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Nursing Care in Special-Needs Shelters
In response to Hurricane Rita, the East Texas community was asked to care for patients with special needs, such as displaced nursing home residents, persons with mental retardation and long-term physical disability, and persons who could no longer be managed in homes that had been destroyed by the storms. Nursing home residents needed shelter and accommodations to meet their complex health care needs; staffs of those facilities required accommodations as well.
The Texas Department of Health Services Special Needs shelter housed the residents and the staffs of several different nursing homes in a local college gym. A total of 348 persons designated as special needs were cared for in 2 shelters in the city limits of Tyler.
An estimated 30 to 40 nurses or nursing students volunteered at the 2 special-needs shelters. The rural shelter was manned by 8 nursing students and 4 RNs.
  • Cross-sector staff deployments
  • Task shifting/delegation
  • Community Health Workers
  • Nurse Practitioners*
  • Nurses - Licensed Practical
  • Nurses - Registered
  • Personal Support Workers
  • Students
  • Volunteers
  • Other Health Care Workers
The hurricanes that slammed into the Texas, Louisiana, and the Mississippi Gulf Coast in 2005 resulted in the displacement of nearly a million people.1 Among the evacuees were residents with special needs, residents of nursing homes, and group home residents with mental retardation and physical disability. With very little warning, shelters had to be created in an East Texas community in anticipation of the arrival of an unknown number of evacuees.

In late August 2005, approximately 4 shelters were opened for persons being evacuated from New Orleans owing to the damage from Hurricane Katrina. Before the shelters closed from Hurricane Katrina, a second hurricane, Rita, hit the Southeast Texas coast area, necessitating more evacuations to safer communities hundreds of miles inland. Despite being saturated with Katrina evacuees, the East Texas area soon began to receive Hurricane Rita evacuees as well. Some Louisiana evacuees who had sought shelter in the South Texas Gulf Coast region were relocated again because of the threats from Hurricane Rita.
  • Long-Term Care
  • Other
  • Urban/Suburban
  • Rural
1. Some shelters had a “master list” where nurses signed in and put their license numbers; it is unknown whether this was a standard practice in all shelters. A list of responsibilities for varying levels of health care providers would assist in delegatio
1. Many challenges were identified regarding shelter personnel authority, responsibility qualifications, and competencies: who was in charge and who could perform what activity or treatment safely and legally. 2.Scheduling volunteers proved to be a chall
Informal Strategy
Deal, B. J., Fountain, R. A., Russell-Broaddus, C. A., & Stanley-Hermanns, M. (2006). Challenges and opportunities of nursing care in special-needs shelters. Disaster Management & Response, 4(4), 100-105.
Belinda Joy Deal
University of Texas at Tyler, College of Nursing and Health Sciences
United States
USA
English
Published Literature

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