Nurses caring beyond duty

Nurses and midwives across Australia have been shocked and saddened by the fires that swept through Victoria on Saturday, 7 February. Hundreds of ANF and NSWNA members were personally affected and many ANF members continue to work tirelessly at the frontline. The Lamp spoke with Elizabeth Foley and Kate Alexandra about their experiences of Black Saturday and its aftermath.

Elizabeth Foley is a nurse and public policy expert with the Australian Nursing Federation. Her home in Wallan, only 45 kilometres from Melbourne’s CBD, was singed by one of the blazes, but escaped the main firestorm on the whim of the wind, which changed direction to devastate nearby Kinglake. The next stop on the train after Wallan is Wandong, where many people perished. Her sister and cousin both lost their homes in another of the fires in Marysville.

‘It’s amazing how widespread the devastation is. Entire towns have been destroyed, and of course nurses are a part of every community. They are involved in the emergency response, treating people whenever they can, but they also have to deal with their own situation, their own loss,’ said Elizabeth.

In Kinglake, nurses and fire fighters reportedly broke into the local doctor’s surgery, after the fire had past, to gather oxygen and medical supplies to treat people on the street. The State Emergency Services building, where community medical supplies were kept, had burned down.

‘Unless nurses are physically injured themselves, they will help those around them,’ said Elizabeth, ‘and certainly there are nurses from Melbourne volunteering to help in any way they can.’

Kate Alexander, RN and midwife, is testament to this. After being evacuated from her home in Whittlesea, at the foot of Mt Disappointment, Kate drove to the local community centre to see if she could help. She quickly organised a community clinic, and worked there non-stop for the next 10 days.

When Kate arrived at the community centre there was a St John’s Ambulance first-aid officer attending to the public. He happened to be there because of a country music festival, but when he left at the end of his shift, Kate was left to treat people by herself. After making a list of what she would need, she sent her 19-year-old daughter to get medical supplies while she attended to the wounded as best she could. Local people were presenting with infected eyes, asthma, smoke inhalation, burns – including severe sun burn, cuts and bruises, and dog bites. (Many people had tried to save dogs from the fires. Frightened, the dogs had bitten the hands that tried to save them.)

‘It was chaos, but everybody wanted to help,’ said Kate. ‘My daughter got everything I needed to start the clinic from local pharmacies, and local GPs came to help too, but it was very improvised to begin with. I had to send people away to shower so I would know what was burn and what was just black,’ she said.

On the following Monday morning, Kate spoke on ABC radio asking for help and equipment. She was quickly inundated with offers from nurses, doctors and pharmaceutical companies, and other clinics were subsequently established in several neighbouring towns.

At Kate’s Whittlesea clinic there were 10 nurses, some locals, others who travelled from Melbourne and Bendigo – all of them volunteers. The nurses worked long hours, but nobody wanted to leave, said Kate.

‘We all wanted to stay with the people and help, and there was a lot of good humour and spirits to keep us going. One man, about 50 years old, said he was happy because all his ear-hair had disappeared in the intense heat. His wife was delighted, too,’ said Kate.

The clinic treated about 90 patients a day. After the first few days, people started arriving with other conditions, such as mouth ulcers and cold sores. There were also several pregnant women, all concerned for the health of their babies. Kate went to a local hospital and brought a Foetal Doppler to the clinic so parents could hear their baby’s heartbeat.

‘Their relief was huge. The mothers might have been able to feel the baby kicking, but just hearing the heartbeat was a big reassurance,’ she said.

Kate is still recovering, and she wakes up at midnight with an instinctive urge to do something.

‘It will take a long time to get back to normal. I don’t think things will ever be quite normal,’ she said.

On Sunday, 22 February, Kate laid a wreath at Melbourne’s memorial event in Rod Laver Arena, on behalf of all the nurses who worked in the fire relief effort.

‘It was a bittersweet event, but I know we all did a really good job running those clinics. Four of us were single mothers, but we made it work, and I know a lot of other nurses have done, and are doing, a great job,’ she said.

Hospital nurses in Melbourne were also among the first professionals to respond to the crises. Burns, Theatre and Intensive Care Wards were inundated with casualties from the fires, many of them in a critical condition. Up to 10 nurses have been needed for every bed – such is the acuity of the treatment needed.

Many burns patients will be hospitalised for six months or more, and will be outpatients for several years. As the patients deal with the physical and emotional traumas of the massive, sudden changes in their lives, nurses will often be the first people to respond to the pain, the tears, the anger, and the fears.

Mental health nurses will also have an important and ongoing job in the months and years to come. With such widespread desolation, and so much to be rebuilt, there will be many people whose injuries are less visible than those of burns victims, but no less serious. It is not just homes that need to be rebuilt, but lives.

A week after the fire, Elizabeth Foley’s sister returned to Marysville with a busload of locals to see what was left of their town. They were not allowed to leave the bus, as the area was still considered a crime scene.

‘The affects of this disaster are going to be long lasting,’ said Elizabeth.

‘A lot of people will be traumatised by the events, and they will need help. There will be a huge role for mental health nurses. I think what will be needed is not just static facilities where people can go if they want to, but mobile teams of mental health professionals who can make themselves available to the communities,’ said Elizabeth.