Call for Disaster Preparedness Specialty Loudens After Orlando Attack

The June mass shooting at a nightclub
in Orlando, Florida, highlighted the
potential need for a specialty in
disaster preparedness in nursing.

Sue Anne Bell, PhD, RN, FNP-BC, clinical associate professor at the University of Michigan School of Nursing and a member of ENA’s Emergency Management and Preparedness Committee, incorporates disaster preparedness into her curriculum.

“One big challenge in undergraduate nursing education is we tend to focus more on the individual patient rather than the community at large,” Bell said. “Students also have so many requirements, and focusing on a theoretical disaster rather than a practical skill is a challenge.” Yet she insists it’s also a priority to teach the next generation of nurses to prepare for any hazards, be it an active shooter, a technological disaster or a natural catastrophe.

Training Resources
She has noticed an uptick in graduating students seeking a
disaster management role in an emergency department or
critical care setting.

Bell advises interested students to volunteer with their local Red Cross chapter or become involved at the hospital level on its emergency preparedness committee. Her own introduction to the emerging specialty was acceptance to a disaster medical assistance team, a federal entity composed of medical personnel and designed to be a rapid response element until federal or contract resources are mobilized.

“A strong point I always make to new grads and nursing students
is to complete the National Disaster Life Support certification
courses and get involved in DMAT,” Bell said. “DMAT’s application
standards are rigorous. It’s a federal appointment requiring a
security clearance, and you’re regarded as federal employees
upon deployment.”
Adopting a Boy Scout’s Mentality
Regardless of certification, the need for mass casualty
preparation is a reality for any nurse.

“In Orlando, one of our greatest assets goes back to why we went into nursing – bringing care and compassion to the city and individuals,” Bell said. “After that, nurses can bring preparedness at the institutional level through drills, mock disasters, simulations and certifications.” The tenets of disaster nursing are mitigation, preparedness, recovery and response. Mitigation and preparedness ideally should be a daily part of patient encounters, Bell said, whether that’s familiarizing patients with www.ready.gov or inquiring about their family communication plans and readiness kits. She said an excellent read is Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital, which describes nurses’ preparedness activities, including nurses who organized their own families’ safety in advance so they could care for victims of Hurricane Katrina.

As speculation increases about the possibility of an attack
targeting hospitals, Bell urged nurses to familiarize themselves
with ENA’s workplace violence documents.

“It takes an incident to bring awareness,” she said. “Typically, we focus on preparation, and there’s a quiet period in the media. Without attention, support for implementing programs disappears. After a disaster, everyone wishes they were more prepared. If we can reach a sustainable level, that’s key to success.” By Robin Hocevar

ENA Connection Contributor

The lack of consistency in how colors are applied to hospital emergency codes throughout the U.S. can cause confusion, especially if emergency nurses and other healthcare personnel move to another facility with different codes. The inconsistencies can have serious consequences, explained Hovey.

“You can get confused if you call a code gray for a lost, elderly patient, when you meant to call a code silver for an active shooter, because you’re not sure of the colors,” she said.

Hovey added the committee hopes this position statement will
spark interest and discussion among various stakeholders, including
hospitals, The Joint Commission, the American Hospital Association,
“We need some structure and we all need to be on the same page,”
she said.

Hovey praised her fellow committee members for their “wealth of knowledge” and said she felt privileged to serve as the 2016 EMPC chairperson. “It’s my opportunity to contribute, and that is what we as emergency nurses do. Our compassion so many times is what sustains the people we care for.” n