Michelle Pitre-Ryals

Michelle Pitre-Ryals is a night-shift nurse at Memorial Medical Center whose work during the blackout puts her between patients in immediate danger and leaders controlling the evacuation. She tries to preserve essential medical information, relays repeated messages from the United States Coast Guard, and, when told to leave a patient behind, helps that patient’s daughter understand how to cancel a Do-not-resuscitate order. Her actions expose how an evacuation decision could turn a treatment instruction into a barrier to rescue—and how staff and families had to push back against that result.

Nursing Through the Blackout

On Memorial Medical Center’s fifth floor, the only light came from the dim blue glow of Toshiba Satellite laptop screens. Pitre-Ryals typed notes into her patients’ electronic charts before the computers’ batteries ran out. She knew that once they did, the electronic medical records system would be useless. The electronic medication dispensing cart presented a different danger: new to her unit, it would shut down with its medicines still locked inside. In the disaster, paper became high technology, and the nurse’s immediate task was to preserve information before the equipment failed.

That practical work unfolded amid signs of a wider breakdown. On the eighth floor, alarms had sounded over the power loss; battery-powered fans later fell silent as the hot air stagnated. Below, LifeCare’s messaging connection failed, and the special mattress supporting Emmett Everett deflated. Ventilators continued to deliver mechanical breaths, but only until their battery backups ran out. Pitre-Ryals’s charting was one part of a hospital confronting the limits of its powered systems, while the people inside still depended on them.

The Rescue Messages

Pitre-Ryals carried a cell phone belonging to a nurse whose husband was at the Coast Guard station. When it rang, a Coast Guard auxiliary member told her that three helicopters had been sent and someone was waving them away. She took the phone downstairs in the dark to the command team. A nursing director dismissed the caller as outside the evacuation plan, spoke with him, and then instructed Pitre-Ryals not to bring the phone down again.

The instructions soon conflicted. A Louisiana health department official and a Coast Guard lieutenant called back; the lieutenant ordered Pitre-Ryals to disregard the earlier direction and bring the phone to someone in charge. She descended the unlit stairs again. The nursing director berated her before taking the phone. A doctor then said that no more patients would be evacuated because visibility was too poor. Pitre-Ryals proposed waking people and putting flashlights in the stairwell, a concrete way to address the stated problem. The suggestion was ignored.

When the phone rang again, a more senior Coast Guard lieutenant insisted on speaking to a hospital leader. Pitre-Ryals gave the phone to a nurse’s husband to carry downstairs and returned to her patients. She could not believe that hospital leaders were yelling at rescuers who were trying to send help. To a fellow nurse, she said, “With these people in charge, we may very well die here.” Her repeated trips did not give her authority over the evacuation, but they made visible the conflict between offers of rescue and the hospital’s decision-making.

A Patient Left Behind

On the fifth-floor Clara Wing, transporters rolled a bed-bound patient toward the stairwell, then stopped when they saw her Do-not-resuscitate order. They repeatedly maneuvered other patients around her. Nurses were told not to tell her daughter that the order was the reason. Instead, they said her mother was not the only patient left on the floor, without explaining that the only other patient there was dead.

That man was James Lafayette, a ninety-seven-year-old with Alzheimer’s disease. His son had brought him to Memorial Medical Center’s emergency room before the storm because of a cough. After he was discharged, he spent two days lying on the lobby floor before being admitted. Hours later, Pitre-Ryals found him pulseless in bed. Staff rushed in with flashlights, and a Code Blue filled the room with light and activity. Their extraordinary efforts could not revive him. Pitre-Ryals was distraught: in her five years as a professional, no patient had died unexpectedly on her watch.

Then a man carrying a walkie-talkie told the staff they had to leave the floor. Nobody had come for the woman with the Do-not-resuscitate order. Pitre-Ryals and her colleagues refused to abandon her. She told the daughter that she could request that the order be discontinued. The daughter had approved the order after her oxygen-dependent mother was admitted for the storm, believing resuscitation at age ninety-three would not make sense. Now she drew a distinction between declining resuscitation and being denied evacuation: “When I made my mother a DNR, I did not know it meant ‘do not rescue.’”

Challenging the Meaning of the Order

The daughter asked to cancel the order and told the nurses who had stayed with her mother that they needed to leave, even as she said the hospital was keeping them. Someone went to find a doctor to remove the order. The patient was moved downstairs and out into the parking garage, on the way to the helipad and rescue; she survived her immediate ordeal.

Pitre-Ryals’s role in this episode was not to make the evacuation policy, but to resist its consequences at the bedside. She did not allow the instruction to leave the floor to end her care of a patient for whom no rescuer had arrived. By explaining the daughter’s option to withdraw consent for the Do-not-resuscitate order, she helped make a path to evacuation possible. The contrast between the patient’s original instruction and her daughter’s changed understanding shows how a medical designation could take on a meaning the family had not intended when the crisis altered what was at stake.

Across the two episodes, Pitre-Ryals repeatedly confronts systems that are failing or withholding information: batteries threaten the records, the medication cart locks away supplies, rescue messages meet conflicting instructions, and a patient’s order is used to defer her evacuation without her daughter being told why. Her responses remain concrete—type the notes, carry the phone, suggest lights, stay with the patient, explain the right to cancel the order. Together, they portray a nurse with limited institutional authority but a persistent responsibility to make patients’ needs heard.