Public Health Nursing and the Disaster Management Cycle, Coursework Example

Introduction

The ability of a community to respond to a disaster requires an effective understanding of the nature and scope of the events leading up to, during, and after the disaster in order to determine the best possible approach to manage its aftermath and to be proactive in meeting the needs of the local population. One of the critical aspects of the process is to exercise strong control over the circumstances and to be effective in communicating the vision to overcome the challenges related to the community during this time of serious need. In this capacity, nurses play a significant role in determining how to best approach the situation using their existing skills and knowledge to benefit the situation in a positive manner. This process will demonstrate the importance of developing new ideas that will work creatively within the context of the situation so that nurses provide an optimal contribution to the situation and its immediate needs.

The response to the disaster is a significant component of the process and requires a high level of support and acknowledgement of the different needs and expectations of the community to overcome the disaster effectively and to minimize the damage as much as possible. This process supports a greater understanding of the different needs and expectations of the role of nurses in this process and how to best manage the disaster, using the tools and resources that are available. The following discussion will address the role of nurses in managing a disaster in greater detail and will emphasize the value of the response to a disaster in supporting the changes that are required and the opportunities that are available to support community residents as they struggle with the circumstances of the disaster.

Body

With every disaster, there are always opportunities to learn new lessons that will aid in managing future disasters and their outcomes. There are considerable efforts required to ensure that a community is prepared to manage the outcomes of a disaster and that there are sufficient opportunities to manage the disaster effectively through its community and public health nursing personnel. It is known that “public health nurses are integral members in emergency operations and command centers, in leadership and management roles, as well as in the field where they provide front-line disaster health and core public health services…one of the most exciting challenges for public health nurses…is to collaborate with other emergency workers from other disciplines to enhance the emergency response infrastructure at the local, regional, state, national, and global levels” (Jakeway, LaRosa, Cary, & Schoenfisch, 2008). This practice enables public health nurses to have a true voice in the direction of the community response to a disaster and in supporting a new direction in order to accomplish the intended objectives in managing the disaster as effectively as possible (Jakeway et.al, 2008). From this perspective, it is likely that the people of Ruby Lake would benefit from the work that public health nurses perform and would be active participants in the development of a strategy to accommodate the needs of the local community in the aftermath of a disaster (Jakeway et.al, 2008). This practice requires an effective understanding of the different elements which support the critical nursing elements of compassion, care, and treatment that are required in any circumstance, and in particular, after a disaster has taken place (Jakeway et.al, 2008). This practice requires a high level understanding and focus on the elements that may be effectively controlled through public health nursing and the areas in which there may be opportunities to expand current activities to accommodate those who are directly affected by the disaster (Jakeway et.al, 2008). It is of considerable importance for public health nurses to utilize the resources that they have at their disposal in an effort to improve the disaster response and to better understand their responsibility to the affected population and how it aligns with the work of other agencies who are also contributing to the effort (Jakeway et.al, 2008).

Communication Procedures

In an effort to streamline activities and to optimize the benefits of the services that are available, public health nurses must serve in a role that is conducive to an effective set of outcomes that will have a lasting impact on local residents who are affected by the disaster. In this context, communication must be precise and appropriate to ensure that local residents receive the news and information that is required to facilitate an effective response to the disaster, while also learning how to manage the immediate aftermath and the population that has been affected (Plough et.al, 2013). Most importantly, communication between public health nurses, other personnel, and residents must be clear and concise in order to improve the response time and effort to the disaster in an effective manner (Plough et.al, 2013). It is necessary to evaluate the lessons that have been learned throughout history and from other disasters that will have a lasting impact on the outcomes associated with current and future disasters, particularly as breakdowns occur and the response effort is cloudy due to poor communication and other challenges that will have an impact on the residents who experience the lasting effects of the disaster (Powell, Hanfling, & Gostin, 2012).

The effectiveness of the response effort requires an opportunity to examine current strengths and weaknesses and to be mindful of the different challenges that exist with any type of coordinated process. For example, it should be noted that “Investments to strengthen health care infrastructure to withstand catastrophic events may seem unrealistic under current fiscal restraints. However, the financial and public health consequences of failing to invest will result in predictable hospital failures in the next disaster. Where possible, investments should be coordinated across multiple institutions, using health care coalitions to ensure resiliency” (Powell et.al, 2012, p. E1). This is an important and meaningful reminder of the different categories under which organizations are able to work collaboratively in order to accomplish the intended objectives and to be aware of the different issues that pose a threat to the integrity of the coordinated effort, including the public health response (Powell et.al, 2012).

For public health nurses, the ability to effectively respond to the disaster requires a greater understanding of the different elements that impact each level of the response effort, including but not limited to the development of first, second, and even third level responders to the disaster so that those who require assistance from public health nurses are supported in a comprehensive manner to accommodate the needs of the population in an effective manner. The proposed triage system must encompass new areas to support the growth of the practice environment and to be proactive in meeting the needs of those affected by the disaster through outreach and direct patient care. Disaster preparedness requires a level of support and acknowledgement that enables public health nurses to effectively prepare for a disaster and to be cognizant of the changes that are required to facilitate a positive response in the desired manner. It is known that a number of core competencies are essential to the response effort, including the following: “response phase competencies include conducting a rapid needs assessment, outbreak investigation and surveillance, public health triage, risk communication, and technical skills such as mass dispensing” (Hassmiller & Stanley, 2012, p. 515). This perspective also supports the continued growth and development of the public health nurse’s role in disaster preparedness on a variety of levels that will have a lasting impact on operations and on the development of new procedures to accommodate patients during these circumstances (Hassmiller & Stanley, 2012). These factors represent the need for ongoing training and support for public health nurses in order to accommodate the demands of the disaster and the needs of the population as it faces a critical path to recovery (Hassmiller & Stanley, 2012).

The coordination of care and treatment by public health nurses requires a response effort that is comprehensive and that minimizes overlap in many key areas. These practices will ensure that patient care needs are accomplished and that they support a continuous level of knowledge growth for nurses to improve their own activities related to disaster response. Public health nursing in this capacity also requires an opportunity to examine the different strengths and weaknesses of the staff and how to best overcome adversity in this manner. The work that public health nurses perform with hospitals and clinics in determining how triage patients based on categorical determinations that will evaluate patients according to their level of need and triage them accordingly. This practice is essential to the discovery of a new method to support the coordination of care for patients and in determining how to best approach the learning curve of any disaster with a positive set of learning tools and resources to direct the response effort through public health nursing. It is evident that the disaster response effort from a public health perspective requires a high level of support and understanding to ensure that there are sufficient objectives in place to minimize barriers and to create an opportunity to examine new ideas to facilitate an effective and organized response.

It is important to note that “Community resilience, or the sustained ability of a community to withstand and recover from adversity, emphasizes that effective and efficient disaster risk reduction, response and recovery requires a whole of community approach, specifying that partnerships with nongovernmental partners, engagement of local communities and orientation to community self-sufficiency is the foundation of this approach” (Eisenman et.al, 2014). From this perspective, it is evident that a wealth of knowledge and resources is required in order to ensure that the response effort is not only timely, but is also appropriate in meeting the needs of the patient population in an effective manner to accommodate the needs of the community population and its long-term resilience (Eisenman et.al, 2014). This level of resilience must continue to be evaluated on a regular basis in order to determine if there are areas where growth and change might be observed to ensure that patients receive the best possible quality care and treatment through an effective method of supporting patient outcomes and wellbeing (Eisenman et.al, 2014).

Vulnerable populations are likely to experience a significant impact as a result of the disaster. Therefore, these groups must be provided with greater attention and focus so that they experience a less significant impact from the disaster. It is known that “Population  characteristics are an important indicator of everything from evacuation  compliance during an event to successful long-term recovery after one with the socially vulnerable more likely to die in a disaster event and less likely to recover after one” (Flanagan, Gregory, Hallisey, Heitgerd, & Lewis, 2011, p. 3). In this context, it is likely that a community with a large vulnerable population requires a response effort that is experienced in nature and that acknowledges the urgent needs of these population groups and what is required to improve their chances of recovery, rather than to succumb to the outcomes of the disaster (Flanagan et.al, 2011). This practice also supports the development of a strategy that focuses attention specifically on these vulnerable populations in order to improve the potential outcomes of the disaster and the development of new ideas to ensure that patient care is not only appropriate but that it also supports the improvement of vulnerable populations as they recover (Flanagan et.al, 2011). This process also encourages the development of new ideas and approaches to support those populations who do not use English as their primary language, as this is also a critical factor in many communities where cultural diversity is prominent; therefore, these groups must also be considered as vulnerable in some respects and must be able to recognize the value of greater attention to these groups to minimize some of the risks that they endure and to also improve communication so that they are aware of what is taking place and how they will be supported by the endeavors that are underway.

For many people who experience a disaster within a given community, they are immediately displaced because the disaster has affected their dwelling in one or another, making it inhabitable for a period of time. This process, therefore, requires an evaluation of how to address displacement and to provide these residents with shelter and accommodations that are appropriate and practical for their needs until they are able to return to their homes. This process requires a strategy to fill shelters and to determine which residents belong in specific types of shelters and the resources that they will require. Public health nurses may play a critical role in this process because they are able to assess patients to determine if they require any medical treatment prior to making any decisions regarding temporary housing. This process is essential to enable public health nurses to communicate with housing officials and other agencies to properly place residents who have been displaced from their homes. It is also necessary to prevent overcrowding within the designated shelters by developing a framework that supports an increased number of shelters as resources permit to minimize the potential risks associated with overcrowding and other complications. Furthermore, public health nurses should be available to those residing in shelters to evaluate residents and to further aid in any other issues that may require medical attention and treatment. One potential opportunity is to partner with the Red Cross in order to place local residents in shelters so that they are able to experience a sense of camaraderie and strength during a difficult period.

The provision of basic resources for the local community also requires a high level of resources that are immediately available and that are shared among different agencies. It is important to recognize that in many cases, until resources are transported to the affected community, they may be scarce and must be properly allocated to extend their use for as long as possible (Hick, Hanfling, & Cantrill, 2011). In regards to medical care in the wake of a disaster, it may be argued that “With a growing emphasis on just-in-time inventory, cost containment, and other inventory and workflow streamlining processes, efforts to preserve inventories of beds, monitors, and clinical supplies for surge capacity may be stymied. Stockpiling of supplies  difficult because expenses for preparedness are a low priority in times of financial instability” (Hick et.al, 2011, p. 2). In this context, it is important to demonstrate the value of resource allocation in the appropriate manner to ensure that resource utilization is extended for as long as possible, while also considering the other factors that may impact the community in the aftermath of a disaster (Hick et.al, 2011). This process will demonstrate a coordinated effort from the medical community, including public health nurses, to identify the resources that are available and to properly allocate these resources on the basis of priority and need to ensure that as many persons as possible receive the necessary care and treatment in the desired manner and in the desired timeframe (Hick et.al, 2011).

Finally, the prevention of disease outbreak within the affected community must be addressed on a comprehensive basis in order to reduce this overall risk and to provide residents with a greater sense of support and acknowledgement of the risks associated with infectious disease after a disaster, including the displacement of residents and the turmoil of the surrounding environment that often has a direct impact on patient health in different ways (Kouadio, Aljunid, Kamigaki, Hammad, & Oshitani, 2012). This process requires the public health nursing community to be proactive in determining how to be effective in reducing disease outbreak under these conditions, using the following as a guide: “Risk assessment is essential in post-disaster situations and the rapid implementation of control measures through re-establishment and improvement of primary healthcare delivery should be given high priority, especially in the absence of pre-disaster surveillance data” (Kouaido et.al, 2012, p. 95). This process requires the continued growth and development of the public health nurse’s response to the disaster and to recognize the value of supporting a framework with a specific objective to reduce the risk of infectious disease by minimizing exposure to the most prominent risk factors that exist, including those in the surrounding environment (Kouaido et.al, 2012).

Conclusion

The response to a disaster requires a comprehensive approach to managing the outcomes in order to ensure the safety and security of as many affected persons as possible. This process also requires a high level understanding of the different strategies that are required to maintain control over the events that are associated with the disaster and the ability of an organization to be proactive in supporting a response effort that aims to support the largest number of people at effectively as possible. Public health nurses are a critical component of the community response and must be able to demonstrate their ability to be proactive in supporting the aims and objectives of the disaster response effort. This process is instrumental in shaping outcomes and in determining how to best approach new directions in the response effort through coordinated care, treatment, and overall support of the process.

Most importantly, public health nurses must be able to work collaboratively with other agencies in order to develop a response that is not only appropriate, but that also supports a long-term approach in order to minimize the damage that is incurred by the community as a result of the disaster. There are considerable efforts required to accommodate patients with varying degrees of injury and risk and to identify those who require immediate attention versus those who are able to wait for treatment, or even those who do not require any medical treatment in the aftermath of the disaster. Therefore, it is important to identify the resources that are required to accommodate these groups and to be effective in communicating throughout the response effort to ensure that all persons receive the desired level of focus and attention that is necessary to minimize the damage incurred from the disaster. This process also supports and encourages the development of public health nursing education and outreach in order to achieve optimal outcomes for the community and its people. In essence, public health nurses must serve as the backbone of the disaster response effort at the community level in order to accomplish the desired outcomes and to minimize the negative impact of the disaster on a widespread basis.

The people of Ruby Lake who face the outcomes of the disaster must be able to find comfort and also develop trust in those who are providing support so that they are able to overcome the disaster with as little lasting damage as possible. Public health nurses within the community must play a critical role in this process and support these residents as they seek not only comfort, but also treatment for any physical complications that they have incurred from the disaster itself. This process will ensure that patients receive the best possible care and treatment under the circumstances and that they are able to support changes as necessary to improve efficiency, communication, and the utilization of resources to accomplish the intended objectives. Therefore, public health nurses must serve as one of the primary sources of leadership, knowledge, and guidance in order to develop a coordinated, organized, attentive, and focused response effort that will minimize the impact of the disaster on the community over the long term.

References

Eisenman, D., Chandra, A., Fogleman, S., Magana, A., Hendricks, A., Wells, K., … & Plough, A. (2014). The Los Angeles County Community Disaster Resilience Project—A Community-Level, Public Health Initiative to Build Community Disaster Resilience. International journal of environmental research and public health, 11(8), 8475-8490.

Flanagan, B. E., Gregory, E. W., Hallisey, E. J., Heitgerd, J. L., & Lewis, B. (2011). A social vulnerability index for disaster management. Journal of Homeland Security and Emergency Management, 8(1).

Hassmiller, S. B., & Stanley, S. A. R. (2012). Public health nursing and the disaster management cycle. Public Health Nursing. Missouri, MO: Mosby, 507-531.

Hick, J. L., Hanfling, D., & Cantrill, S. V. (2012). Allocating scarce resources in disasters: emergency department principles. Annals of emergency medicine, 59(3), 177-187.

Jakeway, C.C., LaRosa, G., Cary, A., & Schoenfisch, S. (2008). The role of public health nurses in emergency preparedness and response: a position paper of the Association of State and Territorial Directors of Nursing. Public Health Nursing, 25(4), 353-361.

Kouadio, I. K., Aljunid, S., Kamigaki, T., Hammad, K., & Oshitani, H. (2012). Infectious diseases following natural disasters: prevention and control measures.

Plough, A., Fielding, J. E., Chandra, A., Williams, M., Eisenman, D., Wells, K. B., … & Magaña, (2013). Building community disaster resilience: perspectives from a large urban county department of public health. American journal of public health, 103(7), 1190-1197.

Powell, T., Hanfling, D., & Gostin, L. O. (2012). Emergency preparedness and public health: the lessons of Hurricane Sandy. JAMA, 308(24), 2569-2570.