GALVESTON, Texas - Not long after Hurricane Ike passed over Galveston Island administrators at the UTMB School of Nursing realized their disaster recovery plan needed updating.
"The playbook that we had was totally inadequate," said Patricia "Trish" Richard, associate dean for undergraduate programs and education technology. "It did not have the level of detail that we needed it to have."
"We were faced with a virtual diaspora after the evacuation," said Kathryn "Kate" Fiandt, associate dean for graduate programs and clinical affairs. "It wasn't as if we were all here and then we went to San Antonio, which was sort of how we visualized it. We were everywhere."
Overcoming sporadic communications and relying for a time on BlackBerries and Wi-Fi cards, the administrators' attention turned to recovery once faculty, staff and students were accounted for.
By Tuesday, Sept. 16, three days after the storm had passed, Dean Pamela G. Watson returned to campus, setting up a temporary office in the Administration Building because the School of Nursing/School of Health Professions building was uninhabitable at the time. "I found that a very small amount of water had come in," she said. "There wasn't even a water line but having sat there since Saturday without air conditioning it was a sludge, and the air quality was so bad you just couldn't breath and I thought, ‘Things are worse than I thought they were.'"
As a result, carpeting was ripped out and drywall was removed to the four-foot level on the first floor. Furniture was discarded, as well as everything in the kitchen and cafeteria. Watson estimated damages to the building at about $500,000. "I think it's unlikely we'll have a cafeteria here again, at least not like what we had before."
Many decisions were made during that first week, not the least of which was setting a date to restart classes. Watson was determined that nothing would get in the way of completing the semester and initially proposed Sept. 22 as the start date. "The associate deans convinced me that that couldn't really happen because we couldn't even reach everybody at that point," she said.
Cameron Slocum, executive director of finance, left, Dr. Garland Anderson, provost and executive vice president, and Pam Watson, dean of the School of Nursing, took a break during the first week after the storm and had lunch in the tent.
"We decided to follow what was on the (UTMB) Web site - that the School of Medicine would be up and running again in early October," Richard said. "So we decided since they're going to be up in early October, then we need to be up in early October, too." They settled on Wednesday, Oct. 1.
Each of the academic nursing programs - baccalaureate, master's and doctoral - faced different challenges. The master's program was the quickest to get up and running because it is largely Web-based. However, that didn't make it easy.
"How much stuff was sitting on the School of Nursing server on campus and, therefore, was not available?" Fiandt asked. "I always had the idea that if it's in cyberspace, then it's sitting out there on some server in Austin or somewhere. Like e-Logs." Based on the Web, e-Logs are used by students to record reports and visits with patients.
Three weeks would pass before the server was back online but faculty couldn't wait. Old-fashioned pencil and paper trumped high-tech solutions for the moment.
"For future recovery plans, now we know that e-Logs won't be available and the faculty will be able to tell students to just write it down and they can put it in later," Richard said.
Faculty in the baccalaureate program met at Clear Lake Regional Medical Center to plan their recovery. Institutions throughout the Galveston-Houston region offered their support. For example, Alvin Community College offered use of its patient simulation laboratories.
Many of the undergraduates who were placed throughout the region were able to continue their clinical rotations and some hospitals offered to extend the rotation so students could make up for days missed because of Ike. For students who were not already doing their clinical training, CCPS came to the rescue.
Using the Computerized Clinical Placement Software, "we could go in and find available spaces in some of the hospitals that were using it," Richard said. "We negotiated for the available evenings and weekends and nights even, so we had students doing clinical rotations around the clock."
Unlike the other nursing programs, the doctoral program is based on campus and has little Web presence. Alice Hill, director of the program, credited the doctoral faculty with putting things back together.
"All I had to say was, ‘Here's what we need to get things going,'" Hill said. "The faculty members set up their own things at Clear Lake library and got it done. They coordinated with students in terms of when they were going to meet and what they were going to do at their (faculty) homes. I will always remember the way we rallied around one another and the cooperation that we had."
One issue that wasn't covered in any recovery plan was the city's dusk-to-dawn curfew during the first weeks after the storm.
"We figured that out the day before students were doing evening clinical rotations in Clear Lake," Richard said of the curfew. "(UTMB) President Callender went to the Galveston mayor to make sure that the students would be able to get back on the island with their ID badges. Otherwise, some of our students might have been sleeping on the side of the road until 6 a.m."
Like many buildings on the UTMB campus, the exterior of the School of Nursing building showed little damage from Ike. However, six weeks after the storm the first floor remained a jumble of temporary air-conditioning conduits with temporary panels covering metal framing where drywall used to be attached. While faculty worked out of the building, only in the last two weeks of October were students able to attend classes there.
Some of the doctoral program faculty wanted to return to UTMB to conduct classes.
"I took a look at the building on Oct. 1 and I thought, ‘This is really not conducive to learning,'" Hill said. The solution was to have the IT department set up a phone number for teleconferencing, which continues today. Even though the students had agreed to use teleconferencing, "some of them showed up here rather than phoning in from where they were staying. They wanted to be here and they wanted to be in class," Hill said.
Other adjustments had to be made to make up for lost time, including condensing some course content and holding classes for three days during Thanksgiving week.
Many students left their books behind when they evacuated, compounding the problems they faced when they returned to Galveston.
"When we had the first meeting with the BSN team it was discussed that the students may have lost books on the island and (assistant professor) Bonnie Webster contacted the publishers and got the publishers to donate books back," said Ernestine "Tina" Cuellar, interim associate dean for student affairs and admissions. Where books weren't replaced, publishers provided access codes to online materials.
Former employers even pitched in. When Fiandt realized her lectures, which she kept online, were unavailable, she spoke with her former dean at the University of Nebraska. "I told her that I'd like access to a few lectures we had done and, in 24 hours, they had given me access to every lecture I ever did at Nebraska," she said. She sent links to her students.
Despite the hardships and uncertainty facing them, some students were eager to help the community recover when they returned. Knowing that her house had been flooded, a group of juniors asked Jeri Jaquis, an assistant professor, how they could help.
"I told them that our neighbor, Marie, could use more help than me," Jacquis wrote in an e-mail. "Six junior nursing students, one husband and three children showed up at Marie's house, emptying her closets, cleaning out the house, pulling up linoleum and moving very damp clothes to dry. Marie was touched by their help and support for a woman they did not know."
Only three of 574 students decided not to return to school following the storm, one each in the BSN, master's and doctoral programs. Prospective students who planned to start classes during the spring semester anxiously deluged the deans with e-mail.
"The application deadline for the spring had already ended but they wanted to know when their interviews were going to be held," Richard explained. "They all wrote, very concerned, ‘Well, you're supposed to contact me about my interview. I know you had a hurricane down there, but when is my interview?'"
Looking toward the future, Watson expects permanent changes in the way that UTMB educates nursing students.
"It's really going to change forever how we make clinical placements because, if the hospital has only 200 beds and we don't have psychiatric patients and we don't have children, a lot of the placements will be at the Texas Medical Center in Houston," she said. "I believe that, looking forward, it's likely that UTMB will have two campuses - Victory Lakes and Galveston Island - and the kind of patients we see and their health care problems will be different in both areas. And I also believe that that will enrich our students' education."
"In the future, students probably will think about living in different places and commuting to the island for classes and to Houston for rotations," Watson said. "We have so many people who do that all the time and the physicians are going to be doing it too. It's just going to be a new way of life."