The Role of Health Personnel and the Public Health Nurse
Public health personnel and public health nurses have many responsibilities in a disaster that are essential to a successful outcome for the community. Their primarily focus is on the safety and health of the public. The health personnel will assess the community’s available resources by providing the necessary assistance and identifying their specific needs related to the disaster. The health care personnel also have the role of educating the community and addressing any physical or psychosocial needs the community might have (Disaster in Franklin County: A Public Health Simulation, 2006).
The health personnel will collaborate with the local health department to assemble resources that are required during a disaster and coordinate with community services to ensure the public’s basic needs are met. These services involve social services, volunteers and rescue workers (Disaster in Franklin County: A Public Health Simulation, 2006). The health personnel issue health advisories and allocate resources to match the needs of the disaster. This could include providing transportation to remove people from their homes during a flood. It is also essential that the health personnel communicates effectively with the public and media to provide updated information on how to obtain help, how to obtain basic necessities, potential health hazards and to reassure the people of Franklin that they are safe (Disaster in Franklin County: A Public Health Simulation, 2006).
The public nurse’s role during a disaster involves helping patients in the emergency shelter for first-aid skills and administering medication. However more emphasis is being placed on population-based public health and disaster preparedness. Public health nurses have gained an increased knowledge about the community’s baseline health status, demographics, environment and exciting resources. Public health nurses now have an awareness of vulnerable populations in the community, who may be at risk in times of disasters. This includes the elderly, disabled, mental illness and non-speaking English residents (Berman, Erb, Kozier, & Synder 2006).
The public health nurse will conduct door to door interviews. This is performed to complete a community assessment to determine who requires medical attention, who has any special needs, such as essential medications and medical equipment (oxygen, nebulizer, and dialysis) and if the community has sanitary food and water. The nurse must also provide imperative education to help keep the public safe, such as providing information about the local crisis call centers for additional care and support and local shelter. The nurse can refer them to proper resources such as social workers, counselors and shelters (Disaster in Franklin County: A Public Health Simulation, 2006).
Chain of command
The chain of command that was used in the Franklin County simulation includes the Incident Commander, Operations Section Chief, Medical/Health branch director, Public Health Groups, Public Health Nursing Supervisor and the Public Health Nurse. The Incident Commander is the decision- making final authority. The Operations Section Chief has the responsibility for managing all operations, supervising organizations in accordance with the incident action plan and directs its execution. The Operation Section Chief also directs the preparation of operational plan, requests resources, makes expedient changes to the action plan when necessary and reports such to the incident commander (Wikipedia, 2013).
The Medical/Health branch director will direct, supervise and evaluate work activities of medical and nursing. Public Health Groups will monitor health status and identify health problems, by investing health problems and health hazards in the community. They will evaluate the effectiveness, accessibility and quality of personal and population-based health services. Public Health Groups also develop policies and plans and enforce laws and regulations to protect the health and safety of the community. The Public Health Nursing supervisor is responsible for providing direction and assistance to the Public Health Nurse and evaluating their work (Wikipedia, 2013).
The Public health nurse communicates directly to the County Public Health Director who is Zachary Burke. Zachary Burke works under the Operation Section Chief who is Rebecca Brower. Rebecca Brower directly speaks to Chris Newhouse, who is the EOC Commander. The Public Health Nurse will also collaborate with other specialists such as epidemiologists, biostatisticians, environmentalists, social workers and such during a disaster (Disaster in Franklin County a Public Health Simulation, 2006).
The Community Nurse has many available resources to the Franklin community when he or she encounters a problem that is not within her scope of practice. A social worker can help individuals who are experiencing problems associated with housing, unemployment and finances. A social worker can also refer individuals suffering from emotional distress to a counselor.
An environmental Health Specialist can help maintain a safe environment by identifying potential environmental problems such as a gas leak or chemical spill. They can help educate the community on safety hazards and find solutions to eliminate any threat to the public by monitoring any possible dangers or environmental threats to the community (Disaster in Franklin County a Public Health Simulation, 2006).
The American Red Cross can provide many resources that can help ease the community’s suffering caused by a disaster. The American Red Cross offers a great deal of emergency assistance such as shelters, cleaning supplies, comfort kits, first aid, food, clothing home repairs, household items, medical supplies, emergency transportation and etc. The American Red Cross can also provide referrals to the government and other agencies providing disaster assistance. Another resource that could benefit the community is the Federal Emergency Management Agency. This organization provides disaster assistance to individuals or families whose property has been damaged or destroyed and whose losses are not covered by insurance.
Actions by the Public Health Nurse
The first residence that the nurse performed a door to door interview was a man named Matt Westlund. Matt Westlund begins to tell the Public Health Nurse that his basement is flooded and the shelf in his shed had collapsed which caused all types of chemicals to spill. Mr. Westlund is seeking help on how to clean this chemical mess up. The public Health nurse responsibility is to seek help from an Environmental Health Specialist (EHS). The EHS will assess and determine the most appropriate way to clean up the house held hazards waste. The nurse must insist that Mr. Westlund does not attempt to clean up this mess and to wait until the Environmental Health Specialist arrives. The Public Health Nurse must provide Mr. Westlund with information regarding how to clean a flood up (Disaster in Franklin County a Public Health Simulation, 2006).
The second resident is women named Susan Fuhr. Susan is extremely frustrated and annoyed. This household is currently lacking the basic supplies such as electricity, diapers, water and baby formula. The Public Health nurse can give Mrs. Fuhr the option for her family to stay at a shelter for a few days where there are hot meals, electricity and plenty other supplies. If Mrs. Fuhr refuses to go to the shelter she can then refer them to social services. A social worker can help provide the Fuhr family with the proper resources to help Mrs. Fuhr take care of her newborn baby and the Public Health Nurse can provide them with one week of supplies (Disaster in Franklin County a Public Health Simulation, 2006).
Rosario Alvarez is a Spanish speaking woman who was unable to answer the nurse’s questions because of a language barrier. Mrs. Alvarez requires Spanish materials on safe food, water and a generator. At this time there is no urgent matter that needs to be addressed. The Public Health Nurse can arrange for a translator to make a visit with this family within a week to address safety regarding food, water and the generator (Disaster in Franklin County a Public Health Simulation, 2006).
Jason Fugate has a history of hypertension and currently ran out of blood pressure medications. The Public Health Nurse’s priority is to find out Mr. Fugate’s medical history and to take his blood pressure. If his systolic blood pressure is greater than 150mmHg, Mr. Fugate will be advised to leave his home and go to the shelter where his antihypertensive medication can be administered. Since Mr. Fugate blood pressure is 112/73, I would arrange his medication to arrive by the next day (Disaster in Franklin County a Public Health Simulation, 2006).
It is important that Mr. Fugate is informed on his options and allows him to make his own decision. Mr. Fugate must be educated on the signs and symptoms of hypertension and when to seek medical attention. The public nurse must also make sure that he has the basic essentials such as clean water, food, electricity and a working phone line in case of an emergency. It is important that the nurse will follow up with all residents to make sure their issues were addressed.
Addressing the community’s fears
After the disaster, the community nurse must be willing to provide physical and emotional comfort to all the residents of Franklin County. The residents will suffer from anxiety, fear, sorrow and post-traumatic stress disorder. The community will be mourning the loss of their loved ones and the loss of their valuables such as their homes and treasured items such as pictures.
It is important that the community nurse offers guidance and support to these families by offering resources and making referrals specific to each family’s needs. The key to any recovery from a disaster is providing the community with the appropriate resources to help them rebuild their life. The basic resources include food, shelter and safety. Other important resources are family and friends.
The community nurse can educate the community members on how to cope, use others for support and how to get further help if needed. It is essential that the community nurse reassures them that they are safe and in good hands. The community nurse must allow them to verbalize their concerns, opinions, and needs to help them with the healing process. The nurse must be calm, compassionate, and confident in order to help this community move forward and feel safe.
Nursing personnel preparedness
The first priority of the nursing personnel is to understand what his or her role is during an emergency crisis. They must be competent with their nursing skills and have the appropriate knowledge regarding an emergency response plan. The nurse must be educated on disaster preparedness and protocols to be able to respond adequately to a large disaster (Berman, Erb, Kozier, & Synder 2006).
The Nursing personnel must also be aware of their community disaster plan and the warning signs associated with natural disasters in that specific area. It is important that they learn the local and state resources, so that they can make referrals to people when a disaster strikes. It is extremely important that the nurse is able to problem solve, critically think, and be able to work independently under stressful situations with very little resources and equipment (Berman, Erb, Kozier, & Synder 2006).
The nursing personnel must understand the chain of command, the lines of authority, and communication during an emergency. They must be familiar with the potential health conditions that could develop during and after a disaster. Nurses must take an active role in participating in a disaster training program and emergency drills. They must be aware of standard personal protective equipment and when it is required. An extensive knowledge of infection control and barrier precautions will help the nurse prevent the spread of infection (Berman, Erb, Kozier, & Synder 2006).
The nurse should first form a task force that includes a civil defense officer, private relief organizational representative, city/county officials, political leaders and media representatives. Together, the task force should involve the American Red Cross who has the expertise in guiding and developing the disaster plan. The disaster plan should include supplies, equipment, transportation, shelter, human resources, government officials, emergency and disaster specialists, weather specialists, recovery,
evacuation plan and supportive care (Berman, Erb, Kozier, & Synder 2006).
Nursing personnel must also be able to implement the four phases of the emergency management when a disaster occurs. This includes preparedness, response, recovery and mitigation. Nurses need to use nursing judgment to make decisions such as, where resources will be used and triaging patients to the appropriate level of care. The nursing personnel could be prepared to help in responding to large scale emergencies by taking Incident Command System (ICS) certification courses. These are provided by the National Incident Management System (NIMS) and the Federal Emergency Management Agency (FEMA). The ICS provides education to nursing personnel regarding emergency preparedness, incident management, and emergency response during a disaster. This is an excellent opportunity for the nursing personnel to gain knowledge and skills needed to serve their community efficiently and effectively during a natural or man-made disaster (Emergency Management Institute, 2013).
Nurses can also benefit from taking the Integrated Emergency Management Course (IEMC), offered by the Emergency Management Institute (EMI) branch of the FEMA. This course provides emergency related scenarios that help test the nurse’s knowledge, awareness, flexibility, leadership, decision-making, and interpersonal skills under extreme pressure in the Emergency Operations Center (EOC) environment. After completion of the IEMC training for emergency preparedness, nurses will be able to apply their new skills, abilities and knowledge when a disaster strikes. This will also allow nurses to respond effectively under stressful situations (Emergency Management Institute, 2013).
Another program that can benefit nursing personnel is the National Fire Academy (NFA). This course provides education and training in hazardous materials, emergency response to terrorism, arson prevention, detection, community risk reduction, fire prevention and protection (Emergency Management Institute, 2013).
In addition, the National Disaster Management System also developed an organization, which is called the National Nurse Response Team (NRRT). This was established to provide additional resources during a disaster. This program is made up of a team of volunteer nurses that help during an emergency. Nurses within this program are certified and must stay current with training in order to provide help during a disaster. The training includes bioterrorism, biologic warfare, and disaster response (Public Health Emergency, 2009). Nurses that are not interested in becoming certified for disaster preparedness should then consider continuing education units (CEU) disaster relief training. This will at least provide a nurse with the basic knowledge to help serve their community if an emergency situation does occur.
Berman, A., Kozier, B., Erb, G., & Synder, S., J. Fundamentals of Nursing Concepts, Process and Practice. (2006). Upper Saddle River, New Jersey.
Disaster in Franklin
Disaster in Franklin County a Public Health Simulation. 2006. Retrieved from: https:// cpheo1.sph.umn.edu/fcs/index.asp
Emergency Management Institute. 2013. Retrieved from: http://training.fema.gov/IS/NIMS.aspx Public Health Emergency. 2009. Retrieved from: https://www.phe.gov/Preparedness/responders/ ndms/teams/Pages/nnrt.aspx
Wikipedia. (2013). Incident Command System. Retrieved from: http://en.wikipedia.org/wiki/ Incident_Command_System