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When Hurricane Sandy barreled into the East Coast fromOctober 29 to 30, the Continuum hospitals were well pre-pared, proving once again that they are ready for any emer-gency. Beth Israel Medical Center and St. Luke’s and Roosevelt

Hospitals played a leading role among New York City hospitalswhen Hurricane Sandy struck. Over the last decade,Continuum storm-hardened its infrastructure by investing

in emergency generators and developing and testing manyother emergency measures.“While Hurricane Sandy presented many challenges,

Continuum responded to this event with great success,” saysWalter Kowalczyk, Continuum’s Director of EmergencyManagement. “Teamwork, patience and plans developed overthe years helped expedite our response to the storm.”Throughout a long and exhausting week, Continuum

stayed in constant contact with New York City’s main healthcare command center, the Greater New York Hospital Asso-

ciation and the city’s Office of Emergency Management.According to Mary Walsh, MSN, RN, Vice President ofPatient Care Services and Chief Nursing Officer, Beth IsraelPetrie was a “beacon of light,” since it was the only hospitalin downtown Manhattan equipped to accept patients duringthe storm. Anticipating possible difficulties, BI had alreadymoved some of its patients to other care sites within theContinuum system, so they could continue to receive treatments.

Continuum staff took extraordinary measures to get towork, some of them riding bicycles from Queens or Brooklyn.Many employees stayed on the job from Sunday throughWednesday, demonstrating a genuine “can-do” attitude. “Wetruly worked together as a team,” Ms. Walsh says. “Thatmade all the difference.”

Along with most of lower Manhattan, Beth Israel lostpower on Monday night, but continued operating, thanksto its nine well-maintained emergency generators. Even so,the Petrie campus was “dark as a tomb,” Ms. Walsh says.“Emergency kits provided extra lights through headlampsand glow sticks, which were useful in dark patient rooms.”Fortunately, the server for the hospital’s electronic medical

records and clinical information system is housed offsite andnever was disrupted. To stay in touch with each other, stafffrom various departments used walkie-talkies and the hospital’s

landlines. There was enough food for staff and patients,places for staff to sleep if they couldn’t return home, plentyof bed linens, and sufficient fuel to keep the generatorshumming. Air mattresses were available for staff when bedsran out, and everyone received a hot meal each day.

Hurricane Sandy’s fierce winds churn up the Hudson River.

St. Luke’s pre-op nurses met nearly every hour to plan for evolving situa-tions caused by Hurricane Sandy, as well as patient transfers from otherNew York City hospitals.

BI Emergency Room Physician Assistants Christine Smajda, left, and Cherie Vivona, along with other staff, keep things running smoothly duringthe height of Hurricane Sandy.

Special Hurricane Sandy Issue

‘While Hurricane Sandy presented many challenges, Continuum responded to thisevent with great success.’—Walter Kowalczyk

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The Food and Nutrition Services management teamcame into work on Sunday afternoon before HurricaneSandy hit and stayed the entire week. “We were ready tomeet the challenges of feeding staff and patients,” says DirectorBarry Schlossberg. “Prior to the storm, each site double-checked their inventories, so we were able to secure additionalfoods on Saturday and Sunday.”

As other hospitals closed their emergency departmentdoors, BI’s ED continued to treat patients—on most days,more than 400 individuals. In fact, there was a 70 percentincrease in ambulance traffic, and the ED reached a recordin overall volume, ambulance volume and admissions fromthe ER to the hospital. To keep up with this steady influx of

patients, clinicians worked for 12 to 16 hours a day, slept atthe hospital and then rotated back to work. Nurse Manager Lisa Dyer, RN, who stayed throughout

the storm, says, “Dealing with Hurricane Irene was a breezecompared to Sandy. This time, we had 100 patients in theER, yet it wasn’t chaotic. The staff banded together.”At BI Brooklyn’s ED, many staff fought the elements to

report to work. “Some of them were the last people to leaveStaten Island at the height of the storm to reach Brooklyn,”says Nurse Manager Ann O’Neill, RN. The generators were switched off when power returned

to the Medical Center on the evening of Friday, November 2.BI President Harris M. Nagler, MD, expressed heartfelt

thanks and gratitude to all members of the Beth Israel

community who worked so tirelessly and selflessly to keepthe hospital fully operational. “As I walked the halls of the Petrie Division during the

height of the storm, I was moved and inspired by everyone’senthusiasm and dedication despite the taxing situation,” hesays. “I know that our colleagues at Beth Israel Brooklyn

demonstrated the same inspiring effort. “All members of the Beth Israel community—no matter

what your contributions—deserve special recognition,” hesays. “You demonstrated what it truly means to be a ‘healthcare worker.’ The people of New York, and especially ourpatients, are most fortunate to have such outstanding care-givers on whom to rely for help.”At the storm’s height, the emergency generators failed at

NYU Langone Medical Center and Bellevue Hospital, forcing

these hospitals to evacuate and transfer patients to institutionsthat had power, including St. Luke’s and Roosevelt Hospitals.SLR’s primary challenge was to take care of 120 displacedpatients. Sixty from NYU and 60 from Bellevue wereadmitted—in roughly equal numbers—to SLR.

Dan Wiener, MD, Chair of St. Luke’s Department ofEmergency Medicine, says that space constraints posed amajor challenge in providing for the transferred patients.“We went from being at nursing capacity to being at physical

capacity, using all of our space to house these patients,” heexplains.Patients were safely discharged from Roosevelt Hospital’s

detox unit and St. Luke’s pediatric unit to provide room forthe influx of med-surg. patients. Beds on several sparsely occu-pied wards were commandeered, and SLR’s Office of Emer-

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Beth Israel’s Dan Steinberg, MD, Vice Chair for Education and Residency ProgramDirector, Department of Medicine; Martin S. Karpeh, Jr., MD, Chairman,Department of Surgery; and Henry C. Bodenheimer, MD, Chairman,Department of Medicine, serve food to staff during Hurricane Sandy.

Ellen Miele and Kevin Elliott on the job at SLR’s Emergency Departmentduring Hurricane Sandy.

BI’S Pediatric team on duty during the storm. Front row, from left, Loriza Almodovar, PCA, Rose Marie Prince, MD, Sylvia Hewitt, USA,and Ann Espina, RN. Back row, from left, Christine Haller, RN, RobertDa Rossa, MD, and [name unavailable at press time.]

‘I was moved and inspired by everyone’s enthusiasm and dedication despite the taxingsituation.’—Harris M. Nagler, MD

‘The reputation of St. Luke’s and Roosevelt Hospitals has been further enhanced by every-one’s efforts in responding to Hurricane Sandy.You are what make our hospitals such outstand-ing resources to all who turn to us for help.’ —Frank J. Cracolici

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gency Management brought in 150 cots to St. Luke’s and100 to Roosevelt to ensure that staffers had places to sleep.During the storm, several hundred staff slept in conferencerooms and in the halls.

Kim Bondy, one of the patients transferred to St. Luke’sfrom NYU, had been hospitalized with an intestinal blockage.A former resident of New Orleans who was there duringHurricane Katrina, she couldn’t believe she was goingthrough a similar experience again. St. Luke’s staff settledMs. Bondy in a room after her transfer. Both St. Luke’s and Roosevelt hospitals are equipped

with emergency generators, but they weren’t needed. All

hospital systems remained fully functional through thestorm, and the transition of care for transferred patients wentsmoothly. SLR administration was actively involved in coordinating

operations. “There was strong leadership and direction,”notes Matt Landers, MS, FNP-BC, Nurse Manager, Emer-gency Department. “The 24-hour emergency command centerwas opened early, and the Director of Emergency Manage-ment helped orchestrate staffing and resources.” The command center’s monitors flashed critical infor-

mation on patients’ vitals and storm news from TV newsorganizations, and its phone system worked overtime to keepstaff connected.

SLR President Frank J. Cracolici stayed on site all week,and administrators walked the floors to help wherever theycould. “We were happy to know that the administrators werebacking us up,” says Audrey Brown, BSN, MPH, NurseManager of the Neurological Medical/Surgical Unit.Patients were moved from the ED to patient care floors

at a quicker than normal pace. Makeshift ID badges—stripsof paper with patients’ names and diagnoses taped to them—were created. “It made patients feel secure, because we couldcall them by name,” says Ms. Brown. According to Greg Calliste, St. Luke’s Administrative

Officer, communication within and outside the hospital was

key to successfully coping with Hurricane Sandy. “Some-times we look at our practiced procedures as tedious, butthanks to them, we were able to rise to the occasion,” hesays.

Joanne Miller, RN, MSN, Senior Vice President ofPatient Care Service and Chief Nursing Officer, agrees. “One

of the most important things we did was constantly commu-nicate with staff about what was happening,” she says.“Telecommunications was not affected as it was at BethIsrael, so staff were able to stay in touch with family mem-bers, which proved a huge comfort. The staff took care notonly of patients, but each other.”Since patients’ family members couldn’t get to the

hospitals, staff became “patient advocates,” making sure thateveryone was getting enough food and sleep. “There weremany moving parts at all times, yet it was a smoothly runoperation,” says Ms. Miller.Mr. Cracolici lauded SLR staff for its unprecedented

demonstration of commitment to patient care duringHurricane Sandy. He felt staff truly went the “extra mile” toensure SLR’s mission to provide the highest quality of care,despite the storm.“I extend my personal thanks to the SLR physicians and

nurses who worked long, hard hours to ensure optimal deliveryof care during those challenging days,” Mr. Cracolici says.“Special thanks also go to our CNAs, unit clerks, technicaland ancillary staff, volunteers and other members of the SLRcommunity who assisted in supporting clinical care, whetherit was helping out in Food Service or Environmental Services,taking calls on the nursing units or in other meaningfulways. Lastly, I wish to acknowledge and thank my leadershipteam and all of the management staff who assisted in the Com-mand Center and helped coordinate and monitor activities.“The reputation of St. Luke’s and Roosevelt Hospitals

has been further enhanced by everyone’s efforts in respondingto Hurricane Sandy,” he says. “You are what make our hospitalssuch outstanding resources to all who turn to us for help.” n

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‘The 24-hour emergency command center wasopened early, and the Director of Emergency Management helped orchestrate staffing andresources.’—Matt Landers, MS, FNP-BC

‘One of the most important things we did was constantly communicate with staff about whatwas happening.’—Joanne Miller, RN, MSN

A lone pedestrian walks the Brooklyn Heights Promenade as Hurricane Sandyapproaches New York City.

Concerned about The New York Eye and Ear Infirmary during HurricaneSandy, the Wills Eye Hospital in Philadelphia sent a unique “CARE” pack-age—Philly’s famed soft pretzels. Enjoying them are, from left, NYEEI’s Allan Fine, Ray Gearity, Gary Enriquez, Ralph Lambiasi, Kwok Chang,Charles Figliozzi, Sonja Tennaro, RN, EdD, and NYEEI President D. McWilliams Kessler.

Stories from the FrontlinesCoping with Hurricane Sandy generated countless storieson how the Continuum hospitals provided critical care topatients—their own as well as those from other hospitals.Here are just a few of those stories. As patients streamed into Beth Israel Petrie’s semi-lit

lobby, they found comfort in the fact that the hospital wasopen. Victor Roriquez, 58, who recently had a stent placedin a blocked artery, came in after feeling tightness in his

chest, and facing the daunting challenge of having to climb13 flights of stairs to his apartment, which had no power orwater. “I feel safer here,” he says. “It’s a fantastic hospital.”Retired postal worker Tony Kwok, 65, had fallen down

a flight of steps in his dark apartment building, sufferingcuts on his legs and a bruise on his head. Normally, he wouldhave gone to New York Downtown Hospital, but he came toBI. “This hospital is very good,” he said after getting a CTscan—and a sandwich.“Managing patients in the ER at the only downtown

hospital open during Hurricane Sandy gave me a perspectiveon the spirit of New Yorkers,” says John M. Samuels,Administrative Director for BI’s David B. Kriser Departmentof Emergency Medicine. “People ran into the ER anxiousand desperate for medical and emotional care. Hospitalemployees, some of them victims of the storm, worked endlesshours and cared for patients with grace and compassion.Amidst the pain and concern, the ER was a place where thespirit of New Yorkers came through, and people cametogether.”

Joseph Habboushe, MD, Attending ER Physician, says,“I was impressed by the dedication of our staff, many ofwhom were displaced themselves and stayed at the hospital.Equally impressive were our administrators for enacting creativesolutions to unique problems—a makeshift nursing homefacility was created where we could admit the elderly andchronically sick who could not go home; and a plan was putin place to handle Level-1 trauma patients who normallywould have gone to Bellevue.”

Andrew Schulman, a musician and former patient who

now volunteers to play at BI’s Surgical Intensive Care Unit,traveled from the Upper West Side on Friday after the stormto work his regular shift. He played for three hours insteadof his usual 90 minutes. One listener was an 85-year-oldpatient who was a close friend of noted Brazilian songwriterAntônio Carlos Jobim. Others were a 92 year-old woman,

and a young woman who just had brain surgery. “Othermusicians in the hospital’s Music Therapy Department alsofound a way to get to the hospital that week,” he says. “Theyare dedicated people, and it was inspiring.”The main concern for Frank Cefali, RN, Nurse Manager,

8 Silver, was to make sure that discharged patients got homesafely. “I gave money to a volunteer who went to a bodegaon First Avenue and bought non-perishable food,” he says.“We then made ‘goodie bags’, so discharged patients couldget through the next48 hours, until homecare or family arrivedto assist or shop forthem.”At BI Brooklyn,

one ED patient camein with a service dog.“The staff adopted‘Sara’ during themany hours she washere with the patient,even taking turns towalk her in the mid-dle of the storm,” saysNurse Manager AnnO’Neill, RN, Depart-ment of EmergencyMedicine. “I am veryfortunate to have such a dedicated team.”Two BI Brooklyn employees—Marie Walsh, RN, Inter-

ventional Nurse and Sal Renda, Radiologic Technologist —whose homes suffered extensive damage, including the lossof many personal items—exhibited a remarkable sense

of responsibility to patients. “Marie and Sal reported to workthroughout the storm,” says Radiology AdministratorVincent Monte. “Their sense of compassion for others trulyexemplifies what it is to be a professional health careprovider.”At 1:30 am on Tuesday morning, during the height of

Hurricane Sandy’s fury, St. Luke’s and Roosevelt Hospitals’Neonatal Intensive Care Unit received an emergency callthat babies were being evacuated from NYU Langone, whichhad lost electricity.

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At Roosevelt Hospital’s ED, Nurse ManagerMatt Landers, MS, FNP-BC, and WendyO’Brien, RN, Director, Patient Care Services,discuss patient admissions from other NewYork City hospitals.

‘I was impressed by the dedication of our staff,many of whom were displaced themselves andstayed at the hospital.’—Joseph Habboushe, MD

‘Amidst the pain and concern, the ER was a placewhere the spirit of New Yorkers came through.’—John M. Samuels

BI Petrie Interventional Radiology nurses and technicians employed head-lamps during urgent procedures. Front row, from left, are AmmeruthCamilosa, RN, MSN; Michael Carrick, BS, RT; Rosita Macrohon, RN,BSN; Marinette Angeles, RN, BSN; Maria Dejesus, RN, BSN, CNOR;and Alexander Jaudines, RN, BSN. Back row, from left, are William Arroyo;Maria Davina Casulla, RN, BSN; Rosalie Handelman, RN; Israel Ramos;and Javier Diaz.

Continued on page 5

“Based on our experience last year with Hurricane Irene,when we received nine babies from NYU and Bellevue, wewere able to plan ahead of time, so when we received the callfrom NYU, we were prepared,” says Farrokh Shahrivar,MD, Director of Neonatology at St. Luke’s and RooseveltHospitals and Beth Israel. “Everything went smoothlybecause we had formulated our disaster preparedness planand communicated it to staff.” “Dr. Shahrivar and I also met days before the storm and

discussed staffing,” says NICU Nurse Manager Nori Yaun,

RN. “We knew which staff members would be here, and theycame to work the day before the hurricane with suitcases.”Despite an already high census of high acuity patients,

SLR’s NICU took in four babies and a mother on Tuesdaymorning at 2:30 am. The NICU team worked rapidly to getthe babies settled in, administering intravenous therapy andfeeding regimens.“An NYU physician filled us in on the patients’ medical

conditions, and the nurse-to-nurse report was done at thebedside,” says Ms. Yaun. “We oriented the mother to theunit and then directed her to the Parents Room to get somerest. The extraordinary devotion of the staff under the mostdifficult conditions was amazing, since they stayed in thehospital for days, taking care of these patients and makingarrangements for their families to be with them.” According to

Glenda Miranda, St. Luke’s Director of Patient Care Serv-ices, it was the “heartwarming camaraderie” among staff thathelped SLR weather Hurricane Sandy and provide patientswith the best possible care.Nurse Manager Avis M. Evans praised her “Marvelous

staff at St. Luke’s, Clark 8 Inpatient Psychiatry Unit. “All ofthem remained in the hospital and gave their all. They tookcare of patients and guest patients from NYU who arrived at3 am. They took care of each other and me as well.” “I acknowledge and thank the members of my Babcock

9W staff who worked so diligently last week to care for ourpatients,” says St. Luke’s Nurse Manager Maureen Sullivan,

RN. “Many remained here for days, separated from theirfamilies and loved ones. I especially wish to express mygratitude to those nurses who arrived at work hours beforetheir scheduled start of shift. It is an honor and pleasureworking with them.”Besides caring for premature babies, SLR continues to

treat evacuees from NYU Langone and Bellevue hospitals.“We are providing NYU Langone and Bellevue physi-

cians with a home for their patients,” says Bruce Polsky,MD, Chairman of SLR’sDepartment of Medicine.St. Luke’s Hospital has

created a “NYU LangoneHospital Service Unit” onBabcock 5W, with approx-imately 25 beds madeavailable for patient trans-fers. The unit operated atclose to full occupancyduring the storm. NYUhospitalists, physicianassistants and nurse prac-titioners rotated throughit, providing 24/7 coveragefor patients. At publication date, the unit is still caring forfive patients.To allow NYU Langone physicians to treat inpatients at

SLR, the hospitals created an expedited credentialing

process, and more than 25 physicians and 15 physician assis-tants and nurse practitioners were provided with credentials. “Credentialing usually takes a couple of months under

normal circumstances,” says Dr. Polsky. “We did it in a week,which is very rare.” The process required a great deal of coordination from

SLR’s clinical departments and Medical Staff Office, in orderto rapidly review each application for privileges and verifythat institutional standards were met. In addition, expeditedinformation systems training was necessary, so visiting staffcould access and review computerized patient results andenter orders for treatment.SLR’s Department of Nursing conducted orientations

to introduce visiting staff to the clinical units.NYU Langone and Bellevue arrhythmia specialists also

sent their patients to SLR. “As luck would have it, we hadjust opened our Al Sabah Arrhythmia Institute, so we couldhandle the increased volume in a state-of-the-art facility,”says Walter J. Pierce,MD,MBA, Interim Director of Elec-trophysiology. “We were equally fortunate to have tremen-dous support from Nursing Services and Anesthesia. I knowthat NYU and Bellevue physicians appreciate the help wewere able to provide. Most important, it is rewarding to helptheir patients get through such a stressful time.” n

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From left, Christina Dacanay,Wangdu Dolma, Cecelia Atienza, andLorna Bryanour, members of SLR’s Emergency Department staff.

WABC-TV’s Dr. Sapna Parikh, right,interviews patient Caroline Hughes,who was transferred from Bellevue Hos-pital Center to SLR when Bellevue lostemergency generator power.

‘The extraordinary devotion of the staff under the most difficult conditions was amazing.’—Nori Yaun, RN

‘Credentialing usually takes a couple of monthsunder normal circumstances. We did it in a week,which is very rare.’—Bruce Polsky, MD

Assisting in the RecoverySt. Luke’s and Roosevelt Hospitals each held blood drives tohelp ease a dire shortage. “During the hurricane, the NewYork Blood Center had to cancel many blood drives in NewYork City, Long Island,New Jersey and theHudson Valley areas,losing thousands ofunits it would nor-mally have had onhand,” says Mark T.Friedman, DO, Med-ical Director, BloodBank and TransfusionService, and Directorof the Pathology Resi-dency Program at SLR.The blood col-

lected by SLR not onlywent to treat regularpatients, but to offset an increase needed for blood createdby patients transferred from Bellevue and NYU Langone.“Although the SLR blood drives were planned months

ago, they turned out to be timely successes in the wake ofthe hurricane, and we thank all of the volunteers who cameto donate or who otherwise gave their time to help out byrecruiting donors or assisting at the drives,” says Dr. Friedman.“Also, special thanks to Grace Phelan, Nursing Education,and Uchenna Acholonu, MD, OB/GYN, who helped makethe drives a success.”At Phillips Beth Israel School of Nursing, the Student

Nursing Association conducted a relief drive for StatenIsland and the Rockaways, collecting such items as blankets,batteries, bottled water, paper goods, shovels and brooms,cleaning products, flashlights, toiletries, medical items, andpet food.BI Brooklyn started a clothing, food and cleaning sup-

ply drive on October 31. Rabbi Jacob Hoenig, Rosa Raffaele, Marisa Ognibene, Irina Chaikhoutdinova,Maia Makharadze, Rose Mittman and Yesenia Perezorganized the drive under the direction of Rhona Hetsrony,Vice President of Administration. “So far, we have collected more than 140 bags of cloth-

ing, coats, and blankets, plus three large boxes of shoes,” saysMs. Perez. “Thanks to the generosity of BI Brooklyn donors,St. Marks Church from Rockaway Beach, Bailey Seton Hos-pital Shelter in Staten Island, Mary Queen of Heaven forGarritsen Beach, YMCA Shelter for Special Medical Needsin Park Slope, New Dorp Shelter in Staten Island and theAmerican Legion Post from Oakwood Beach have receivedessential items.” n

Were You Personally Affected byHurricane Sandy?Many Continuum employees suffered property loss andsignificant damage to their homes during and after thestorm. In an effort to support them as they cope with theirlosses, Continuum has identified the following resources:n Free and confidential social work services are available to allBI and SLR employees. At BI, call Program Supervisor Carole Sher, LCSW, at (212) 420-4516 for information orto make an appointment. At SLR, call the Crime VictimsTreatment Center (CVTC) at (212) 523-4728. n The Federal Emergency Management Agency’s (FEMA)website has a Hurricane Sandy portal and an online applica-tion for assistance at http://www.fema.gov/sandy. In addi-tion, FEMA’s Call Center can be reached at (800) 621-FEMA. FEMA also has established mobile recov-ery assistance centers in Brooklyn and Queens.n Individuals with flood insurance for their homes can reachout to the National Flood Insurance Program (NFIP) atwww.fema.gov/national-flood-insurance-program. n The Internet contains a lot of valuable information. Forexample, the lawyers at www.lawhelp.org have pulledtogether a comprehensive list of disaster relief resources.n The New York Legal Assistance Group (NYLAG) has apresence at Beth Israel’s Phillips Ambulatory Care Center,10 Union Square East, and St. Luke’s Hospital to provideindividual legal guidance to staff. NYLAG also has mobilizeda legal aid disaster relief program to help patients and staffdeal with legal issues in the aftermath of Hurricane Sandy.The program’s hotline number is (212) 921-5000.n Continuum is working closely with the New York CityBar Justice Center to secure volunteer lawyers to helpemployees report property damage and personal losses. n

The Connections staff thanks everyone who submitted stories and photos for this special issue.

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‘So far, we have collected more than 140 bags ofclothing and blankets, plus three large boxes ofshoes.’—Yesenia Perez

Water from the East River floods 14th St. and Avenue C, just blocks awayfrom Beth Israel Petrie.

BI Brooklyn’s Rosa Raffaele, left, and YeseniaPerez helped organize a clothing, food andcleaning supplies drive that assisted hard-hitresidents in that borough.