DISASTER-NURSING-PRELIM

Introduction to Disaster Nursing

  • Definition of Disaster:

    • A serious disruption of the functioning of a community or society due to hazardous events interacting with conditions of exposure, vulnerability, and capacity, leading to losses.

    • Examples include human, material, economic, and environmental impacts. (UNISDR, 2017)

    • Can result from ecological breakdown necessitating extraordinary efforts to cope, either through community action or international aid.

Disaster Nursing

  • Definition:

    • Nursing that adapts professional knowledge, skills, and attitudes to meet the physical and emotional needs of disaster victims.

Goals of Disaster Nursing

  • Prepare nurses physically and psychologically for disaster response.

  • Assess preparedness in terms of:

    • Knowledge about disasters.

    • Skills competencies for disaster response.

  • Develop self-confidence and self-efficacy in disaster preparedness.

  • Enhance psychological preparedness through improved mental well-being.

Historical Perspectives

Key Figures in Disaster Nursing

  • Florence Nightingale:

    • Functioned as a disaster nurse during the Crimean War.

    • Wartime care is akin to disaster health care due to overwhelming needs versus available resources.

  • Clara Barton:

    • Provided care during the Civil War and founded the American Red Cross in 1881.

    • Pioneered volunteerism for disaster assistance.

  • The 1918-1919 Flu Pandemic:

    • Overwhelmed healthcare systems, leading to alternate care sites due to nursing shortages.

    • The need for quick adaptation by nurses was vital to care.

Principles of Disaster Nursing

  1. Rapid assessment of situations and nursing care needs.

  2. Triage and initiation of life-saving measures.

  3. Selective use of essential interventions by eliminating non-essential activities.

  4. Adaptation of necessary skills for disaster environments.

  5. Evaluation of the environment to mitigate health hazards.

  6. Leadership in patient care coordination.

  7. Teaching and supervising auxiliary personnel.

  8. Providing emotional support to victims and families.

Types of Disasters

Natural Disasters

  • May cause mass casualties and include:

    • Tornadoes, hurricanes, floods, avalanches, tidal waves, earthquakes, volcanic eruptions.

Man-Made Disasters

  • Involves human intent or negligence including:

    • Crime, terrorism, biological/chemical threats, war.

Phases of Disaster Reaction

Phases of Psychological Reactions during Disasters

  1. Threat Phase:

    • Pre-impact conditions affecting the community.

  2. Warning Phase:

    • Official notice of an impending disaster; survivors feel vulnerable.

  3. Impact Phase:

    • Destruction affects survivor reactions.

  4. Heroic Phase:

    • Altruistic responses among helpers and survivors.

  5. Honeymoon Phase:

    • Early optimism with government assistance.

  6. Inventory Phase:

    • Recognition of limited resources; optimism wanes.

  7. Disillusionment Phase:

    • Feelings of abandonment as aid diminishes; frustration with bureaucracy.

  8. Recovery Phase:

    • Rebuilding physical and emotional aspects of communities.

Disaster Levels (Goolsby and Kulkarni, 2006)

  • Level I:

    • Local capacity can effectively manage the event.

  • Level II:

    • External assistance required from nearby agencies.

  • Level III:

    • Major disaster needing state or federal aid.

Characteristics of Disasters

Key Factors Affecting Disaster Impact

  • Intensity of Impact:

    • Higher intensity leads to greater emotional distress.

  • Impact Ratio:

    • Larger affected populations limit available support.

  • Potential Recurrence:

    • Risk of future hazards increases anxiety.

  • Social & Cultural Aspects:

    • Disasters disrupt cultural identities and social structures.

Key Elements

  • Hazards:

    • Potential sources of harm.

  • Vulnerability:

    • Inability to withstand hostile environments.

  • Capacity:

    • Community resources to mitigate disaster effects.

Immediate Reactions to Trauma

Reactions of Adults

  • Physical Symptoms:

    • Dizziness, agitation, gastrointestinal distress.

  • Behavioral Symptoms:

    • Sleep disturbances, increased substance use.

  • Emotional Responses:

    • Shock, grief, anxiety, anger.

  • Cognitive Impacts:

    • Confusion, decision-making difficulties.

Reactions of Children

  • Younger Children (1-5 y/o):

    • Anxiety, sleep disturbances, regression.

  • School-Aged Children (6-11 y/o):

    • Growth in safety concerns, anger.

  • Adolescents:

    • Detachment, anger, shifting relationships.

Communication During Disasters

Importance of Effective Communication

  • Essential for connecting with family, support systems, and first responders.

  • Helps coordinate responses and prevent panic.

Tools and Systems

  • Disaster Management Information System (DMIS):

    • A software database using GIS to inform decision-making during disasters.

  • Communication Tools:

    • Mobile apps, social media, and traditional media like TV and radio.

Major Roles of Nurses in Disasters

  • Assessment of disaster magnitude.

  • Identifying health needs and public health problems.

  • Collaborating with organizations and managing communication.

Preparedness Exercises

Importance of Mock Drills

  • Simulate disaster responses to test readiness.

  • Identify and address potential errors in plans.

  • Enhance coordination among disaster response teams.

Types of Exercises

  • Discussion-Based:

    • Familiarization with plans and policies.

  • Operation-Based:

    • Validate plans and clarify roles.

Evaluation of Disaster Plans

  • Continuous review and testing through drills and feedback from exercises.