No water, then no power. How one St. Petersburg hospital survived Milton.

St. Anthony’s Hospital looked well set to ride out Hurricane Milton.

The downtown St. Petersburg hospital had its own generators and backup systems. It had 24,000 bottles of water and extra medical supplies on hand. Its location 52 feet above sea level offered protection from storm surge.

Just over 361 patients, including five evacuated from other hospitals, and 800 workers were in the 448-bed facility the night of landfall. The late-shift crew of doctors, nurses and other essential workers arrived five hours ahead of their 7 p.m. start to ensure road and bridge closures didn’t prevent them from getting to work. The day-shift crew they relieved would spend the night on cots in classrooms and other sleeping areas and be back on duty by 6 a.m.

But the Category 3 hurricane, which came onshore 50 miles south of St. Petersburg, had no respect for any well-laid plans and preparation.

Here’s the timeline of a storm that dealt St. Anthony’s one crisis after another.

Wednesday Oct. 9. Late afternoon:

Milton’s first impacts arrive with rain and saturated ground causing water to intrude into the hospital’s ground floor, breaching a mechanical closet. A sub-basement also takes in water, forcing workers to relocate supplies. Several other leaks throughout the hospital require patients be moved to different rooms

6 - 7 p.m.

In a portent of later trouble, a city of St. Petersburg official calls to tell the hospital that the sewage treatment plants are being evacuated as a precaution. The hospital’s incident command team responds with a hospital-wide message urging workers to conserve water.

8:30 p.m.

Hurricane Milton makes landfall as a Category 3 storm in the Siesta Key area, just south of Sarasota. Within 90 minutes near 100 mph winds are recorded in downtown St. Petersburg.

10:45 p.m.

The hospital loses water pressure. There’s no water in faucets, no way for patients to flush the toilets in their rooms and no word on when service will resume.

It also means there’s no way to sterilize medical equipment so only procedures to prevent loss of life can be performed, said Scott Shields, the hospital’s operations director.

The abrupt failure interrupted a dialysis treatment of a patient.

“My first reaction was ‘oh boy,’” Jasmine Nicholas, a registered nurse and director of patient services, said. “We were able to complete the treatment using other processes. But we knew that we could no longer do dialysis or any surgical procedures.”

There were other concerns too. Sprinklers wouldn’t work in event of a fire. Cafeterias were limited to refrigerated and shelf food. Coffee vending machines were shut down.

“The only water we had was the water in our pipes,” said Shields.

It’s a scenario hospital staffers have dealt with before. A maintenance crew was able to tap into an on-campus well to keep the hospital’s chiller plant functioning. Nursing staff began an immediate inventory of bedpans, commodes, bathing cloths and liners. Teams of workers distributed 2,000 bottles of water to patients and clinical areas before midnight. Kitchen staff begin work on providing patients and workers a continental breakfast.

Thursday, Oct. 10. 3:15 a.m.

The hospital loses its computer systems after its internet service crashes. It leaves nurses with no way to access and update the electronic medical records of the patients they are caring for. Desktop phones are also down.

Backup devices that have medical information up to the recent past can still be used. Where there is no other option, nurses go back to recording patient data with pen and paper. For communication, handheld radios are used.

3:45 a.m.

A fuel pump failure causes two of the hospital’s three generators to stop working, reducing much of the hospital to emergency lighting only.

“My first experience in a hospital seeing pitch black and I hope to never see it again,” said Shields

On wards and in the intensive care unit, nurses rushed to make sure that critical life-saving equipment like ventilators had switched over to battery power. But that would only give the hospital about an hour’s grace before battery power failed.

Shields and hospital president Scott Smith rushed to the central energy plant. The hospital had switched to generator power before the storm as that is usually more reliable. With just one generator, it would not be possible to power the chiller that provide air conditioning.

The hospital caught a break, however, when the main power line from Duke Energy was still active. The lights were back on within 10 minutes.

“It certainly felt overwhelming,” said Smith. “It was like holy cow, what else are we going to have to deal with?”

7:28 a.m.

Daybreak brought a sense of relief. With computer systems still down, a team meeting normally held by video conference was held as an in-person huddle. Workers climbed up to the roof seeking better cell phone signal. City water came back online around 9:30 a.m. The water wasn’t potable but was enough to run the chiller.

Aftermath

One week after the storm, Smith said he’s proud of how hospital workers coped during the most stressful of nights. Every patient was kept safe throughout the storm. But there are lessons to be learned., he said. He wants the hospital to invest in a better backup water supply with additional wells.

“This speaks to our normal state of readiness,” he said. “Its a special group of people that sign up for this.”

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