Managing Disaster
Nurses are at the forefront of managing disasters in their communities and facilities. Knowing the cause and location of the disaster will help determine the appropriate response. Disasters are defined by an event or situation that overwhelms the capacity of a community to respond due to the magnitude of loss such as economic, environmental, loss of life, property, or infrastructure.
John has prepared himself to meet the demand of incidents that could occur by participating in training that the local emergency management professionals provided. Preparation of nurses for disasters involves formal training and practice during disaster drills to test skills and leadership abilities under pressure. Triage is the sorting out of patients to be seen based on level of injury. In disasters, the emphasis in triage changes from ordinary circumstances. Tools for preparation of a potential disaster include:
- Education in disaster management (namely, life-saving skills such as CPR, first aid, and advanced trauma life support are critical classes for emergency nurses)
- Triage training in disaster management
- Familiarity with facility disaster plan (i.e., structure, staff roster, and forms for assignments)
- Knowledge of the location of needed equipment and how to use it
- Knowledge of personal protective equipment (i.e., gloves, gowns, masks, and PAPRS)
- Teamwork is crucial to meet the needs of those involved in a disaster incident
Five blocks away from the ER, an explosion changes everything for John and the staff. Patients and families will be streaming into the ER, a high-level disaster is called hospital-wide for more clinical staff to assist.
Communication is top priority. Sending a clear, direct message and listening to the response is a process that can save lives, including your own. Keep all of those in your care informed and if you don't know something, it's alright to express that.
You will not be able to care for others well if you are in need of food or a bathroom break. Teamwork is all about helping one another and looking out for each other. If the staff is worn out and has had no food that could be a problem for safety.
There are several essential tools for responding in a disaster. They include things like the following:
- Life-saving tools such as CPR or other advanced training for critical care of injured patients
- A unit-specific disaster manual for resources and assignments
- Leadership - Know who is in charge. Leadership is responsible for setting up a command center.
- Be ready to give emotional support to patients who may not be able to process what has happened.
- Know who to call in the community for back-up, for instance, public health, community social services, and Red Cross if needed.
John already has a plan in place for assisting patients and families with assistance and home care to follow up after discharge from the ER. Disaster recovery begins before the first patient arrives for care. Planning for ongoing medical surveillance for disaster victims and families will aid in the recovery process, including mental health status of patients and families will be vital to care. Making an assessment of what worked and what did not work is an important learning tool and can help refine the disaster management program for nurses. Mistakes can be corrected by reviewing the nursing responses and review of the event.
Mitigation involves the prevention of disasters or the actions that would lessen the impact of the events. Nurses can help reduce the impact by being prepared for disasters and informed regarding current events. If there is a possibility of a second wave of disasters, plans should be in place to help nursing staff be prepared with additional resources.
Before another event, John will meet with staff to formulate changes to the disaster plan that will lessen the impact. Asking the question, ''How can we improve next time?'' is a great place to begin the mitigation process.
Lesson Summary
Disasters are defined by an event or situation that overwhelms the capacity of a community to respond due to the magnitude of loss, such as economic, environmental, loss of life, property, or infrastructure. These events are events that overwhelm the ordinary staff and resources. Nurses are at the forefront of disasters and take an active role in management of the event. Training and disaster drills are two ways to help prepare nurses to meet the patients' and families' needs. Nurses are responsible to learn about the risks and their role in a real disaster by knowing the location and content of the disaster manual.
The process for disaster management combines preparation, response, recovery, and mitigation. Nurses can be prepared to meet the challenges by education in disaster management and by participating in disaster drills to test the plan and nursing response. Responding to disasters takes a well-trained teamwork approach, bringing life-saving skills to the event and providing emotional support to patients, families, and staff. Triage is assessment and priority of the injured patients and is a vital role of the nurse.
Recovery takes time and close observation of patients and families. Assessment and early intervention can make a huge difference in the lives of disaster victims. Follow-up care is essential. Community resources are a great place to start.
Mitigation is the prevention of the disaster or lessening the impact of the event on a community. This takes a team approach to evaluate what could happen and how to respond to it. Nurses can advise where changes are necessary.
Medical Disclaimer: The information on this site is for your information only and is not a substitute for professional medical advice.
