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Nursing students experience a real-life "immersion" in West Virginia

On a Thursday morning in late June, Emory nursing students Phil Dillard and Abby Wetzel hit the road in Charleston, West Virginia, bound for the Clendenin Health Center, some 30 minutes northeast. Their drive had become routine during their two-week immersion with Cabin Creek Health Systems, founded by coal miners to serve families in central Appalachia. Over the course of the next 36 hours, Dillard and Wetzel would assist Clendenin staff and patients in ways they never imagined.

The bond between the nursing school’s Lillian Carter Center for Global Health & Social Responsibility and Cabin Creek is strong. Since 2010, students have traveled to West Virginia in early summer to gain practical experience at the Federally Qualified Health Centers (FQHCs), operated by Cabin Creek to reach medically underserved patients. This year, seven advanced practice students took part, led by Emory nursing faculty advisers Carolyn Clevenger and Debbie Gunter. Each day, the students fanned out to work at four FQHCs outside of Charleston, where they returned each night.

By the students’ second week, the temperature was cooler than Atlanta’s and the rain intermittent. By Thursday, June 23, rainfall was heavy across much of West Virginia, now under a flash flood watch.

That morning, Dillard and Wetzel arrived at the Clendenin Health Center as usual. Wetzel parked her car in front of the center, housed in a handsome three-story brick building some 30 feet from the bank of the Elk River. Dillard saw patients until noon and then turned his attention to homework. Wetzel continued seeing patients in another part of the clinic. By early afternoon, it started to rain.

"There was some conversation about are we going to stay here," says Dillard, an emergency nurse practitioner student in the Fuld Palliative Care Fellowship program. "There might be a potential for a flood."

Several clinic staff soon left to check on their homes since some area roads had flooded. Others stayed, aided by Wetzel, to finish seeing patients. By 3:45 PM, no one could leave. The parking lot and street in front of the clinic were knee-deep in swift brown water.

"We were just about to get all of the patients out and then hop in the car and get out and all of a sudden, the flood just happened," Dillard says. "It was amazing. You could see the water gushing down from the hill across town. You could see it rushing around the buildings and in the back door and out the front door of a house. I would not have felt safe walking from the clinic to the fire department across the street."

Everyone at the Clendenin Health Center, including the seniors living in basement and third-floor apartments, had to stay put. The clinic, located on the main floor, was a safe place to be, with potable water, a kitchen and food, electricity, restrooms, and plenty of flashlights and working cell phones. "If you could pick were you wanted to be during a flood, that’s where you wanted to be," says Wetzel, a student in the family nurse practitioner + nurse-midwifery program.

By early evening, the rain subsided, and the water stopped rising. All was calm until 9:00 PM, when rumor spread that the dam upriver might be opened to avoid a breach. Within the hour, the water from the Elk River rose and lapped at the sides of the building. Water in the basement was ankle deep. It was time to evacuate the seniors from there.

As staff and students began knocking on apartment doors, the power went out and so did the elevator. Armed with flashlights, everyone helped each senior up the stairs and outside into an all-terrain vehicle for the short ride to the fire station across the street.

The timing of the evacuation proved providential. Around midnight, the basement flooded to the ceiling and set off the building’s fire alarm, which blared and flashed for more than two hours. Dillard, Wetzel, and a physician assistant (PA) student escaped to the stairwell, where the noise was less obtrusive, and tried to rest.

Around 7:00 AM the next day, Dillard awoke and looked out a crescent-shaped window in the stairwell. The cars in front of the clinic—including Wetzel’s—were submerged. The fire station and other town buildings were flooded 8 to 9 feet deep. The tops of stop signs were barely visible. Before the floodwaters rose, the seniors at the fire station had been moved to higher ground.

"We realized we were going to be there a while," Wetzel says. "We were in the middle of the river. It was all around us."

The wait until rescue began. Come afternoon, the water receded quickly, leaving behind a sea of smelly mud littered with debris. Finally, word came around 5:00 PM—prepare to evacuate. Clinic staff and students rallied again, this time to help senior residents down from the third floor and onto a National Guard truck, which took them to a church a half-mile away. The students were among the last to leave around 7:00 PM.

Once at the church, Wetzel helped some of the medically fragile with their health needs, while Dillard helped others onto another truck bound for a high school in Charleston.

Around 9:00 PM, Dillard, Wetzel, and the PA student also were headed to Charleston in a heavy-duty pickup truck driven by the father of a PA who worked at the Clendenin Health Center.

Hot showers, pizza, and salad awaited Dillard and Wetzel at their hotel in Charleston, where a relieved Clevenger and five fellow nursing students greeted them. Students at the other Cabin Creek clinics came through the flooding unscathed, thanks to less rainfall and gentler terrain at each facility.

Now, a month later, Dillard and Wetzel continue to reflect on their experiences during the third-worst flood in West Virginia history.

"The nursing school/Emory ethos reinforces the idea of being a leader and someone who gives back and looks out for those who have less than we do," says Dillard. "That came through multiple times. There was never any question that we should be the last to leave. We wanted to be there to help in any way possible."

"There are a lot of people in West Virginia facing challenges that a lot of us can’t fully relate to," adds Wetzel. "The best thing we can do as students is go on immersion trips like this one and just be humble and learn and take in everything you can.  This trip was very affirming to me for a lot of reasons. It was a reminder of how resilient people are when they have to be."

Note: The week after the flood of July 24, the Clendenin Health Center set up two tent sites to fill prescriptions for lost medications and provide routine and urgent care for area residents. On July 13, the health center reopened in its three-story facility.

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