Nursing and disaster preparedness

Abstract

Disaster Preparedness is one of several Position Statements that ICN has announced it will be reviewing during 2010, to be carried out with National Nursing Associations and the ICN Bank of Experts. ICN's proposed review could not be more timely in the light of the Haiti earthquake on 12 January that resulted in such devastating loss of life and infrastructure, followed on 27 February by yet another earthquake and tsunami in Chile. Hard evidence supports an impression that disasters are becoming much more frequent. A 60% increase in disasters was reported between 1997–2006 compared with the decade1987–1996; the number of reported deaths for the same periods grew from 600,000 to over 1.2 million; and the numbers of people affected rose from 230 to 270 million, a 17% increase (Klyman et al. 2007). ICN is already very active in this area (see International Perspectives in this issue on assistance in Haiti). In March 2007 (then) President Hiroko Minami wrote about her personal experiences of nursing in a disaster area, and urged nurses in every nation to assume a leadership role in their efforts to prepare their countries and regions in the event that disaster strikes (Minami 2007). Then, last year, ICN published in conjunction with the World Health Organization in the Western Pacific Region, an invaluable booklet on the ICN Framework of Disaster Nursing Competencies (ICN & WHO Western Pacific Region 2009). With a wealth of background information, definitions and statistics, this framework of disaster nursing competencies for the generalist nurse should be compulsory reading for nurses everywhere. Disasters come in many forms, natural and man made, and no one knows when they will strike and who will be called upon to assist. Experience in many disasters suggests that although teams of experts may later fly in to help, it is the available services from local hospitals and clinics that are called upon to provide immediate assistance. Too often these personnel are confused, disoriented and left to work without prior guidelines (Nasrabadi 2007). An article on Chinese nurses' experience in the Wenchuan earthquake relief in this issue (pp. 217–223) reinforces the need to ensure that all nurses are well prepared for such eventualities. Destruction of the infrastructure with thousands of deaths and many more injuries over wide areas of Wenchuan and Li counties, resulted in an overwhelming situation for the ten nurses who were later interviewed about their experiences. Voluntarily joining rescue teams from tertiary hospitals affiliated with Chongquing University, all participants had emergency and peri-operative care backgrounds, but none had any formal disaster nursing training. They found that previous experience did not guarantee productive work in disaster conditions, and they questioned their abilities to undertake this relief work. The authors point out that while health professionals working in rural hospitals and community care areas are expected to play a key role in disaster relief, generally they are not well prepared and that is only military hospitals that provide appropriate training. Although these comments are made in the context of developing countries, similar reactions have been identified in developed world disasters (Arbon et al. 2006; Bless 2005). The ICN Framework described will not only ensure better responsiveness to disasters when they occur, but also encourage the development of competencies for nurses in the areas of prevention, preparedness and recovery. These must surely be a priority for nursing in the 21st Century.