The January 2025 wildfires in Southern California have caused unprecedented devastation, with flames consuming vast landscapes and impacting countless lives.
By mid-month, at least 25 people had died, dozens were injured, and over 12,000 structures had been destroyed, displacing tens of thousands of residents, according to an NBC News online report.
Since igniting on January 7, these fires have rapidly spread across more than 40,000 acres — among the hardest-hit areas being Pacific Palisades, Altadena, and Pasadena. The fires were fueled by severe drought conditions and hurricane-force Santa Ana winds reaching up to 100 mph.
Amid the efforts to care for the injured, nurses and other healthcare professionals continue to give their all, even as they face their own personal challenges — protecting their homes and looking after loved ones.
Here, we explore how these wildfires have impacted hospitals and the dedicated nurses working tirelessly through the crisis.
How hospitals respond to wildfires
Disaster planning is a collective effort, with administrators and healthcare professionals all playing an ongoing role in periodically reviewing policies and procedures. As soon as there is an indication that wildfires may be an ongoing threat, hospitals in the area begin activating appropriate phases of their disaster plans and facility-specific procedures. Hospitals’ disaster plans in the case of a wildfire may include:
- Staff mobilization: Emergency staffing plans are activated, additional personnel are called in, and staff safety measures are implemented.
- Triage and emergency care: On-site or nearby triage centers may be established to handle wildfire-related injuries, such as burns and smoke inhalation.
- Securing ventilation systems: Measures are taken to prevent smoke infiltration, including sealing windows and switching to internal air filtration systems.
- Supply management: Medical supplies, such as oxygen tanks, burn treatments, and respiratory support equipment, are secured to meet increased patient needs.
- Preparing for patient evacuation: Hospitals will prioritize critical care and non-ambulatory patients if evacuations to predesignated, safe facilities are necessary.
California hospitals also must adhere to state and federal disaster preparedness requirements. These plans include risk assessment and planning, communication, and patient transfers.
Despite these preparations, the rapid spread of the wildfires tested California’s medical facilities and staff. At times, the wildfires caused disruptions in services at outpatient clinics and surgery centers in evacuation areas, as well as the suspension of elective surgeries and non-emergency services due to air quality and safety concerns, resource allocation, and many other factors.
Treating wildfire-related injuries
During the crisis, nurses and front-line staff focus on treating injuries, which could include:
Burn injuries
Minor to severe burns are among the most common injuries sustained during wildfires. Nurses manage these cases through wound care, addressing pain, preventing infections, and facilitating wound healing.
Traumatic injuries
Traumatic injuries sustained during chaotic evacuations, including broken bones and lacerations, required rapid triage and stabilization.
Respiratory issues and smoke inhalation
Smoke inhalation can lead to respiratory distress, with symptoms ranging from coughing and shortness of breath to life-threatening carbon monoxide poisoning. Nurses frequently administer oxygen therapy and assist with intubation for those with severe exposure.
The CDC emphasizes that wildfire smoke exacerbates chronic conditions like asthma and chronic obstructive pulmonary disease (COPD), particularly in vulnerable populations such as children and older adults.
In a National Nurses United news release, one nurse explained how smoke from the wildfire can aggravate certain pre-existing conditions.
“Just a little smoke inhalation with these conditions can send you into the hospital,” said UCLA Santa Monica Pediatric RN Kristan Delmarty in the news release. “Even for healthy people, it’s not good to be out there in the toxic air. It’s not just trees burning, it’s houses and toxic things. We all need to take precautions.”
Eye injuries
Ash and debris are common irritants during wildfires, often leading to eye injuries such as corneal abrasions. Nursing treatment protocols could include flushing out irritants and monitoring patients for infections.
Beyond physical injuries, the psychological toll on patients can be significant. Being in the midst of a natural disaster can lead to mental health conditions such as post-traumatic stress disorder (PTSD), anxiety, depression, and feelings of guilt.
Nurses often help with these emotional wounds by offering comfort and support while connecting patients with mental health resources.
Nurses’ personal and professional trials
Nurses who are on duty during this crisis navigate a complex intersection of personal circumstances and professional responsibilities.
Professionally, nurses may need to adapt to:
- Extended hours: Increased patient influx necessitates longer shifts, leading to physical exhaustion.
- Resource limitations: Shortages of medical supplies and personnel can hinder the ability to provide optimal care.
- The emotional toll: Nurses working in wildfire response often endure emotional and psychological strain. Seeing patients in turmoil can lead to burnout and compassion fatigue.
Personally, nurses often contend with the same fears that plague their patients. These may include:
- Evacuations: Some nurses are forced to evacuate from their homes and find shelter for themselves, loved ones, and pets.
- Family safety: Concerns about the safety of loved ones while they’re on duty add to nurses’ emotional strain during already taxing shifts.
- Loss of property: The destruction of personal belongings and homes can lead to feelings of grief and loss, leaving individuals struggling to process the emotional impact of losing not just physical items but also the memories and sense of security tied to them.
When nurses live under the same threat and uncertainty as their patients, they need even more support, empathy, and understanding from their leaders. Immediate access to counseling, peer support, and stress management training can help nurses maintain the confidence and composure their patients rely on.
Where these resources are lacking, leaders can prioritize creating or expanding them to meet the need. Equally important is maintaining open lines of communication — listening to nurses without judgment and addressing their concerns promptly when they express their fears or frustrations. Frank conversations with nurses could lead to ideas on how to improve the support system for nurses.
What we can learn from these wildfires
Hospitals and healthcare providers continually refine their disaster preparedness plans, often using lessons from recent events to identify deficiencies and make improvements. This disaster, in particular, will likely be scrutinized for years to come by healthcare professionals and other first responders, policymakers, and many others seeking to improve future responses.
For nurses and other healthcare professionals, the goals for response reviews may include:
- Identifying opportunities to improve collaboration between hospitals, emergency services, and public health departments
- Updating disaster training programs to address challenges revealed during the wildfire
- Advocating for public health initiatives and improved resource allocation, drawing on their frontline experience to propose practical, effective solutions
The physical and emotional impact of these wildfires has been profound. Nurses face the added burden of managing their stress and trauma while supporting patients. While the wildfires continue, it’s important to focus on giving nurses and other healthcare professionals the support they need to keep going. Their efforts have been inspiring, but sustaining these efforts requires practical solutions.
Steps like improving disaster preparedness plans and providing better access to mental health resources can make a real difference in helping them continue their work.
When the immediate crisis has passed, there will be time to reflect, share stories of resilience, and determine what adjustments to make in the future. But for now, the focus must remain on providing the support that nurses and healthcare professionals need to keep moving forward in the coming weeks and beyond.
