Time Heals But Doesn’t Forget
When a bomb ripped apart an Oklahoma City government building 10 years ago, nurses responded the best way they knew how — by doing their jobs well.

By Mark Cantrell
March 28, 2005

In the heart of downtown Oklahoma City, there stands a pair of monolithic bronze-clad granite gates. A peaceful reflecting pool stretches between them, beside a gentle slope on which 168 chair-shaped monuments stand. Visitors move quietly around the grounds speaking in hushed tones, if they speak at all, as befits hallowed ground.

Shortly before 9 AM on April 19,1995, ex-Army sergeant and antigovernment activist Timothy McVeigh parked a yellow Ryder truck beside the Alfred P. Murrah Building, where the memorial now stands, and walked away. The truck was packed with 5,000 pounds of explosives, and when it detonated at 9:02 AM, the world ended for nearly half the building’s workers and many others in nearby offices.

At Sant Anthony hospital, just five blocks away, windows blew out from the force of the blast. Head ICU nurse Ann Burkle, RN, BSN, heard and felt the explosion and thought that perhaps a boiler had blown up. Nearly two miles from the blast at Children’s Hospital of Oklahoma (now Children’s Hospital at OU Medical Center), PICU director Rhonda Flowers, RN, didn’t feel the explosion, but some of her nurses did. They ran to the roof and saw a massive cloud of black smoke rising from downtown.

Fast response

Within minutes every hospital in the area was aware of the blast and had activated its disaster plan. Of course, in those pre-9/11 days no one’s plans included contingencies for terrorist activity, especially in America’s Heartland. Nevertheless, the plans were flexible enough to provide immediate response. Within minutes, emergency workers had arrived on the scene, triage areas were being set up, and the hospitals were prepared to accept patients.

It didn’t take long. Within three minutes, victims began to arrive at Saint Anthony. “The first ones we saw were what we called the walking wounded,” remembers Diane Fulton, RN, MSN, clinical coordinator for the ED at the time. “They literally walked or ran to the hospital. Some of them had a child tucked under each arm. The wounds were primarily from the shrapnel — lots of eye injuries, lacerations, puncture wounds, and percussive injuries. I remember immediately calling surgery. I told them, ‘I don’t know what’s happened, but if you have any 9 AM cases you haven’t started, just hold off.’”

At the University of Oklahoma College of Nursing, instructor Francene Weatherby, RNC, PhD, had just come out of a meeting when she learned about the blast. “A number of our clinical students were based at Saint Anthony, and they were called to the hospital right away to help care for the wounded.”

And then the trickle of wounded arriving at Saint Anthony turned into a torrent, with victims arriving by ambulance, private vehicles, and anything else that rolled. The hospital accepted about 200 patients in the first two hours after the bombing, and with so many patients with eye injuries, decision-makers quickly converted the hospital’s dental clinic into an eye care center.

“It worked really well since we had dental chairs and excellent lighting there,” Fulton says. “We had one floor that was closed, and within 20 minutes the staff had gone up there, opened it up, and had it ready for patients. We called the emergency room and told them we could take 20 more patients whenever they were ready.”

Surprisingly, the facility was able to accommodate all who sought care there. “The ER filled up very quickly, but the good thing is that the patients were triaged very effectively,” Fulton remembers. “Minor injuries went to our outpatient clinic for suturing, people who came in with eye injuries were sent to the dental clinic, and when the ER became full of critical patients, we sent them directly to ICU.”

At Children’s Hospital, Flowers told her staff to expect a huge influx of patients. “Since we’re an intensive care unit, we thought we’d be taking patients regardless of whether they were pediatric or not, so we immediately went into that mode,” she recalls. “But we received just a few patients — the last one came in about 11 PM. And then we waited, and waited, and waited. It was a horribly sad situation because we thought we’d be getting tons of patients, but they were all gone. Just lost.”

One thing none of the hospitals experienced was a shortage of help. “We didn’t need to call anyone in — there was a tremendous outpouring of help, with people coming in from off shift,” recalls Cyndy Ray, RN, who was assistant head nurse at Integris Southwest Medical Center at the time. “When it became clear that this wasn’t going to be a short-term event, I actually had to start sending people home to get some sleep so they could come back and help the next day.”

Reality sinks in

Many nurses and other workers couldn’t help but be profoundly affected by the experience as the long day wore on. “I guess at first I was in shock and didn’t realize it was real,” Fulton says. “It was a couple of hours into it when I became aware of all the glass crunching under my feet as I walked through the hospital. I remember slipping on blood in the back of an ambulance at one point, and that’s when it hit me: ‘This is not a drill. This is real.’”

For Burkle, the worst part of the day was when the flow of patients ended. “As long as we had patients and kept getting more, we felt like we were helping and making a difference,” she says. “But when the patients stopped coming, that was very difficult.”

That sentiment was echoed by one of Weatherby’s nursing students. “She had gone down to the blast site on the day that it happened since she was also an EMT and wanted to help,” Weatherby says. “They had set up triage stations with cots and IVs and were ready to take care of the bombing victims. Eventually, the word came that there were no more patients — they had rescued everyone they could find. She told me, ‘I remember looking at those cots with their IVs, hanging useless now, and thinking that they represented people I could no longer help.’ She was really moved by it, and I was moved by her reaction.”

Not all the victims were working in the building at the time of the explosion. Rebecca Needham Anderson, LPN, appalled by the carnage she saw on TV, rushed down to the bombing site to render aid. She had already helped several people out of the rubble when she was killed by a falling chunk of debris. A U.S. Department of Education nursing scholarship now bears her name.

“To know that she didn’t have to be there, but stepped in to help even though it cost her her life, makes me very proud to be a nurse,” Weatherby says.

Overcoming the evil

Incredibly, just a day after the Murrah explosion, a bomb threat was called in to Children’s Hospital. “I think that was even more frightening than the bombing itself,” Flowers says. “They wanted to evacuate our building, but we had 18 critical care patients. Not just bombing victims, but others, as well.”

Faced with the prospect of abandoning their patients, the nurses stood firm and wouldn’t leave; neither would Weatherby’s nursing students. “We had a faculty member over there [at Children’s Hospital] who told the students, ‘I need you to get out right now because there’s been a bomb threat,’” Weatherby says. “She told me later she was so proud of the students. One of them looked at her for a moment and then asked, ‘But who’ll take care of the babies?’”

Fortunately, there was no bomb, and all the patients brought to the Children’s Hospital survived. In the wake of the blast, critical incident management teams were brought in to counsel hospital employees, disaster plans were amended, and changes were made to many of the city’s other buildings. Around some, especially government installations, there are now barricades to keep vehicles a safe distance away. And the city now takes disaster preparedness very seriously.

Could any good possibly come out of such a disaster? Fulton recalls how proud she was of the hospital staff, which came together like never before to help the victims. Burkle was heartened to learn just how much the Saint Anthony team was capable of when tested by a disaster of such magnitude. And Weatherby was amazed at the reaction of the community, which quickly banded together in an unprecedented show of support.

“Right after it happened, the reaction was: ‘How can evil crop up like this? Look how destructive people can be and what a horrible situation they can create,’” Weatherby says. “And yet almost immediately, people started coming in and asking us what they could do to help. Overwhelmingly then, there were all sorts of positive things to overcome the evil. That showed that there were far more good people out there than the person who caused all the trouble.”

After enduring that horrible day, many nurses feel fundamentally changed by the experience. “It just makes you want to hug your kids a little more often,” Ray says. “You become even more aware of how lucky you are to have them.”

“I think that anything that blindsides you and is catastrophic changes your perception,” Flowers adds. “It warps you somewhat, and I think makes you better — helps you put your priorities in the right place forever and ever.”

Mark Cantrell is a freelance writer.