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Editorial: Disaster Preparedness: Are You Ready?
Although viewed as a top healthcare facility in the region, this hospital ran out of bottled water, food, and medications; there was no running water; and the emergency generators started to fail. Patients on the rehabilitation, neonatal intensive care, and other units were barely receiving basic health care. Unaware of these dire conditions, local residents with acute and chronic illnesses struggled to get to this hospital for life-sustaining interventions such as dialysis, respiratory therapy, blood transfusions, insulin, and antihypertensive medications. Those outside who were healthy and productive a few days ago now were at risk for injury, dehydration, starvation, and infection. Disasters such as hurricane Katrina, the recent tsunami in Asia, and 911 precipitated a cascade of tragic circumstances that have become etched in our minds. Perhaps most importantly, these devastating events dramatically affected the public’s general overall sense of security, shook confidence in our local, regional, and national leaders, and illustrated the potential chaos in healthcare services.
For most individuals, the recollection of disasters ultimately subsides, and normalcy soon reappears. What have we learned from these catastrophes? What can be applied to our respective rehabilitation and chronic care settings? If you were asked to locate the disaster plan in your setting and state the first essential action, could you do this without hesitation? Does your setting even have a readily operational and realistic disaster plan? Would you truly be prepared and able to execute the plan as conceived? What role would you and your colleagues have? Has the disaster plan taken into account what would happen if such resources as water, electricity, medications, communications systems, and manpower were not available? What would happen if the disaster lasted more than a few hours or days? Are you and your colleagues prepared for the possible physical, emotional, ethical, spiritual, and environmental demands?
What specific ramifications does a disaster have to rehabilitation nurses? Here are three priorities to consider:
First, all nurses—not just rehabilitation nurses—need to have some sort of disaster preparedness certification or mandatory continuing education program. It should be structured similarly to CPR training, which includes yearly evaluation of knowledge and its immediate application. For CRRNs, this could perhaps be incorporated in the certification. All settings should have a specific and readily accessible disaster plan in place that reflects the uniqueness of their circumstances and resources. By informing all nurses of what to do through yearly updates as things change, everyone functions on automatic pilot when a disaster occurs. Nurses know what to do and do not have to totally rely on appointed leaders for direction. In addition, nurses should have a standardized background of disaster-related information to collaboratively function as a team with other professionals—a fundamental attribute of rehabilitation nursing practice.
Second, in recent disasters, it has become readily evident that our diverse patient population with disabilities is at greater risk for poor outcomes and even death. In all practice settings, it is essential that our patients and their families at time of discharge have a realistic personal disaster plan in place. This basic preparation would be applicable in a major disaster or even a minor situation such as the loss of electricity and heat.
Finally, rehabilitation nurses need to become better acquainted with excellent Web sites that have valuable disaster information. Explore some of the following Web sites to develop or refine your setting’s disaster plan as well as one for your patients and their families at the time of discharge:
Since we do not know when the next disaster will occur, now is the time to take action. Rehabilitation nurses cannot become complacent. Join the effort to become prepared individually and organizationally.