Disaster nursing is the systematic use of specific knowledge and skills to reduce life-threatening harm caused by disasters. From mitigation and preparedness to response and recovery, nursing officers play roles as clinicians, communicators, coordinators, leaders, and psychological supporters. Every nursing officer must be aware of their roles and disaster management planning, because a disaster can happen to any person, place, or nation.
Nusrat Manzoor
Disaster nursing is the application of professional nursing knowledge, skills, and attitudes to recognise and meet the nursing, health, and emotional needs of disaster victims. Disaster nursing is the systematic use of specific knowledge and skills, in collaboration with other disciplines, to reduce life-threatening harm and health-related hazards caused by disasters (Jennings-Sanders, Frisch, & Wing, 2005).
According to Powers and Daily (2010), the main aim of disaster nursing is to “ensure that the highest achievable level of care is delivered through identifying, advocating, and caring for all impacted populations throughout all phases of a disaster event, including active participation in all levels of disaster planning and preparedness.”
Earthquake disaster nursing is the art of care delivered under conditions of limited resources by using knowledge, skills, and judgment related to earthquake disasters, and cooperating with other rescuers in order to help and reduce loss and harm to people and their livelihoods caused by unpreventable elements. Rescue and psychological comfort are two important aspects for nursing officers in earthquake disaster relief. In order to respond to earthquake disasters effectively, nursing officers must possess competencies related to earthquake disaster nursing.
For effective management of disasters, different phases have been described. The International Council of Nurses (ICN) described disaster management phases as the pre-incident phase (mitigation and preparedness), the incident phase (response), and the post-incident phase (recovery and rehabilitation) (ICN, 2009).
Roles Of Nursing Officers In Earthquake Disaster
The role of nursing officers during a disaster situation differs greatly from their daily routine work, as nursing officers have to work with limited resources. It has been emphasised that regardless of the setting in which nursing officers work, every nursing officer must be aware of their roles, basic knowledge regarding disasters, and the disaster management planning of their respective countries to get prepared for disasters, because a disaster can happen to any person, place, or nation. Nursing officers play a great role from the mitigation phase until the recovery phase (ICN, 2009).
Mitigation/Prevention Phase
Nursing officers working in the mitigation phase have the responsibility to prevent and minimise the risks of health hazards associated with disasters. Their role in the prevention and mitigation phase begins with identifying risks at both the individual and community levels. Nursing officers can work in collaboration with other health professionals to reduce the identified risks. In addition, nursing officers help communities to identify their needs in order to determine the existing condition of disease and health facilities, along with the identification of high-risk populations, such as those with mental health problems, chronic disease, or disability.
Nursing officers help to plan for the evacuation of health facilities and the relocation of patients as necessary by collaborating with community leaders and other healthcare providers.
Preparedness Phase
Planning and preparedness activities performed before a disaster are included in this phase. The preparedness phase involves the assessment and evaluation of potential vulnerability in order to design and prepare structures for disaster response before a disaster occurs. The main role of nursing officers in the preparedness phase is to assess the community’s vulnerability to earthquakes. For instance, nursing officers obtain information about vulnerable populations (children, pregnant women, the elderly, and the disabled) in their respective communities in order to prepare and protect them from disasters. In addition, nursing officers play a great role in planning the structure for earthquake disaster response with the help of other disaster team members.
A health educator is another role of nursing officers, helping community people to prepare for earthquake disasters. For example, nursing officers as health educators teach and help community people and their families to prepare a family disaster plan, which includes a disaster kit and other essential equipment to respond to disasters effectively. Moreover, a nursing officer can be a trainer to prepare community health volunteers in various disaster management topics such as triage, first aid, and effective transportation of victims.
Response Phase
In this phase, nursing officers and other healthcare members make efforts to minimise the health hazards created by earthquake disasters. In fact, it is the actual implementation phase of disaster planning, which focuses primarily on relief activities such as saving human life, triage, providing first aid, care, and basic life-supporting needs to victims. Nursing officers, as first responders, are actively involved in health responses in various earthquake disasters. During the earthquake response phase, most nursing officers work in local hospitals, evacuation centres, and nursing homes in earthquake-affected areas.
First and foremost, nursing officers act in a clinician role at the earthquake disaster site, where they provide mass casualty triage, transportation, first aid, intravenous insertion, bandaging, homeostasis, cardiopulmonary resuscitation, and so forth, as well as providing continuity of care to vulnerable populations. Nursing officers during earthquake response work as communicators with other healthcare professionals as well as their colleagues for the effective transportation and management of victims.
A coordinator is another role of nursing officers in earthquake response, in which they coordinate patient care through careful handling and movement of patients from one area or hospital to another disaster area or hospital. For nursing officers who have the responsibility to lead and coordinate healthcare teams for effective and managed care to patients, leadership is an essential role. In addition, establishing effective communication routes, collecting complex information, and coordinating with local hospitals are roles for the leading nursing officer during an earthquake disaster. Moreover, nursing officers become psychological supporters whose role is to provide psychological first aid to both directly and indirectly affected victims.
Additional specialised nursing roles are essential to provide continuity of care to patients during an earthquake. These roles include infection control, perioperative care, neonatal care, and oncology care.
Recovery/Rehabilitation Phase
After a disaster, individuals, communities, and the nation need to return to their normal state, and recovery actions help to do so. Rehabilitation efforts help to overcome the long-term effects caused by disasters to individuals, communities, and the nation. Before attempting recovery actions, nursing officers need to assess ongoing community needs and have accurate data about the population in order to determine effective interventions for the best possible outcomes.
In addition, after an earthquake, people face different physical, psychosocial, and emotional impacts, which may be long-term and require the support of the healthcare team. For instance, earthquakes result in traumatic injuries such as brain injuries, spinal cord injuries, musculoskeletal fractures, and crush injuries. Vulnerable groups such as women, children, the elderly, and the disabled are at greater risk than other people and need long-term continuity of care as well as rehabilitative care. Therefore, nursing officers play a major role in providing continuous rehabilitative care to these patients.
A psychological supporter is another role of nurses, helping earthquake victims who experience feelings of severe hopelessness, anxiety, depression, and grief in the post-traumatic phase. Moreover, additional roles in the recovery and rehabilitative phase include public health surveillance, screening, infection control, and health promotion through health education.
The writer is a Nursing Officer
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