Disaster Nursing

By Nancy Kimmel

In these troubled times in which we live, there exists a constant threat of disaster. Whether the disaster is man made, such as war or terrorism, or from nature, nursing has always been at the forefront. In the past, nurses were on the battlefield dressing the soldier's wounds and giving emotional support to those whose time was at hand.

Formally, the occupation of nursing began with Florence Nightingale during the Crimean war. Even prior to that time there were those caring individuals who were first responders to disaster situations. Now more than ever, there is a need for nurses to become educated in the field of disaster nursing. The destruction unleashed by Hurricane Katrina tested the immediate response and mobilization of many doctors and nurses, as well as the merit of government response, to which in the final analysis the general consensus was one of "we could have done better."

In spite of the many critics that abounded after the destruction, there stood those individuals who shined so brightly with their selflessness and compassion. These are nurses and doctors working around the clock in unsanitary conditions not unlike a battlefield hundreds of years ago.

One has to ask, "How is this possible in today's world, with all of the state of the art technology that abounds in medicine and communications." And yet, there it was in black and white, people were dying from lack of medical supplies and unsanitary conditions. The brave and caring souls who stood by and could perhaps only hold a hand, give a comforting touch, and say some kind word to someone who was taking their few last breaths were the ones that made the difference. Here was a case of disaster nursing like no other. These are men and women who stayed behind to care for the sick and dying, not knowing when or if any supplies would arrive.

In classes that are now taught currently in nursing schools on disaster nursing, the pervading theme for every new nurse to remember is to treat the walking wounded first. One would not think that this should be the case when someone is dying from blood loss or is badly wounded. Shouldn't those who are so badly wounded be treated first? The experienced nursing instructor will nod her head and ask the student, "O.K., what happens when you exhaust all of your blood supplies on a patient that perhaps won't last a few hours? What will you do when a patient who needs only minor care and does not get it due to your time expended on someone who is dying, goes into complications that could have been prevented? Now what kind of situation do you have?" The student nurse will not know what to reply. However the nursing instructor will reply the following, "Treat your walking wounded first. They will be your help."

This statement may seem harsh at best. It is however the rule of the disaster scenario. There will be those that you cannot help, and that is a fact. Therefore, you must treat those that can be of help to the nurse. Once you have treated these people, they can then proceed to follow your instructions. They will be the ones to give CPR, wrap tourniquets and do whatever it is that the nurse thinks that they can handle. How many of us can actually imagine a situation like this? The nurses who assisted the wounded during Hurricane Katrina lived it day after day.

No one knows where or when a disaster may occur. We are constantly being bombarded by the news informing us of elevated terror threats using colors. The fact is that most people are never prepared for a disaster. This does not mean that we should not try. This is the reason for teaching disaster nursing in nursing schools. Nurses have to learn about how to be a leader, how to mobilize teams, and organize people. Not a small task. This is why that nurses should constantly update their knowledge.

With the advent of new types of biological and chemical warfare, scenarios such as Hurricane Katrina could pale in comparison. First of all, every nurse should register themselves with a local emergency response team in their area. Secondly, every nurse should begin to read and obtain various continuing education credits in the field of disaster nursing. Hopefully they will never have to use their new found knowledge. However, if the time were to arrive that their nursing experience was required, then they would have some idea what to do. For it is their decision making and leadership skills that will facilitate saving the most people, and it is very possible that they will be alone in making such decisions.

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