Operating rooms are built around preparation. Cases are scheduled, instruments are counted, teams receive assignments, and every stage follows an established protocol. Then a disaster occurs, and the normal order of the day disappears.
A hospital may suddenly face injured patients arriving without identification, failed communication systems, damaged infrastructure, exhausted staff, or supplies that cannot meet demand. At that moment, policies still matter, but so do judgment, adaptability, and trust.
In Flintstones to Jetsons: A Perioperative Journey Across the Ages, Joanne D. Oliver-Coleman collects accounts from nurses who worked through some of the most difficult emergencies in recent history. These experiences make the book more than a history of surgical technology. They show what perioperative professionals do when familiar systems are placed under extraordinary pressure.
Preparedness Begins Before the Emergency
Mass-casualty preparation can feel remote during an ordinary workday. Staff may question the value of drills that interrupt schedules or simulate events that seem unlikely to happen.
The book demonstrates why those rehearsals matter. During a real emergency, teams do not have time to invent every responsibility from the beginning. They need familiar communication pathways, clear leadership, accessible supplies, and confidence in one another.
Preparation cannot predict every complication. Its purpose is to give people a working structure when the situation no longer resembles normal hospital practice.
On September 11, Readiness Met Silence
Richard Dorritie’s account of September 11, 2001, captures a part of disaster response that receives little attention. As a Manhattan paramedic, he reported for duty expecting further attacks and believing he might not return home.
Healthcare workers gathered, prepared to receive patients. Emergency staff, operating-room teams, and intensive-care professionals were ready, but the anticipated stream of survivors did not arrive.
That absence carried its own trauma. Professionals trained to help were confronted with the reality that there were too few people left to treat. Dorritie later supported stress debriefing efforts as the mission moved from rescue to recovery.
Katrina Turned One Hospital Into a Lifeline
During Hurricane Katrina, a hospital specializing in women and infants received evacuees from New Orleans as surrounding facilities became inaccessible. Its patient population doubled within days.
Kristy Simmons describes staff working outside their normal roles, assisting with triage, transporting supplies, and supporting any department that needed help. One critically ill infant arrived by boat and helicopter for emergency abdominal surgery, but the parents could not be found to provide consent.
The hospital obtained emergency authorization while trying to locate the family. When the mother finally called, a nurse was able to tell her that the baby was safe and receiving care.
A Disaster Can Enter Through the Front Door
Katrina also created unexpected security concerns. People arrived seeking food, shelter, cooling, and protection. In one incident, a person presented herself as a nurse accompanying evacuees. Staff gave her food, scrubs, and shoes after hearing that she had walked through floodwater.
She later disappeared, and the hospital learned she was not a nurse.
The experience led to tighter identity checks and visible bands distinguishing patients from visitors. It is a reminder that compassion and security are not opposing responsibilities. During a crisis, hospitals must provide humane assistance while still controlling access to vulnerable patients and clinical areas.
Repeated Drills Shaped the Boston Response
When bombs exploded near the Boston Marathon finish line in 2013, nearby hospitals had only minutes to prepare. Patients arrived with severe blast injuries, burns, shrapnel wounds, and traumatic amputations.
Barbara DiTullio and Charlotte Guglielmi describe almost one hundred staff members reporting to help. Seventeen operating rooms became available, equipment was gathered, and teams were assigned according to specialty and patient need.
Years of mass-casualty exercises gave the hospital a framework for action. The event still brought confusion, emotional strain, identification problems, security threats, and questions about handling evidence. Yet practiced teamwork allowed the hospital to move patients from triage into surgery rapidly.
COVID-19 Took Perioperative Knowledge Beyond Surgery
The COVID-19 pandemic disrupted normal surgical work, but it also showed how perioperative skills could support an entire hospital.
Daphny Peneza recounts leading a surgical-services task force focused on personal protective equipment. Perioperative nurses taught other professionals how to select, put on, and remove protective gear without causing contamination. Their knowledge of sterile practice became essential in intensive-care and emergency settings.
They also helped reorganize spaces, prepare equipment, standardize procedures, and support overwhelmed colleagues. Programs were created to check on staff well-being and recognize early signs of exhaustion.
The Palisades Fire Tested Personal Commitment
During the Palisades Fire in January 2025, Gerry Asuncion faced responsibilities as both a healthcare leader and a resident threatened by the same disaster.
Hospital teams monitored air quality, reviewed evacuation plans, coordinated with other facilities, protected supplies, and reassessed patients as conditions changed. At the same time, many staff members faced road closures, displacement, or possible loss of their homes.
Asuncion and his wife moved into a hotel, but his hospital responsibilities continued. His account shows that healthcare workers do not stand outside a community emergency. They may be caring for patients while experiencing the same fear and uncertainty themselves.
Advocacy Still Applies to the Accused
The book’s account of the 2009 Fort Hood shooting raises a difficult ethical issue. One injured patient receiving surgical care was identified as the shooter.
A nurse caught a blood-matching error before transfusion, preventing further injury. Once the patient’s identity became known, the hospital also had to protect him from media attention, angry individuals, and possible retaliation. He was housed in a secure operating-room area until he could be transferred.
The duty to protect a patient did not disappear because of what he was accused of doing. This episode presents patient advocacy in its most demanding form, when professional responsibility must remain steady despite powerful emotions.
Crisis Leadership Is Built on Coordination
Across these accounts, effective leadership rarely appears as one commanding figure giving orders. It appears through communication, role clarity, resource sharing, honest updates, and people willing to perform unfamiliar tasks.
Nurses prepare rooms, locate equipment, calm families, protect privacy, teach infection-control practices, detect errors, manage transfers, and support colleagues. Their leadership is practical and immediate.
The strongest teams also examine what went wrong after the event. Failed phone systems lead to new communication plans. Confusing specimen procedures lead to clearer authority. Weak access controls produce stronger identification measures. A crisis becomes a source of learning only when its lessons are carried forward.
Preserving Experience Before It Disappears
Joanne D. Oliver-Coleman understands that professional knowledge does not exist only in policies and clinical manuals. It also lives in the memories of people who were present when plans failed, resources ran short, and ordinary roles changed without warning.
By preserving these accounts, Flintstones to Jetsons: A Perioperative Journey Across the Ages gives future nurses access to lessons they should not have to learn for the first time during their own disaster.
The book honors surgical progress, but it also recognizes the people who keep care moving when advanced systems are disrupted. Machines can support a prepared team. They cannot create courage, compassion, or responsibility. Those qualities still come from the professionals who report for duty when the schedule stops mattering, and every decision carries human weight.
