After a winter of near record snowfall and a very wet Spring in Cedar Rapids, Iowa was at risk for record flooding in June.  On June 12^th the city was preparing for the crest to be above the 100 year flood plain.  Mercy Medical Center is ten blocks from the river and outside even the 500 year flood plain, but was taking precautionary measures.  The morning of June 12^th at 8:15 am during a unit meeting we experienced a power failure.  The switch to emergency power was delayed and we immediately knew something was very different.  Elective cases were cancelled.  There were a series of meetings to keep the management team informed.  There were also several communications to staff.  As the water kept rising the level of response escalated.             Over the next 12 hours the decision was made to evacuate all patients from the hospital.  The evacuation started at midnight and all 176 patients were transferred to surrounding areas facilities by 7:30 am.  There was no protocol or policy manual to follow for the role of the manager during this process.  The manager found herself being the support and guide for staff and patients as they experienced this frightening event.  The unit stayed closed for ten days.  During this time the manager found herself being the primary support and guide for a staff of 60.  This was a 24 hour job with constant phone communication.  The responsibility had a cumulative effect, with the emotional and physical toll causing extreme fatigue with no rest in sight.             The hospital went through a series of steps to re-open.  This involved close communication with the Department of Inspections and Appeals and JACHO.  Each unit developed checklists to complete before being allowed to re-open.  The manager kept in close communication with the medical director.  Once re-opened patients had to be reassured that the hospital was once again a safe environment for them to come to have their baby.             Throughout the experience the manager’s role was one of guide, support and role model.  There were staff who had lost their homes and everything they owned.  During the flood staff had to find alternate, circuitous routes just to get to the hospital.  Everyone was going through an upheaval of their normal work day along with the upheaval in the community.  The manager had to be the one stabilizing force.              There are many stories to share to help describe and define the human suffering that occurs during a disaster of this magnitude.  Telling the stories is the best way to begin to understand how to prepare and react.