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Julia L. Compton, RN, BSN |
Editor's Note: Julia Compton, RN, BSN, was in the midst of an unusually quiet Boston Marathon day in the emergency department (ED) of Tufts Medical Center in Boston, Massachusetts. Planning for an influx of patients with strains, sprains, and more serious running-related conditions, the ED had kept the patient census low and added extra nursing and medical staff. But when the bombing occurred, the ED staff had to respond quickly. Susan Yox, RN, EdD, of Medscape, talked to Julia Compton, the clinical nursing director of Tufts' ED, about her experiences.
A Typical Marathon Monday
Medscape:What sort of day were you having in the ED before anything happened? Had you made any special preparations because it was the day of the Boston Marathon?
Julia Compton: The hospital was very full when I walked in that morning. Because it was Marathon Monday I thought, "Oh, this is not good." I called some key management colleagues and said, "Okay, can we perhaps cancel grand rounds this morning, get the residents rounding early, and get case management involved? Because we need to get some of these patients discharged early." We were expecting a surge of admissions because last year we had so many admissions from the marathon. We knew that the reason we were able to care for them so well in the past was that we diagnosed, treated, and got them admitted all within an hour, which is something that rarely happens in an ED.
The hospital responded -- they moved resources and opened up more beds. By the time this all started, I think we had already booked 10 patients for an admission by 10:00 AM. The ED was eerily empty.
In addition, we actually set up one of our emergency management tents and put it in the ambulance bay just so we had extra places to put patients. We usually get a surge of about 35 people on marathon day and they're usually pretty sick, medically sick. That surge usually happens between 2:30 and 7:00 PM for us. So, we have about 4-5 extra nurses on duty, including me. We have extra ED techs and extra physicians as well.