13
Yvonne Harris
We see all comers, from the worried well to the critically ill; from birth to death; and with conditions involving all parts of the mind, body, and spirit; from brain trauma to ingrown toenails. Our patients come to us trusting that we will respect their concerns and that we will provide care for them. As emergency nurses, we have a responsibility to respect that trust and provide our patients with the skill and expert knowledge required for their care.
—Jean Proehl (2009, p. xi)
Introduction
Emergency nurses see it all. Disasters have claimed millions of lives and cost billions of dollars worldwide in the past few decades. Goodwin Veenema suggests that there is, on average, a disaster requiring international assistance every week (2013). Tragedies such as the September 11th World Trade Center attacks, Hurricane Katrina, and the 2010 earthquake in Haiti have led heath care providers to critically review their processes in order to deal with such events.
Figure 13.1 Waiting to be Rescued after Hurricane Katrina, New Orleans
Nurses need to be familiar with their role in emergency preparedness and disaster planning as they frequently have wide-ranging leadership responsibilities for community- and hospital-level disaster preparedness and response. This chapter discusses the definition of a disaster, either natural or anthropogenic (caused by humans), disaster preparedness and planning, and the disaster response.
Learning Objectives
- Discuss the four areas of focus in emergency and disaster planning—mitigation, preparedness, response, and recovery.
- Describe the core preparedness actions.
- Recognize situations that may call for additional comprehensive planning.
13.1 Disaster
Disasters are defined in many ways. The World Health Organization (WHO, n.d.) defines disaster as “a situation or event, which overwhelms local capacity, necessitating a request to the national or international level for external assistance.” The United States Department of Homeland Security (USDHS) defines it as an emergency that “requires responsive action to protect life or property” (USDHS, 2008, p. 138). Hammond, Arbon, Gebbie, & Hutton (2012) summarize these definitions in their statement that
A disaster is a serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources.” (p. 236)
Simply put, a disaster is a catastrophic event that overwhelms available resources. Disasters can be natural or anthropogenic (caused by human activity). In May 2016, a fire in Fort McMurray, Alberta, destroyed 2,400 structures in the area, forcing more than 90,000 people to evacuate the region.
The fire grew so much that at one point it was creating its own weather and required firefighting reinforcements from across the country. All the stores and amenities in Fort McMurray were closed . . . and