Delivering Nurse Practitioner Care Following Hurricane Helene
Meet the nurse practitioner who stepped up to provide free health care for hurricane victims in North Carolina.
Late in the evening on Sept. 26, Hurricane Helene made landfall on the Florida Gulf Coast as a Category 4 hurricane. According to the National Weather Service, “Helene's largest impacts were across the southern Appalachians where widespread severe and unprecedented flooding occurred with hundreds of fatalities and billions in property damage. Strong wind gusts damaged property and blew trees and power lines down in a swath from the Gulf Coast to the North Carolina mountains.” The damage caused by Hurricane Helene in North Carolina was devastating — impacting rural communities and other areas with high social vulnerability to disasters. Of all the counties under a major disaster declaration following the storm, “10 of the 27 counties were predominantly rural (counties with 80% or more of the population living in a rural area in the 2020 Census).”
The torrential rainfall caused by Hurricane Helene brought catastrophic flooding and subsequent landslides, mudslides and other damage to North Carolina — devastating communities and cutting them off from aid. Amidst the tragedy, one nurse practitioner (NP) in Saluda, North Carolina, set up a temporary medical station and provided free health care for the community there. In honor of all the health care providers caring for their patients in the wake of Hurricane Helene, the American Association of Nurse Practitioners® (AANP) spoke with Lisa Reece, FNP, about her experience setting up her makeshift clinic and meeting patients’ needs during this difficult time in North Carolina’s history.
Q: What was your journey toward becoming an NP, and how did you end up providing care for patients in rural North Carolina?
Lisa Reece: Since I was a kid, I have always wanted to be a nurse. I worked as an emergency medical technician (EMT) while I was in high school. Once I graduated from the University of Scranton in 1996, I went back to work in the small town where I grew up: Yardley, Pennsylvania. I ended up working at a children's hospital in the PICU for like a year and a half before going into the emergency room (ER) at Jefferson Abington Hospital. I knew right away this was where I was meant to be — it was during this time that I felt the push to become an NP.
It took me 10 years, but I graduated from La Salle University in 2011. I started off at St. Mary Medical Center as a hospitalist NP before joining the same doctor's office that I worked for as a kid in high school. I saw patients in the hospital, rounded at a nursing home and saw patients in the office. Collaborating with others has always been important to me, and this role allowed me to do that.
During the pandemic, my husband’s job went remote and the youngest of all our kids got a scholarship at Gardner Webb University, in Boiling Springs, NC. I had been working for the University of Pennsylvania in Chester County for about eight or nine years, and I truly loved my patients there. Moving was a very difficult and emotional decision for me — one that involved a lot of tears. Leaving my patients and my Penn family was hard, but in July of 2022 we arrived in Arden, NC.
When we moved to North Carolina, I was without a job and still in the process of getting my new license. During a job interview, I learned of a rural health clinic in Saluda, NC. It needed an advanced practice provider to run the clinic, and as soon as I learned of this, I applied. Soon after, I was offered the position, and I was ecstatic! It took some time for the community to begin to trust me, but as I showed them that I was just like them and that I cared about them and their community, doors began to open all over, and soon Saluda became my second home.
Q: How were you and other members of your community affected by the storm? At what point did you decide to set up a temporary medical station and see patients at no cost?
Reece: I live in Columbus, which is the town one exit down on I-26 from Saluda. Thankfully, my family and I were perfectly fine. We didn't have power and water just like everyone else, but we had a generator to power our fridge and didn't suffer any significant damage. Sure, trees and things went down, but it was no big deal compared to the rural communities around us where mudslides and flooding destroyed all the roads.
A few days after the storm, I went up to the clinic. I knew I had patients at home who were on oxygen who were likely without power and would need oxygen tanks. It was then I began to see and hear of the devastation that hit this small rural community.
When I arrived at my office, I was amazed to find the parking lot was full of volunteers, rescuers, hikers and kayakers, and donations were pouring in by the truck load. Hundreds of people from Colorado, Georgia and Texas, just to name a few, assembled to help this community which was their stomping ground. They loved to kayak in Green River Cove and all those who knew the Cove were ready to help. They were so organized — you name it, they had it. I was like, ‘I want to be a part of this.’
Q: How did you go about setting up the temporary medical station in Saluda? What were some of the challenges you encountered during the process?
Reece: You know, it just sort of fell upon us. The business next to us, MountainTrue, had called upon the community of kayakers and hikers in the area to get together and make donations for hurricane victims. Our parking lot was full of camper vans and pop-up tents with all these people who came in to help; they just needed help getting those donations and medical supplies distributed. They sent all medical donations my way and I was able to turn our waiting room into a makeshift clinic to offer free health care.
There was no power, internet or phone service, but people still needed their medications. I thought, ‘Oh, my gosh, I can't even get onto the computer to send their prescriptions.’ So, I went looking for a prescription pad, like in the old days, so I could actually write prescriptions for people to get what they needed.
All the while, we packed first-aid bags, medication and food for the hikers who would leave each morning — kayaking and hiking into the gorge or the Green River area — to rescue people. The kayakers and hikers would come back at the end of the day and tell us about different things they saw and heard. One person had rappelled down to save a dog, and ended up hiking with the dog for five miles because the dog couldn't go back up that way. There were so many amazing stories and listening to them, I just thought, ‘You guys are the heroes.’
Q: What were the community’s health care needs following the storm, and what kind of treatments were you able to administer from your station?
Reece: I was able to treat simple things like cuts, sprains and allergic reactions, but I also treated more complex issues like new onset A-FIB, anxiety, depression and insomnia along with acute shock. I was able to do what I love to do most: sit and be present with my patients, listen to them, hug them and cry with them. I had the opportunity to witness the incredible strength in people, as well as hear of tragic loss, and to see that dramatic contrast was incredibly inspiring to me.
There was a lot of teaching, as well. I truly enjoy teaching patients and helping them understand what’s wrong with them so they can take care of themselves. Many people would come in and just want to talk, some people just came in wanting a hug, while some just wanted to charge their phone or go to the bathroom. Without cell service, people couldn't contact their families. They were lonely, scared, overwhelmed and sad.
On a positive note, all the kayakers’ and hikers’ families were making dinner for all of us in the parking lot every night. I’m a horrible cook, but these women would make homemade soup, burgers and grilled cheese for the hundreds of us that were here. Whatever difficulties the community faced, there were so many good people involved in all this keeping our spirits high. It was just amazing.
Q: Could you provide an example of a patient visit to this clinic that validated your decision to set up this station and care for patients, free of charge?
Reece: One of my first days working the clinic, we were visited by a couple that was performing home checks to make sure that people were safe in their homes. They came to our clinic, and they said, ‘there’s a woman nearby with horrible belly pain and we think she has appendicitis’ There was no 911 in those first few days, so we just got in their SUV and drove out to see her.
When we arrived at her house, the woman told us she already had her appendix removed, which led me to think, ‘Ok, there's something else going on here.’ This woman was caring for her 96-year-old aunt in that house, so between us and this couple, we took them out of the house, drove the patient to the hospital and took the aunt to an emergency shelter.
She’s doing fine now, but it was one of those situations where, if these people hadn’t come into our clinic, that woman probably would have stayed at home and who knows what would have happened. That was one of our first days here, and it made us feel like we were doing the right thing. The worst thing we could do is shut our door and not be here — and that was something I couldn’t do.
Q: As we approach the one-month anniversary of Hurricane Helene, what is the status of your clinic today? How have the community’s health care needs changed, and how have providers such as yourself adjusted to meet those needs?
Reece: Many roads still aren't back up. One of our big grocery stores was destroyed during the storm. So, they’re running a pharmacy out of a trailer in the parking lot so people can get their medicine. In our clinic, we just got our computers back online. We were without phones for almost three weeks. As you can imagine, this was very frustrating for all and made running a medical clinic challenging.
Now, we are shifting our focus to the upcoming months and the needs of the community in the winter. We are working with our food pantry and local businesses to both receive and deliver supplies to those who need them. It is getting colder already, and folks need shelter and heaters, and that is just the beginning. Financial donations are what’s most needed so building supplies can be obtained — and restoring and rebuilding can begin.
Q: Are there any other stories you’d like to share?
Reece: People lost loved ones, their homes and their means of transport. These are people who were already in a financially tough spot to begin with. Yet, these people are out there caring for each other, helping shovel mud out of their neighbor's driveway, cooking what was in their freezers and sharing it with those around them.
During that first week, one man walked in here who had lost his wife during the storm. Their home was literally washed away with a mudslide right as she was handing him a cup of coffee. She was swept away in an instant, while the man got thrown out of his chair, through a window of the house and survived.
As I was speaking to this man in our clinic, another woman came in with a small injury on her toe. She had a lot of anxiety, so the man ended up holding her hand and joking with her while we bandaged her toe. I couldn’t believe his selflessness and compassion. I think that's why I'm so happy to be here.
I am truly grateful for all my years as an ER nurse, and the mentors who fostered my learning so that I was able to think, plan, collaborate and serve my community and my family in Saluda during this disaster. Thank you for giving me this opportunity to share about our special community and I hope that this story empowers other NPs to do the same should disaster strike their own communities.
Nurses Helping Nurses in the Aftermath of Hurricane Helene
The North Carolina Nurses Association (NCNA) and the North Carolina Foundation for Nursing (NCFN) have launched a campaign to financially assist nurses impacted by Helene. The NCFN – Nurse Recovery Fund is designed to quickly distribute money directly to nurses suffering from loss or damages due to catastrophic flooding, wind or landslides in the western parts of North Carolina. Donations to this special fund will be distributed to actively licensed registered nurses in North Carolina who have been impacted by Helene based on a sliding scale of needs.