Prepare for danger....

Abstract

The need for health services to be in a state of readiness to cope with major emergencies or disasters is now recognized worldwide. This decade has seen some of the worst ever natural disasters and, at the same time, the event now known as ‘9/11’ has sharpened everyone’s understanding that a single act of terrorism can cause unprecedented death and destruction. The concept of ‘disaster preparedness’ has been in the nursing literature for some years now. The need to incorporate disaster management training into nurse education programmes is a well-established principle. But whether or not this is happening in practice is an important question to ask. In Hong Kong, as we discover from Fung et al.’s paper in this issue of JAN (pp. 698–703), there is no formal training in disaster management and, as a result, nurses do not feel adequately prepared. Hong Kong is not particularly vulnerable to natural disaster, and arguably it is less likely than other places to be a target of a major terrorist attack. However, in 2003, it was at the centre of the outbreak of SARS (Severe Acute Respiratory Syndrome) and this deadly infection took hold with frightening speed and, as everyone will remember, it quickly spread. There were almost 300 deaths in Hong Kong and, in total, 812 deaths worldwide and, for governments everywhere – and for ordinary people around the world – the SARS pandemic provided a salutary reminder that infection must be regarded as one of the most potent potential threats in the modern world. Whether as nurses, or simply as members of the public, presumably we all hope that our own government has now set in place, if it did not have before this decade began, a comprehensive set of plans that set out how any kind of disaster will be ‘managed’. It is perfectly reasonable that we see this as a responsibility of government and its agencies and, indeed, this was the clear expectation of almost all (97·6%) of the nurses in Hong Kong who responded to Fung et al.’s questionnaire survey. The sample did not demonstrate the same uniformity, however, when it came to the matter of taking personal responsibility for their own ‘disaster preparedness’. Only 61% of respondents had read the disaster management protocol that applies to their own workplace, and the remainder either had not read this (24%) or did not even know if one was available (15%). The sample of Registered Nurses in Fung et al.’s survey was not representative – it was made up of Master’s degree registrants in one university – but over 90% of the 164 respondents were “bedside nurses” and two-thirds had over 5 years of nursing experience. So the sample reasonably can be expected to be more aware and better prepared than the norm. But, clearly, they did not feel well prepared. They identified a range of practical learning needs (including first aid and triage) and, in addition, the majority (84%) considered that, in the workplace, drills are helpful and a disaster management protocol is a necessity (p. 701). Being ‘disaster prepared’ requires a lot more than simply being familiar with a protocol. But that’s a good place to start and it is something that each of us can – and should – do as a direct result of reading this JAN article. Go read it now. That would be a good way of responding to the Chinese saying that Fung et al. point out to us (p. 699): ‘Prepare for danger while enjoying a peaceful life’.