Living in the southeastern U.S., hurricanes are a regular feature of life — it’s less a matter of if they’ll happen, and more a matter of when. As a physician and Floridian, I have seen many times the dramatic effects of hurricanes on life in the hospital and beyond. At a health system level, hurricanes lead to a post-storm patient volume flux which often includes typically preventable admissions, such as the patient who missed dialysis and requires admission for volume overload, or the patient with hypertension who is unable to obtain their antihypertensive refill and presents with hypertensive emergency. And at an individual level, we physicians not only have to manage this influx of new patients, we also have to help our patients whose health relies on our close evaluation and management regardless of the hurricane raging outside. Not to mention, we have our own personal and family obligations to contend with as well. All that said, there are ways to soften the blow of the inevitable. The oft-repeated Benjamin Franklin saying “an ounce of prevention is worth a pound of cure” continues to hold true when it comes to physicians and their hurricane preparation.
The first thing physicians should do is be aware of what their role is within their practice when a storm is projected to hit nearby. Outpatient clinics will close, but the hospital will continue to function. While the specifics vary by health system, many systems have different teams assigned to specific shifts that are activated in a natural disaster scenario — most frequently the team that is staffing the hospital with all hands on deck during the storm, and subsequently the second shift team that comes to relieve the first one. If you’re in residency, like myself, your required work obligations will likely depend on which shift you’re a part of. If you’re not a resident and are able to choose which, if any, storm response team you’re on, take the time during dry season to consider your personal preferences and obligations. Importantly, some systems may even pay an increased rate while working during a storm, so be sure to consider this factor if it applies to you.
Regardless of which team you may be on if you have inpatient responsibilities, there is always a chance you may have to stay at the hospital for an extended period of time. Whether you are being relieved when the storm is still raging, or the beginning of your shift is at a time when travel may be unpredictable, it’s possible you may have to sleep at the hospital before and/or after your shift. It’s never quite as comfortable as it could be when you’re not sleeping at home, but little touches can go a long way. Bring small items like your favorite pillow, a cozy blanket, a fresh change of scrubs, and disposable toothbrushes. These items in a duffle bag brought with you to your shift can make a world of difference in your comfort level through an inherently stressful time.
Next, it is important to be keenly aware of your organization’s downtime procedures. While most systems have back-up generators to power the hospital’s essential services in the event of widespread power outages, there is still the chance that EHR systems will experience interruptions. If this happens, knowing how notes are written, how orders are placed, and how results are communicated in downtime will be of the utmost importance re: continuing to provide quality care. If you’re unsure of your hospital’s downtime procedures, ask your supervisor or medical director where you can find this information. Additionally, it may be a good idea to take a particularly thorough handoff and know the patients under your care especially well when coming onto service in the event that there are EHR interruptions.
It is also important to be mentally prepared for a more stressful and intense work environment than you may normally experience. During hurricanes, everyone is a little more stressed than usual as they navigate coordinating their own professional and personal obligations. There will be a palpable sense of tension and anxiety. In these times, a little grace goes a long way. In the face of ramped up rudeness, taking a breath and remembering that everyone has several stressors impacting them at the moment will help you go forth with kindness and understanding.
Additionally, it can be helpful to anticipate the ebbs and flows that will inevitably present themselves. Leading up to a storm, everyone is on heightened alert and patient volume will likely be high as patients try to resolve issues and obtain medications. When the storm arrives and wind speeds exceed your local emergency service’s threshold, there will be extremely limited (or even zero) emergency services available for a short period of time. It will also be too dangerous for patients to individually travel to health care centers, which will likely bring a lull in the workload. During this slowdown in work, enjoy the light load! If there is no outstanding work for any of your current patients, consider catching up on sleep or bonding with your colleagues. Nonetheless, it will only be a matter of time until the storm dies down and patients are rushing to obtain the care they needed but were unable to access during peak weather.
Finally, physicians can ameliorate the stresses of hurricanes on their personal lives by taking care of personal obligations in advance. Prior to hurricane season, ensure you have an emergency supply of necessities for everyone in your family, including three days of nonperishable food and water, hygiene items, flashlights, batteries, a weather radio, and cash. And don’t forget food and water for your pets! The time to assemble this emergency kit is well before a storm is predicted, as the stores will be chaotic and the supply of available items will be disrupted. Additionally, take care of your home or apartment by bringing outdoor items inside. If you own a home, it may be worthwhile to consider a tree-trimming service to evaluate your property for high-risk limbs and trees that could pose a threat to your house. Keep an eye out for sandbag locations if your property is prone to flooding. And of course, be sure to always have up-to-date homeowner’s or renter’s insurance. Lastly, have an idea of where you would evacuate if necessary prior to a storm, especially if you live in a high risk area or structure.
While hurricanes are stressful, they are part of the way of life for those of us in the southeastern United States. For physicians and other health care workers, the challenges are particularly intense: we have the same personal duties as everyone else, while also having to perform essential professional duties at a high level. In any case, a little preparation beforehand goes a long way toward removing a considerable amount of stress from the next hurricane that comes barreling down the path.
Have you ever been part of the emergency response shift during a hurricane? Share what the experience was like in the comments.
Dr. Del Carter is a family medicine resident physician in Tallahassee, FL. He enjoys traveling, watching sports, working on cars, and spending time with friends and family. Dr. Carter is a 2024–2025 Doximity Op-Med Fellow.
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