How did you join the disaster team?

I joined when I was a paramedic. I had extensive training in search and rescue and hazardous materials. When I became a nurse, I got interested in forensic nursing. I have taught EMTs and paramedics, so the emergency and disaster aspect just became natural to me. I was a flight paramedic. I've always done emergency room nursing. I love having the ability to help someone in a crisis, to be the calming effect in that crisis. Sometimes you're the only focus they have to get them through that.

Why did you go into emergency work?

It is one of those things I never wanted to do, but God kept putting me in the position where I was placed in an emergency. It was like He would take over and all my training would come to the surface. Only when it was over would I fall apart. I would look back and wonder how I functioned through it. It was almost as if it wasn't me-your training just rises to the top. You have a roller coaster of emotions after it is over.

I joined the disaster team years ago. The national disaster medical system has 26 participating states and about 50 teams in those states. We're called Arkansas One DMAT. We're made up of more than 100 different professionals, from communications people who deal with radios, to logisticians who can be anything from a plumber to a mechanic. Their job is to keep everything going. The team is mostly made up of paramedics and EMTs.

On the team that went to New York, there were 20 people: two physicians, two advanced practice nurses, five nurses and the rest were paramedics, EMTs, logisticians and so forth. We also had a pharmacist and a chaplain. You have to have one on every disaster, someone who just watches the team and prevents them from becoming harmed themselves. The team is much like a military command structure, with a commander, deputy commander and administrative personnel.

What was your role on the New York team?

I functioned as an advanced practice nurse. When we went in, there were three clinics on the site of the emergency. We had to do everything from minor surgery to taking care of the rescuers. At any one time there were maybe 2,000 people at the site. It was almost like a family practice clinic; people came in with ear aches, runny noses, lacerations, puncture wounds. Foreign bodies in the eye were a big thing. It was our job to take care of those rescuers and get them back to their jobs.

Did you have any special training?

The team meets every other month for training. We have a tractor-trailer full of our equipment, everything from tents to heaters to generators and all our medical equipment.

Within two hours from the time we've been activated, Wal-Mart, our sponsor, sends a truck and driver there to take us anywhere we need to go. We can be on a plane to where they tell us to go in six hours or less.

We become part of the U.S. Public Health Service when we are activated. Until we are deployed, we're volunteers. We train on our own, buy our uniforms. Once we are deployed, we become federal employees. We're paid at whatever rate we signed up for, with federal employee benefits, to go to the emergency and react in that role.

I am certified to do anything up to the level of my licensure and certification no matter where I am. So I can provide the level of care I'm licensed to provide here in Arkansas.

Is disaster work fulfilling?

It is one of the most rewarding things I've ever done in my life. I've participated in four tornadoes and a plane crash in Arkansas. This is my first deployment nationally. I was afraid to go in the beginning-the thought of what I was about to see and the emotions that go along with it made me apprehensive. But I also had a sense that I had to go. It is voluntary; you're not obligated when deployed. But as a citizen, I have a responsibility to this country, and this is the niche in which I can fill my service. It was one of the most fulfilling things I've ever done.

We were there one month into the disaster. The quality of the care we provided at the scene was minor-blisters, lacerations, washing out eyes. But we were able to begin the emotional, psychological and spiritual healing of the workers. Because it was a month into it, people were ready to talk to someone who was willing to listen and could understand.

As a nurse, sometimes it is not what you do for them medically, it is how you hold their hand. It is the empathy, not sympathy, but the willingness to listen and understand. I really believe the Arkansas team began the healing. We were able to see it.

Before this, what was the biggest disaster you worked?

The one that had the most effect on me was a tornado in my own hometown. We lost a young married couple. The tornado totally blew away their house, but their 6-month-old was found after about an hour in a plowed rice field a quarter mile away, face down. It was dark, the rescuers were doing hand-to-hand searches of the fields. There was nothing left you could see of the house, no debris, yet this baby was found.

What do you say to criticism of the efforts?

They haven't been there. I saw the focused dedication of the people there. They are so focused, they aren't leaving until they find their last friend and co-worker. This was an assault on them. I was amazed at the dedication of the ironworkers. There were men whose fathers had built the Trade Center and now they are there tearing it down, and they are dedicated to being there until it is done. They wouldn't go home even though they had nosebleeds and chronic hypertension.

At first, they wouldn't come see us because they were afraid we would send them home. Once they realized we wouldn't, they would see us every day, sometimes just to say, "Hey, I'm better, thanks." A lot of times when they came in for something in their eye, it was really because they had just found a body and weren't sure how they were supposed to feel about it. They needed us to tell them they're OK.

These are ironworkers and truck drivers; they aren't accustomed to that. The dedication was just amazing. One of the criticisms has been that all this money is raised and it hasn't been given out, but people are there and trying to figure out how it can be done in an organized manner.

Did you have any kind of debriefing when you returned?

Every day there, the chaplain came around and asked, "Are your head and your heart OK?" We would talk, and we did several things, like on the last day we drew cartoon characters of each other, to blow off steam.

We were on the buddy system also; you don't do anything by yourself for two weeks. That is part of the command structure. When we returned, we had a critical incident stress debriefing. That was a wonderful opportunity to put all the pieces together. Everybody sees the disaster from a different view.

The nurses put behind a desk with a computer found this real frustrating-you want to have human contact, to be helping people.

They had to go through the fact that they didn't get any of the hugs, the crying with someone, holding hands-those soft, fuzzy things nurses thrive on. They needed the debriefing to feel like they did their part. Their job was vital to the mission, but they were not part of the caregiving.

Will you go back?

There's a good possibility. New York City is in control and as long as they feel there is a need for a medical team on site, teams will continue to rotate in. We replaced teams from Alaska, Florida and Texas and were there with Georgia and New Mexico. By Oct. 16, teams had treated 7,053 injuries.

Having the teams there took a lot of the burden off an already strained system. It kept them from having to use EMS. They lost a lot of EMTs and paramedics.