” Wagner said. “Then people are going to have to eat, so meals for people who aren’t generally at the hospital are going to have to be prepared.
“It went from being a hospital to a complex hospital that was acting as a hotel.”
Meanwhile, Wagner said, the needs of the patients at the facility had in no way diminished. At census meetings, floor managers congregated to take stock of the resources needed for their operations. The campus where Wagner works, Children’s at Egleston, has the highest acuity rating of any pediatric healthcare system in the country, he said, meaning that, even in the face of considerable confusion, their patients could ill afford any drop in the quality of care provided there.
“We have the highest patient volume and we also take care of the sickest,” Wagner said. “I literally was up for about 36 straight hours because I felt a need to just help however I could.”
Although it was largely a symbolic gesture, Wagner joined up with a representative from human resources, and toured the facility, handing out stuffed dolls of the hospital mascots, Hope and Will, at every nurse’s station he could find.
“I loaded them up in a trash bag and just handed them out to staff to say, ‘Here, I hope this puts a smile on your face,’ ” Wagner said. “Give it to a kid on your unit, give it to your kid; it was just something to help.”
Despite the myriad pressures of the day, Wagner did recall a moment of respite among the exhausted staff at the facility: once they knew their patients were being cared for, nursing staff changed into their pajamas and played in the courtyard garden at the hospital. They were building snowmen, making snow angels, getting into snowball fights; setting the scene that should have been for so many more children in the Atlanta metro area during the day of emergency.