The document considers disaster management, and specifically the role of the community health nurse when disasters strike. Various public health roles are examined, along with how a community health nurse can play a role to mitigate not only the medical needs of the community, but also their psychological and mental needs.
Emergency Response
Part and parcel of human life today is the necessity to sometimes cope with wide scale disasters. These have an effect not only on the physical infrastructure of an area, but also on the health and well-being of those involved. For this reason, disaster response agencies are a necessary component of coping with either man-made or natural disasters. According to Qureshi, Gebbie & Gebbie (2005, p. 4) it is also necessary to manage and ensure sound public health during such emergencies. Public health agencies therefore have the responsibility to collaborate and cooperate with other agencies responding during emergencies, since many different kinds of agencies will be involved. The system for such interagency emergency management is known as the National Incident Management System (NIMS). The first responsibility of public health agencies is therefore to be familiar with NIMS and its frameworks for responding to public disasters. To facilitate this coordination and cooperation effort, several officers are at the head of the various aspects of public health management, including officials such as the finance/administration chief, logistics chief, liaison officer, public health nurse, and so on.
The finance/administration chief is responsible for several key management actions. This official must, for example ensure that there is a contractual and financial process in place to secure supplies, equipment, space and personnel for those struck by the disaster (Qureshi, Gebbie & Gebbie, 2005, p. 14). This officer must also be able to interpret human resource policies, track resources used during the disaster response so that costs can be recovered. In some cases, these officers also need to take responsibility for the physiological and psychological well-being of volunteers engaged in responding to the disaster. In general, the finance/administration officer is responsible for preventing financial disaster on the heels of mitigating a natural or man-made disaster.
The planning chief has a general responsibility to develop an Incident Action Plan (Qureshi, Gebbie & Gebbie, 2005, p. 10). This includes allocating resources and making sure that the appropriate sections are activated or deactivated. The key goals of the incident mission should also be managed by the planning chief. In other words, the planning and implementation of the response effort is the responsibility of the planning chief.
The public information officer is responsible to make sure that the public, government officials and collaborating agencies receive the necessary information to effectively mitigate the disaster (Qureshi, Gebbie & Gebbie, 2005, p. 11). The public information officer also provides information to the public health agency staff, ensuring consistency and synchronicity with other agencies. In addition, this officer will need to serve as official spokesperson for the public health agency during press conferences or other information sessions. All information must be cleared by the public information officer before being offered to the public.
The operations chief is responsible for actually ensuring that specific tasks and objectives are carried out by the public health agency, and also ensuring that the Incident Action Plan in general is carried out (Qureshi, Gebbie & Gebbie, 2005, p. 13). This may include distributing vaccines, sampling water or soil, delivering risk messages, or case investigation, among others. This person also ensures that the public health agency carries out its day-to-day operations, depending on which of these is essential, which should be reduced, and which should be temporarily suspended.
The logistics chief ensures that support is provided to all sections activated during the disaster mitigation effort Qureshi, Gebbie & Gebbie (2005, p. 13). These duties may be to acquire space, supplies, and equipment to ensure that the public health agency can carry out its duties to the public. Bottled water and blankets are included in the physical resources acquired by the logistics chief to ensure that responders are securely supplied and able to carry out their duties in mitigating the disaster. Other duties may include providing drivers for case investigators or setting up materials for the Operations section.
The liaison officer, as implied by the term, is expected to interface with and coordinate all the activities contributed by external agencies (Qureshi, Gebbie & Gebbie, 2005, p. 10). They also provide resources and supplies to those working with the department of health. The liaison officer must ensure that all agency policies, procedures and sovereignty are respected by all involved in the relief effort.
The public health nurse is expected to liaise with members of the public who are injured or traumatized by the events related to the disaster. The nurse is also expected to help provide for those in need of regular or immediate medications or vaccinations. Those in a state of fragile health need particular guidance when their support systems are compromised by the disaster.
The chain of command involved in the simulation included Chris Newhouse as the EOC Commander, who worked with five people in the positions of Safety Officer, Liaison Officer, Public Information Officer, Legal Officer, and EOC Coordinator. Directly subordinate to these positions were the Operations, Chief, Logistics Chief, Financial/Admin Chief, and Planning/Intelligence Chief. These positions are supported by five Branch Directors, including Community Service, Medical/Health, Fire, Public Works, and Law Enforcement. The final element in the chain of command was the Public Health Group.
In a disaster situation, the community health nurse is often required to deal with situations outside his or her direct scope of practice. Such situations include potential health hazards as a result of contaminated food or water, in turn resulting from a lack of electricity supply to homes. Furthermore, many households may include young children and babies with needs such as diapers, formula milk, and bottled baby food. These supplies can be offered by the logistics chief, while the public communications officer can provide information regarding contaminated food or water supplies.
The community health nurse may need to deal with emergency situations such as people dependent on particular medications such as insulin shots for diabetes. She might also be required to offer assistance or advice regarding the health of young children, babies, or old people who are in a fragile state of health. Finally, for people who are in a state of shock or trauma, the nurse would need to offer reassurance and concrete advice regarding further actions.
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