‘The Best of Humanity’

Beaufort Memorial departments, off-duty staffers unite to support ER during mass casualty response 

A month ago, in the middle of a rainy Lowcountry night, the mid-shift at the Beaufort Memorial Pratt Emergency Center was drawing to a close.

Then, just before 1 a.m., the unthinkable happened on St. Helena Island as gunshots rang out at a local business.

Law enforcement and EMS responded to the incident, reporting multiple casualties. As the minutes passed and the situation evolved, the Beaufort Memorial Pratt Emergency Center staff members were toe-to-toe with a scenario unlike what many of the nurses had ever experienced.

Staff, prepped by initial reports of only a handful of injuries, were now facing something much different. Alongside support that arrived from those off-duty and across hospital departments, ER staff that night showed their courage, resilience and passion for lifesaving care in the face of tragedy, proving that in a moment of need, we are truly stronger together.

Dr. Saeed Rehman, medical director of the Beaufort Memorial ER and the only emergency medicine physician on duty that shift, put it simply: “Everyone was at their best that night.”

Leading the Charge

At about 1 a.m., patient volume is typically low – which works out, since in-house staff at that time of the night is generally limited, said Kevin Kremer, RN, BSN, CEN, Beaufort Memorial Pratt Emergency Center director.

Dr. Rehman and ER charge nurse Shelby Padgett, RN, were leading the department that night. In the Beaufort Memorial ER, 1 a.m. sees the changing of the guard; the nurses who worked the day’s mid-shift go home. When the report of the incident on St. Helena Island came in, the mid-shift staff was winding down and preparing to leave for the night.

Padgett has been working as a nurse in the ER at Beaufort Memorial since 2021. As charge nurse, she handles staffing assignments and oversees the nurses in the department.

“You’re the team leader and point person for the shift,” she explained. “I oversee the whole department to make sure everything runs smoothly. I coordinate where patients go and help keep things moving as it gets busy.”

Padgett’s critical role evolved quicky in the wee hours immediately after the tragedy. She and Dr. Rehman led a structured response in the ER, communicating clearly and effectively from the minute the report came in.

She wasted no time contacting off-duty staff to bring more support to the ER. Nine staff members, including Kremer and emergency medicine physician Dr. Griffin Salzer, responded to the request for aid. Five mid-shift staff members stayed in the ER to administer care.

Staff from multiple hospital departments also responded swiftly to the need in the ER, and staff worked “seamlessly” from beginning to end.

In the Thick of It

As reports of patients being transported to the hospital rolled in, processes in the ER unfolded quickly.

Glaychia Reber, RN, rushed to the department from her home to respond to Padgett’s call for aid; after getting the message from Padgett, she was on the way and walking into the facility “within 15 minutes,” she recalled.

Amanda Klenk, RN, who has been working at Beaufort Memorial since January 2024, said that the ER that night was “buzzing” when the incident began to progress.

“We all immediately sprang into action,” she described, “preparing rooms, prepping supplies, notifying all departments and saying a silent prayer for a smooth operation that was about to unfold.”

Reber echoed Klenk’s observation, noting that the atmosphere was “tense.”

“Everyone was working; everyone was moving,” she said. “I think in situations like that, where everything is heightened, you look to each other differently. When you pass a coworker, you meet eyes and there’s a wordless exchange that occurs with the words, ‘Are you good?’ and ‘I’m here if you need me.’”

Numbers posed the biggest challenge for the staff that night; the nursing staff and Dr. Rehman didn’t know until they were in the midst of the incident how many patients would be coming to Beaufort Memorial that night.

“I didn’t realize the extent of the incident until I was looking at it face to face,” said Dr. Rehman. “I thought we were going to just get a few patients. I thought, ‘This is getting out of hand; how am I going to get through this?’”

In the span of 30 minutes, support arrived from all sides. Nurses like Reber who arrived from home jumped in to help, and staff from the hospital’s ICU, PCU, radiology, surgery, pediatrics and security departments all pitched in, supporting the administering of care to the wave of patients arriving via both ambulance and private vehicle to the Beaufort hospital.

“When I first learned what was going on, I thought to myself, ‘We can do this, but we’re going to need some more hands,’” Padgett said. “As things progressed, I found myself reflecting on how well my team was handling everything, and how smoothly the ER was operating.”

"As things progressed, I found myself reflecting on how well my team was handling everything, and how smoothly the ER was operating."  Shelby Padgett, RN, ER charge nurse

Throughout the night, Padgett was in constant contact with Beaufort County EMS, the Beaufort County Sheriff’s Office, nurse leadership at the hospital, hospital security and her fellow staff members, she said.

“I tried to ensure everything stayed as organized as possible by making sure that nursing staff and patients had the resources they needed,” she explained. “I felt like it was a constant cycle of figuring things out while facing the next challenge.”

For Beaufort Memorial ER nurses, compassion and commitment to life-saving care is in their blood – no matter what it takes.

Klenk, who was scheduled to go home at 1 a.m., quickly texted her husband that she’d be late and took over administering care to a patient in critical condition. She ended up riding with that patient in an ambulance to MUSC to maintain seamless care and ensure their stability en route to Charleston.

“I had never transported a patient before, so that was all so new to me,” Klenk admitted. “Being inside the ambulance was pretty wild and nerve-racking, but watching the EMS staff function within their own system was awesome and eased a lot of my tension and apprehension.”

A Lasting Impact

Padgett said that while she’s worked a shift following many difficult and tragic events, a mass casualty incident like this one was entirely new for her.

It was Klenk’s first time experiencing a mass casualty event, too.

“It’s something that you’re trained for, but you’re never truly ready for it until you’re in the moment and grinding with the best beside you,” she said.

Over his 29-year career, Dr. Rehman said he has experienced three or four catastrophes like the one the ER responded to early on Oct. 12. Those incidents leave a lasting mark, the physician said.

“Scenarios like that, you can’t forget them,” he said. “They just stay with you.”

Though a mass casualty incident was a new experience for many working that night, the Beaufort Memorial ER saves lives every day. That’s what they’re trained for, Klenk said.

"There's a sense of calm before the chaos, and you do your job. You do what you do every day, what you have been trained for, and that is to provide immediate care to those in need." Amanda Klenk, RN

“Staying calm in a scenario like that is difficult,” she said, describing the initial “jitters” as she anticipated the wave that was about to rush the department. “Then, there’s a sense of calm before the chaos, and you do your job. You do what you do every day, what you have been trained for, and that is to provide immediate care to those in need.”

The staff faced the scenario with courage, empathy and skill, whether they had experience in such a tragic event or not.

“Remaining calm in a crisis is just a core ER nurse trait. It’s a job necessity,” Reber said. “In an overwhelming situation, you lean on your team, rely on your training and experience and get to work.”

Kremer added, “There was no panic – only a calm, professional and focused effort.”

Stepping Up to the Plate

It was “amazing” to see the dedication of the staff during such an incident, and the strong teamwork and support that Beaufort Memorial staff provided each other, Padgett said.

“That night reminded me that our ER team can handle any situation with confidence and compassion while maintaining a calm composure,” she said. “The most memorable part was witnessing how effectively our ER team at Beaufort Memorial came together during an event that none of us had ever faced before.”

The factors at play in the ER that night made for a challenge for nurses and the departments who provided support, but they all rose to the occasion – and then some.

“We were set up for a difficult time, but every single person in that department – as well as EMS – stepped up to the plate and accomplished more than we could have ever imagined,” Klenk said.

Dr. Rehman said that the most difficult thing for the team that night was the number of patients that required care.

“The most challenging part for the first hour was figuring out how to handle such a large number of patients and triage them,” he recalled. “But people in the lab, in the blood bank, in radiology, everyone just banded together to take care of it.”

Humanity at its Finest

Reber said that one of the memories from that night that will stay with her is the connection between her and the patients she cared for that night. They were kind, polite and understanding, she said, and mourned together for the tragic impact the event would have on the Beaufort community.

“We shared the understanding that this whole experience was so wrong and should never happen anywhere,” she said. “On top of safety and patient care, a big part of the job that night was patient comfort and reassurance."

"On top of safety and patient care, a big part of the job that night was patient comfort and reassurance." Glaychia Reber, RN

Afterwards, the ER staff was bursting with gratitude – for their compatriots in the ER who came from their homes to help, for staff offering support from other floors of the hospital, for every ancillary department, for hospital security and for the local law enforcement and EMS responders.

“Truly, I want to thank anyone who showed up that early morning for us,” Klenk said. “Anyone who answered their phones at 1:15 in the morning and drove to the hospital to ensure we provided for our community.”

And as for staff and external agencies who supported the ER that night?

“Someone was there to ensure we had resources and we could provide to those who needed it most,” Klenk added. “Overall, the experience was something that I know my colleagues and I will never forget.”

Dr. Rehman added his thanks for the Beaufort County EMS paramedics and the BCSO and Beaufort Police Department officers who arrived and immediately corded off the ER to ensure order and safety.

“They were a lot of help,” he said. “There were a lot of great people working that night.”

A few days after the tragedy, Beaufort Memorial ER staff and leadership participated in a cross-departmental drill-down discussion, walking through the entire incident from start to finish, highlighting the successes and challenges throughout the response. This after-action debrief, also called a “hot wash,” is a standard process used to assess response and find opportunities for improvement and improving readiness for the future.

The teamwork, skill and commitment to compassionate care in the community’s time of need is something that will stay with the staff and the entire Beaufort Memorial organization.

“Beaufort is a small community, but it stepped up in a big way, and that’s something that changed me profoundly,” Klenk said. “We will do whatever is necessary for our jobs, but also our neighbors. Beaufort Memorial is always here to provide care, whether big or small, to this community.”

That care is a part of the organization’s ethos, shown every day in the courage and dedication of the staff that went above and beyond for their community.

“We saw the best of humanity that night,” Dr. Rehman described. “This is the face of humanity that you want to see. If you’ve lost faith in humanity, you see that, and it just restores your faith."

If a Beaufort Memorial healthcare professional made a difference in your life, show your gratitude through a meaningful gift that not only honors that caregiver, but supports a healthier, brighter future for all.