PU545 Unit 6 Response Failure Reflection Example

I Blamed the Staff Until the Seminar Asked Who Wrote the Plan: A Unit 6 Reflection on the 2017 Nursing Home Deaths After Hurricane Irma and the Nine Long-Term Care Facilities in Composite Brennock County That Could Repeat Them

[Student Name]

Purdue University Global

PU545: Disaster Management

Unit 6 Seminar Reflection

[Instructor Name]

[Date]

Brennock County and its facility counts are composite; the 2017 events, the mortality research and everything cited are real.

What I Thought the Case Was About

In September 2017, after Hurricane Irma cut power to a nursing home in Hollywood, Florida, the building's air conditioning failed and residents died of heat exposure. A fully powered hospital stood across the street. I came to the seminar with a settled view: the staff had watched a room get hotter and hotter and failed to act, and the correct response was accountability for the people in the building that night.

What the Seminar Asked Instead

The facilitator put four questions in front of us, and none of them was about the staff. What did the facility's emergency plan say about loss of cooling? Who had reviewed and approved that plan? What was the facility's generator rated to run, and was cooling on the list? And who in the county knew that this building had 150 frail residents and no air conditioning capability on emergency power? When the group worked through them, the answer to the last question was the one that changed my view. Nobody in a position to help knew, because nobody collected that information in advance, and the hospital across the street learned of the problem when patients began arriving.

The Evidence That Settled It

Two studies made the case general rather than particular. Across Florida nursing homes that lost power after Irma, residents had measurably higher odds of death and hospitalization in the following weeks, which means the harm was not confined to one badly run building (Skarha et al., 2021). And the alternative that seems obvious, evacuating everybody in advance, carries its own mortality for frail long-stay residents, so a blanket evacuation policy is not a costless fix (Dosa et al., 2012). The choice is not between a careless facility and a safe one. It is between two risky options, and resolving a trade-off like that is work a plan has to finish long before the night it matters. If the answer to who knew is nobody, then what failed was the planning system, and the staff were the last line of a system with no earlier lines.

Where I Was Still Right

I do not now think staff conduct is irrelevant. Someone in that building could have called for help sooner, and the regulatory findings afterward said as much. What changed is the weight I give it. Staff behavior is the last of five or six points where this outcome could have been prevented, and it is the only one that cannot be fixed in advance by a county emergency manager. Putting my attention there was comfortable because it required nothing of the planning system I work in.

What This Means for Brennock County

Our county has nine long-term care facilities holding roughly 740 residents. I checked three things after the seminar, and the results are why this reflection has a recommendation in it. First, the county's emergency operations plan references long-term care facilities in one sentence, under evacuation. Second, we hold no record of what each facility's generator is rated to run, and cooling is the item most often excluded. Third, our electrically dependent patient registry covers people living at home and not residents of facilities, on the assumption that the facility is itself the plan.

What I Will Do

I am asking our preparedness committee for three things in the next quarter. A one-page capability sheet from each of the nine facilities, stating generator capacity, whether cooling and oxygen concentrators are on emergency power, how many residents cannot be moved without a stretcher, and which receiving facility has agreed in writing to take them. Second, a standing item in our exercise schedule that tests one facility's plan each year with the facility present, since a plan nobody has exercised with the county carries an untested assumption at both ends, and exercises are where that kind of gap becomes measurable (Savoia et al., 2014). Third, a change to the patient registry so that facility residents are counted, because the county cannot prioritize power restoration for a building it has not listed.

The Question I Cannot Answer Yet

It is not clear to me where the authority sits when a facility's own plan is inadequate and the event is already underway. Our health officer can order evacuation of a facility in an imminent threat, but the threshold is vague, and the Irma case shows that the dangerous hours look survivable from outside until they are not. That question will take me the rest of the term, and I suspect the honest answer is that the power exists on paper and has never once been used, which is a planning failure of its own kind.

References

Dosa, D., Hyer, K., Thomas, K., Swaminathan, S., Feng, Z., Brown, L., & Mor, V. (2012). To evacuate or shelter in place: Implications of universal hurricane evacuation policies on nursing home residents. Journal of the American Medical Directors Association, 13(2), 190.e1-190.e7. https://doi.org/10.1016/j.jamda.2011.07.011

Savoia, E., Agboola, F., & Biddinger, P. D. (2014). A conceptual framework to measure systems' performance during emergency preparedness exercises. International Journal of Environmental Research and Public Health, 11(9), 9712-9722. https://doi.org/10.3390/ijerph110909712

Skarha, J., Dosa, D., Bustamante Dominguez, L. F., Peterson, L. J., Andel, R., Hyer, K., & Chen, F. (2021). Association of power outage with mortality and hospitalizations among Florida nursing home residents after Hurricane Irma. JAMA Health Forum, 2(11), e213900. https://doi.org/10.1001/jamahealthforum.2021.3900