Section A. The Emergency Operations Center (EOC) has a large Chain of command. At the head is the EOC Commander, who receives information from the other parts of the chain, and is responsible for relaying that information to other agencies, and also the Homeland Security agency (formerly Federal Emergency Management Agency). The Safety Officer is in charge of making sure safety policies are followed, and also for relaying what safety equipment might be needed. This person also keeps track and investigates injuries reported as a result of rescue operations. The Liaison Officer answers questions and provides briefings for the other agencies during this emergency. This person is the main point of contact for other agencies. This role takes the pressure off of the agency commander, diverting attention and questions to the liaison officer. The Public Information Officer gathers together the proper health information needed and ensures that the public is informed of pertinent health information specific to the emergency.
This person also ensures that everyone has the same information and is aware of which information is to be disseminated to the public. The Legal Officer will ensure that the legal aspects of emergency operations are followed. This will include following and enforcing the contractual obligations of several different agencies involved in this emergency event. The EOC coordinator will coordinate all of the command staff, and ensure that each one is performing adequately, and assisting each unit as necessary in obtaining or completing required tasks. The next tier of command includes the Operations Chief, the Logistics Chief, the Financial/administrative Chief, and the Planning/Intelligence Chief. The Operations Chief will develop, organize, and carry out the incident objectives. Such objectives will include which areas to search, or survey, and which assets and field resources are utilized. The Operations Chief will supervise each team and area, utilizing the resources effectively. The Logistics Chief does exactly that, takes care of logistics. This can consist of finding equipment needed for health workers, emergency personnel, or finding space to put refugees and pets.
The Finance and Administrative Section Chief plays an important role in tracking finances, expenditures and tracking both resources on hand and resources that have been distributed during the emergency. This enables the department to be aware of supplies that are low and allows for the department to request needed items from outside sources. This section also ensures that proper contractual processes are in place. The Planning Section Chief gathers information, analyzes the information, and then manages the information gathered, ensuring that all of the sections of the incident responders are informed of everything happening with each section of the response. They then compile the Incident Action Plan. The last tier of the EOC group is the individual Public Health Organizations. This includes the Community Services Branch Director, the Medical/Health Branch Director, the Fire Branch Director, the Public Works Branch Director, and the Law Enforcement Branch Director.
Each director forms their own Chain of Command similar to the EOC chain of command for their own department. Each director is in essence the EOC commander for their particular department. The Public Health Nurse serves under the direction of the Medical/Health Branch director (United States Department of Labor, n.d.). Section B. Public health personnel played several different roles in this disaster scenario. The command structure is the incident commander on the first tier, the public information officer and the liaison officer on the second tier, and the third tier consisting of the operations chief, planning chief, logistic chief and finance/administration chief finishing out the third and last tier. The Public Health Nurse is not listed on the departmental command structure. The Public Health Nurse will analyze the incident and apply nursing judgment to public health needs for the incident. In the disaster scenario, the nurse needed to be aware and ask for needed resources such as potable water and sanitation, as well as vulnerable populations in need of home oxygen, needed medications for various co-morbidities such as hypertension and diabetes, and environmental hazards brought about by the natural disaster, such as the possibility of typhoid, cholera, possible mold exposure.
The Public Health Nurse will also conduct interviews with the affected population, access and populate information to be relayed to the Public about direct and/or possible health hazards and safety hints/tips to help keep the population safe. This may include public information sheets, information fairs, public meetings, and media interviews. The Public Health Nurse should also be aware of possible environmental hazards and which supporting agencies to contact in regards to the possible environmental hazards (University of Minnesota, School of Public Health, 2006). Section C. The community health nurse has many resources available to enable them to deal with situations outside of the community health nurse’s scope of practice. These include the Public Works department, for sewage, water, road management, building inspection, and environmental services. This department also has resource information available to the nurse for companies in the private sector. The public nurse will also have available to them the Fire and Police departments, which also include the State and County Police.
The Fire department and Police departments have search and rescue teams available, which can include water, mountain, and land rescues. The Health Department also has resources for the Community Health Nurse, such as environmental inspectors, food inspectors, and resources available such as the Center for Disease Control (CDC). Available through Community Services Department are work crews, interpreters, and public buildings to be used as shelters (University of Minnesota, School of Public Health, 2006). Section D. The nurse utilized the resources available at the time to arrange for environmental health specialists to inspect residences and assist community members. The nurse also arranged for transportation to shelters, provisions and medications for those sheltering in place. The nurse also relayed information regarding hazardous waste cleanup and education concerning combustions engines and inadequate venting.
The nurse was able to get information on the needs of the community at large and relay that information to the EOC task force to enable education and interpretative needs to be fulfilled (University of Minnesota, School of Public Health, 2006). Section E. The community health nurse was able to advise residents on depression and Post Traumatic Stress Disorder (PTSD) signs and symptoms, and was able to make referrals to community services for treatment of the possible depression and PTSD. The nurse was able to take the information gathered from the phone calls to facilitate news flyers for distribution to the community and churches on what symptoms and behaviors to look for, and resources to help the affected residents. The nurse was also able to educate community members on health and mold issues, and to refer and send out a specialist to inspect potential hazards.
The nurse notified 911 in response to a reported injury from a chemical spill that had been reported contained and cleaned up. The nurse then notified environmental specialists about possible contamination and chemical exposure near public parks and recreation sites. By facilitating the emergency response, the area was secured and helped prevent other possible injuries (University of Minnesota, School of Public Health, 2006). Techniques used to comfort, calm and educate the people consisted of empathy and an open approach. Active listening, non-confrontational empathetic concern relayed to the people that their fears were normal and were valid concerns. This approach made the people feel comfortable and facilitated open conversation between the nurse and the community members (University of Minnesota, School of Public Health, 2006).
Section F. Nursing personnel can be prepared for large scale disasters by joining the National Nurse Response Team (NNRT). The National Nurse Response Team is a specialty team used in any scenario requiring hundreds of nurses to assist in chemoprophylaxis, a mass vaccination program, or a scenario that overwhelms the nation’s supply of nurses in responding to a weapon of mass destruction event (Public Health Emergency, 2009, para. 1). Nurses can also be better prepared for disasters by being prepared at home, as well as attending continuing education classes on disaster preparedness, as well as large scale disaster training and scenarios.
Public Health Emergency. (2009). http://www.phe.gov/Preparedness/responders/ndms/teams/Pages/nnrt.aspx United States Department of Labor. (n.d.). https://www.osha.gov/SLTC/etools/ics/what_is_ics.html#Information University of Minnesota, School of Public Health. (2006). https://cpheo1.sph.umn.edu/fcs/index.asp