Nurses play a critical role in ensuring that the healthcare system provides essential services that foster the provision of universal care at state and national level within the United States. Nurse leaders have a great influence in shaping the social policy, education, health practice and support health initiatives that ensure all Americans are entitled to quality care (Ortega et al., 2018). Disaster response and management is among the most essential roles of a nurse leader. In this process, nurse leaders are tasked with pointing out the events that pose the greatest concern for the response. According to Veenema et al. (2017), disasters and mass casualty incidents burden the healthcare system as they create a certain, huge, and unanticipated demand for services, as patients may come in large numbers to a point of interfering with the functionality of the facility. In this case, demand for healthcare services may exceed the facility’s available resources, therefore, interfering with the logistics and the acceptable pattern of operation of the facility (Veenema et al., 2017). Sommer et al. (2013) indicate that a facility should have an emergency operating plan, tested twice each year, that provide training for the staff on each aspect of the plan. The plan indicates the responsibilities of each personnel in an emergency situation, interfacing the local, state, and national agencies to provide the required resources to respond to the situation. Therefore, nurse leaders are required have competent leadership capacities to make complex and rapid decisions and make effective and timely response to implement the emergency operating plan and manage disasters. These decisions are made in the absence of complete information on how the facility will allocate its scarce resources to respond to the disaster.
Importance of Disaster Response to Nursing
The need for care when a disaster occurs is different from the day-to-day operations within the healthcare facility. Nurses are always required to make quick response and offer additional services to counter such emergency issues. Therefore, when nurse leaders are prepared and have the relevant skills to respond and manage a disaster, nurses receive the required disaster education on important aspects including the expectations of the public and the hospital providing care, understanding their special roles during care, role conflicts, and self-management of such issues as disaster drills, core competencies, preparedness, and training (Grochtdreis et al., 2016). Understanding the key roles of nurses in disaster management is therefore important for the nursing sector. This will guide the sector to recognize nurses as the key players in the response, and therefore integrate education on disaster response and management in the curriculum. When nurses are aware of the stressors, the work environment, and have both personal and professional preparedness, the healthcare sector will be in a better position to adequately handle and manage a disaster, therefore saving lives. Further, addressing the disaster response and management will guide the nursing sector to document special roles of each nurse during the disaster, and equip them with sufficient education and training to improve their skills and competencies, and avoid role conflicts.
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The nursing sector will be guided to develop state and national disaster competencies to complement the basic knowledge and skills that nurses receive in their basic nursing curriculum. Grochtdreis et al. (2016) indicate that nursing sector should give special attention during and after the disaster to the work environment, stressors and the feeling of nurses, to raise their willingness to take part in the disaster process and document national directives and concepts that clearly dictate the role of each nurse during the process. The nursing sector will therefore direct the nursing educators to adjust the nursing curriculum and integrate the need for additional education and training in disaster nursing. This will improve the nursing competencies and foster their preparedness to respond to any disaster in an appropriate and professional manner.
Impacts of Disaster Response to Nursing Practice
Considering the devastating implications of a disaster on individuals, families and the government, disaster response and management plays a critical at local, state and federal level. Nurses are required in such times to reduce the risk of the disaster, and provide response and recovery services to the community (International Council of Nurses, 2019). Therefore, nurses put in practice their skills and training in emergency response and disaster management in such situations. Applying these skills are important for the nurses to reach out individuals and families within the community affected by the disaster, provide them with the basic healthcare services and help them recover from the disaster. Further, disaster preparedness enables the healthcare sector to prepare and adequately respond to the upsurge in the need for the healthcare services as a result of the disaster (Veenema et al., 2017). In this way, they will be in a better position to put aside emergency response resources and facilities to counter such issues as mass casualty incidents so that the implications of the disaster will not interfere with the normal operations of the facility.
Further, creating awareness on the disaster preparedness, response, and recovery and developing emergency response and preparedness plans ensures that nurses and all stakeholders involved in an emergency situation, including the community, the health department, law enforcement agencies, and other partners understand the complexity of disaster management and competencies for successful planning and implementation (Rafferty-Semon et al., 2017). Nurses, through their nursing educators, may also receive training on core competencies of disaster management, including provision and promotion of sustainable health to the community. As they receive such knowledge, they learn, understand, and put to practice the critical phases of the disaster preparedness, response and recovery. Nurses also improve their skills and competencies as they engage more and more in disaster response and management situations, and this will prepare them to offer better services in the future as they advance with their career. In addition, application of different distance response and management plan increases the available content related to disaster nursing and roles of nurses. This increases the opportunities for nurses to learn and improve their skills and competencies in nursing, therefore fostering improved patient care.
One of the challenges of disaster response and management is the different styles and curricula applied by nursing educators. This means that nurses will receive diverse skills and competencies following the variation in content, concept, and chosen competencies. In addition, healthcare providers may train their nurses on a particular approach to disaster management, such that if a nurse changes the workplace environment, it will be difficult for him/her to adapt to the new culture of disaster response and management. Rafferty-Semon et al. (2017) illustrates that nurse educators, and some healthcare providers may tend to provide education and training to nurses by applying the traditional approach of using objective testing, classroom discussion, or case studies to deliver content on the disaster preparedness, response and recovery. Such an approach would be less practical in countering a disaster. Rafferty-Semon et al. (2017) further recommends the use of more active and engaging learning methods, where nurses and student nurses get a realistic exposure to disaster response and management through virtual reality, inter-professional education, and simulation.
Impacts of Disaster Response to Patient Care
International Council of Nurses (2019) requires nurses to actively involve themselves in developing and implementing policies on disaster risk reduction, response and recovery, as well as advocate for the policies to be adopted at national and international levels. By doing this, nurses advocate for quality patient care by promoting strategies that foster the equity of access of required social and healthcare services among all patients. In addition, distance response and management may train and equip nurses to active engage themselves, in conjunction with the government agencies and other bodies, to prepare in advance for the implications of the disaster and evaluate impending risks and vulnerabilities of the disaster such that upon occurrence, the impact of the disaster and the number of causalities will be significantly reduced (International Council of Nurses, 2019). Through this, healthcare sector will evade the risk of mass casualty incidents, such that the scarce resources within the facilities will be used to manage and treat the few casualties, hence improving patient care. Further, proper disaster response and management plan ensures that the government and the healthcare providers put in place enough resources to handle the basic needs of the nurses and the casualties in the event of a disaster, including food, shelter, water, protective equipment, and incentives that motivate the nurses to address the situation appropriately (International Council of Nurses, 2019).
However, in some cases, a disaster could bring huge impacts beyond the capacity of the healthcare to handle, for example, in the rise of a global pandemic such as the Corona Virus Disease, or a natural disaster such as an earthquake. In such cases, many causalities may be reported to an extent that the available resources are not enough to manage them. To respond to such situations, nurses will be required to make very critical decisions that may not favor patient care. Sommer et al. (2013) indicates that the principles of mass casualty triage should be applied by healthcare practitioners in the event of mass casualty incident. In such cases, casualties are put categories with respect to their chance survival (Sommer et al., 2013). Medication is then provided according to these groups, for the facility to do the greatest good for the better number of causalities (Sommer et al., 2013). Therefore, the principles of the day-to-day healthcare operations, that entitle each patient to quality care, are not followed, thus interfering with patient care. In addition, nurses undergo different stressors during these times as they have to attend last to casualties with smaller chances of survival. This may lead to the development of a post-traumatic stress disorder among the nurses. Such cases may also interfere with the International Council of Nurses (2019) statement that requires nurses to advocate for the continued care needs of people suffering from disabilities, injuries, communicable and non-communicable disease, and mental health needs, with close attention to more vulnerable groups.
Lessons
The most important lesson is that healthcare facilities should have an emergency operating plan that integrates all stakeholders of disaster response and management, and is tested at least twice to keep the plan up-to-date, and to continuously improve the preparedness, response and recovery strategies (Sommer et al., 2013). Secondly, in an event of a disaster, healthcare facilities can go against the principles of triage, where each patient is provided with quality care, and adopt the principles of mass casualty triage, where all causalities are grouped together basing on their chances of survival, and giving priority treatment to the groups with higher chances of survival (Sommer et al., 2013).
Application
The research on disaster response and management has equipped me with insights on preparedness, response and recovery operations when managing a disaster. These insights are important for my nursing practice since upon occurrence of a distance, I will have the basic knowledge to handle the situation and help the healthcare sector save lives. I now understand that an emergency operating plan is essential for any healthcare facility as an important element of disaster preparedness, response and recovery, and would therefore advocate that any healthcare facility should have one, which is kept up-to-date to improve its strategies.
Conclusion
Nurse leaders ought to have competent leadership capacities to make complex and rapid decisions and make effective and timely response to implement the emergency operating plan and manage disasters. These decisions are made in the absence of complete information on how the facility will allocate its scarce resources to respond to the disaster. Appropriate disaster preparedness and training helps mitigate the immensity of disaster outbreaks,
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