Critique on Challenges in Disaster Nursing
Introduction
Nursing has always been needed far more beyond the four
walls of the hospital, particularly in disaster hit areas of the world.
Consequently, nurses need to know the what, when, who, why’s and how’s of
handling people who are in dire need of basic healthcare during disasters.
Therefore, this paper will review 5 related articles and argue on the essential
challenges faced by nurses during disaster nursing.
Review
There are various
articles in hand that describes the myriad of challenges faced by nurses on
site where disaster had taken place. In the research paper done by Zhou,
Turale, Stone and Petrini (2015), the importance of acquiring essential skills
in nurses during disaster is reviewed where the nurse’s incompetence in
disaster events due to lack of exposure to disaster situation is highlighted.
The narrative interview conducted with 12 participants who have encountered
disaster situations resulted in the finding where the lack of knowledge,
skills, communication and psychological support have placed disaster managing
nurse at a disadvantage. Therefore, to ensure nurses are competent,
continuous
nursing disaster training and simulations are required. Besides that, in
another study by May, Colbert, Nara-Venkata, Rea and Wood (2015), the
preparedness of nurses and training of staff in response to disasters is also
greatly supported where in this case the study focuses on the burn mass
disaster I Western Australia specifically. Of the 6-question survey that’s
handed out to 310 staff involved in the response to the burn mass disaster,
only 144 surveys were completed and it is found that a majority of staff
involved in the disaster received formal training where nurses were more likely
to participate in hospital based exercises than doctors. The study also
believes that a continued training in formal disaster and practical exercises
in mock disasters should be ongoing for all staff. Relatively, in a descriptive
correlational design study of 406 nurses, the preparedness and core
competencies of nurses in Turkey were studied and it is found that Turkish
nurses are competent in one area than the other and there are clear gaps in
disaster preparedness. Hence, a formal training in disaster training through
regular hospital exercises should be implemented to advocate all nurses to be
better prepared in disaster response. On the other hand, Noh, Geum Oh, Sun Kim,
Soo Jang, Soo Chung and Lee (2018) delved deeper into the heart of training
programmes by using a 3 round Delphi survey method to collect and analyse the
results of 50 surveys handed out to emergency physicians and nurses involved in
disaster training. It is found that to implement disaster preparedness training
for nurses, the specific standardized method with relevant component and best
practice curriculum for training content should be implemented for better
understanding and retention of disaster preparedness. 
Consequently, Usher, Redman-McLaren, Mills, West, Casella,
Hapsari, Bonita, Rosaldo, Liswar and Zhang (2015) studied a tailored research
capacity building course where 23 delegates of Emergency and Disaster Nursing
Network from 19 countries attended a 3 week course where they learn and taught
about investigating nurses’ preparedness for disaster response. It is found
that a formal mentoring relationship among experienced and less experienced
nurses can be established in preparing for disaster response.
Evaluation
Zhou, Turale, Stone and Petrini (2015) found that the lack
of exposure to disaster situations primarily contributes to nurses’
incompetence on field. Furthermore, they identified that the lack of knowledge,
skills, communication and psychological support have placed nurses in disaster
areas in disadvantage. Hence, the best way to learn disaster nursing is through
exposure to such areas. However, despite the high awareness of the need for disaster
preparedness, the opportunities to gain experience and training are limited
according to Noh, Geum Oh, Sun Kim, Soo Jang, Soo Chung and Lee (2018) based on
their study. Besides that, its’s also difficult to cater to a large number of
nurses for disaster preparedness. Nevertheless, we could still tap on the
available resources at hand in the context of disaster preparedness. In other
words, senior nurses who are experienced and have been on medical missions in
disaster stricken areas could teach and guide the less experienced nurses,
acting as a platform for learning and growth. As Usher, Redma-McLaren, Mills,
West, Casella, Hapsari, Bonita, Rosaldo, Liswar and Zhang (2015) describes in
their study, formal mentoring relationship have a significant impact in
creating a collaborative shared experience among nurses to learn from as
they’re guided on what to expect and how to perform in a disaster stricken
area. On the other hand, it also can’t be a one-time programme and instead such
trainings should be conducted consistently throughout timely basis. Ongoing and
continuous disaster planning and training among nurses in a healthcare settings
such as the hospital, is believed to be one of the most crucial factor for an
effective learning outcome based on the study conducted by May, Colbert,
Nara-Venkata, Rea and Wood (2015). This is further supported by Taskiran and
Baykal (2019) where they concluded that regular evaluation of nurses’ disaster
training and exercises is important to advocate for increasing disaster
response for all nurses.
Discussion
It is of utmost important for any healthcare worker to
comply to the specific standards in the realm of patient care as the risks for
potential legal challenges are always high. Under the ICN framework of
prevention and mitigation competency, it’s vital for nurses to recognize the
risk reduction and disaster prevention by first collaborating with other
professionals and leaders to reduce risks and vulnerability of people (ICN
Framework). In fact, health care workers in general have to comply with legal
responsibilities according to federal, states and local contexts (Neil, 2014). In
order to achieve compliance, healthcare providers and legal expert must
understand each other’s responsibilities so they can collaborate together and
prevent litigation (Neil, 2014).
Conclusion
In conclusion, nurses who make up the majority of healthcare
workers in hospitals should be properly trained and prepared in disaster
response to better cater to the need of people in vulnerable situations. In
order to achieve a comprehensive goal of effective disaster preparedness among
nurses, the hospital, government and all healthcare institutions must cooperate
together and collaborate on planning and implementing quality training
programmes at an early stage and continuously support the learning and growth
of healthcare workers in line with the technological advancements. As Helen
Keller once said, “alone we can do so little, together we can do so much”
By Jessica John Posko 💗
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