Disaster Response

Summary

The podcast by Nurse Practitioner focuses on disaster response, highlighting the vital roles nurse practitioners (NPs) play in preparing and responding to disasters. It clarifies differences between emergencies and disasters, emphasizing that disasters overwhelm local response teams. NPs are crucial in various roles, from providing immediate care during a disaster to participating in recovery and planning. They often operate beyond their normal scope of practice due to resource constraints. Effective communication and ongoing mental health support post-disaster are essential. The episode outlines avenues for further training and learning to enhance NP preparedness and competency in disaster scenarios.

Highlights

• Disasters occur when emergencies exceed local response capacities, demanding extended help. 🌪️
• NPs are integral in disaster planning, response, and recovery phases. 💉
• In disasters, NPs may perform tasks outside their regular duties, such as minor surgeries. 🚨
• Communication can be disrupted during disasters, but it's crucial for effective response. 📡
• Mental health debriefings are essential for responders post-disaster to manage stress. 🧠

Key Takeaways

• Disasters overwhelm local response capabilities, requiring broader intervention. 🌪️
• Nurse Practitioners play a pivotal role in disaster preparedness and response. 💉
• NPs may operate beyond their usual scope during disaster due to shortages. 🚨
• Disaster response involves unique communication challenges and needs. 📡
• Post-disaster mental health support and debriefing are crucial. 🧠

Overview

In this insightful podcast, the Nurse Practitioner team dives deep into the critical role of NPs in handling disasters, highlighting the distinction between emergencies and disasters. They explain that while emergencies are events that can be managed locally, disasters require external intervention due to overwhelming impacts. Nurse Practitioners find themselves at the frontline, applying their diverse medical skills to manage chaotic scenarios effectively.

The discussion moves through the unique challenges NPs face during disasters, ranging from communication hurdles to the necessity of stepping beyond typical medical boundaries when resources are thin. An NP might, for instance, need to perform tasks they wouldn't normally tackle, like minor surgery, due to the absence of other specialists, showing the flexibility needed in disaster settings.

After the dust settles, the importance of post-disaster processes is underscored. The podcast emphasizes the need for mental health support and debriefing sessions to help responders process their experiences and stress. It also guides NPs on where to seek further training, such as FEMA courses, ensuring they are well-prepared for future challenges.

Chapters

• 00:00 - 00:30: National Conference for Nurse Practitioners The 'National Conference for Nurse Practitioners' is a major gathering for primary and acute care clinicians, scheduled to take place from March 20th to 23rd, 2020, at the Gaylord Opryland Resort Hotel in Nashville, Tennessee. This biannual event, sponsored by Walters Kluwer and publisher of 'The Nurse Practitioner', focuses on offering educational sessions pertinent to advanced clinical practice. The conference aims to equip attendees with tools to enhance the quality of patient care. Registration is available online at ncnpcconference.com. Attendees are encouraged to attend this spring event in Nashville.
• 00:30 - 01:00: Episode Introduction and Disaster Definition In the episode titled 'Episode Introduction and Disaster Definition' from the Nurse Practitioner Podcast, hosts Deborah Adelman, Katherine Fant, Laura Wood, and Conetta Zach engage in a discussion about disaster response. They clarify the common misconception that a disaster is synonymous with an emergency, indicating that this belief is widespread among those who are not part of disaster response teams. The chapter aims to delineate the differences between emergencies and disasters.
• 01:00 - 01:30: Difference between Emergencies and Disasters The chapter discusses the difference between emergencies and disasters. It highlights that an emergency can escalate into a disaster when it overwhelms local response capabilities. It is noted that a situation might be a disaster for one area but not for a larger region, such as when a small town experiences an event that requires county-level assistance.
• 01:30 - 02:00: Disasters in Small Towns and Cities In this chapter, the fluidity of the term 'disaster' and its varying impact is discussed. It elaborates on how what constitutes a disaster can differ across levels of governance and communities. In the example given, an incident may be a personal disaster but an emergency at the community level, and may only become a disaster at the county or state level as it escalates. It suggests that small towns perceive disasters differently, and it questions the common notion that small towns and cities are free from disasters or terrorist attacks.
• 02:00 - 02:30: Preparedness for Disasters and Terrorist Attacks The chapter 'Preparedness for Disasters and Terrorist Attacks' discusses the unfortunate reality that no area within the United States is immune to disasters or terrorist attacks. It highlights the ubiquity of natural disasters, ranging from hurricanes and tornadoes to earthquakes and pandemics like influenza, affecting both small rural areas and large metropolitan cities with high populations. The chapter emphasizes widespread vulnerability and the need for preparedness across all regions.
• 02:30 - 03:30: Healthcare Response in a Disaster This chapter discusses the differences in psychological impacts of terrorist attacks on small towns versus cities. It emphasizes the symbolic significance of such attacks on places like Springfield, Illinois, which represents emancipation and freedom, highlighting that the goal of terrorism often targets the psychological well-being instead of just physical destruction.
• 03:30 - 05:30: Roles of Nurse Practitioners in Disaster Response The chapter titled 'Roles of Nurse Practitioners in Disaster Response' emphasizes the importance of being prepared for disaster events, whether living in a small town or a large metropolis. It highlights the necessity of having an emergency kit and strategies to support all household members, including pets. The chapter also touches on health care responses to disasters, noting that the response varies based on the individual's role, such as being a nurse or an ordinary person walking down the street.
• 05:30 - 07:00: Disaster Nursing Competencies and Licenses The chapter discusses the critical role of nurse practitioners in disaster scenarios. Upon witnessing a disaster, they are expected to provide immediate healthcare and coordinate with other responders as they arrive. If involved with organizations like the Red Cross, they receive orientation on the disaster context and required actions. They participate based on the organization's guidelines, playing versatile roles in disaster response.
• 07:00 - 08:30: Communication during Disasters The chapter 'Communication during Disasters' highlights the role and preparation required when working with a Disaster Medical Assistance Team (DMAT). It emphasizes that team members are assigned roles based on their skills and the needs of the disaster area. The focus is on utilizing the specific skills that are necessary, ensuring that individuals do not engage in activities without adequate preparation. The chapter stresses the importance of being ready to provide disaster care.
• 08:30 - 10:00: Post-Disaster Actions and Mental Health The chapter discusses the role of triage and the altered level of care in post-disaster scenarios. It emphasizes that the type of care provided will differ significantly from that in usual settings such as an emergency room, clinic, hospital, or doctor's office. Specifically, if a patient in a disaster has no breathing or respirations, the standard procedure of starting CPR is not followed. Instead, after attempting to reposition the head twice, if there is still no spontaneous breathing, the patient is marked as dead to allow caregivers to proceed to other victims who might have treatable conditions like a bleeding injury. This approach underscores a pragmatic shift in priorities to maximize the number of lives saved.
• 10:00 - 11:00: Learning More about Disaster Response The chapter explores the unique aspects of disaster healthcare and highlights the differences in emergency responses, including when to apply life-saving techniques like CPR.

Disaster Response Transcription

• 00:00 - 00:30 the National Conference for nurse practitioners is the conference for primary and acute care clinicians ncnp will be held March 20th through 23rd 2020 at the Gaylord operand Resort Hotel in Nashville Tennessee this biannual event is sponsored by Walters cluer publisher of the nurse practitioner and offers you educational sessions relevant to Advanced clinical practice giving you the tools you need to improve the overall quality of patient care to register for this event visit us online at ncnpc conference.com we hope to see you in Nashville this spring
• 00:30 - 01:00 in this episode of the nurse practitioner podcast Deborah Adelman Katherine Fant Laura Wood and conetta Zach discuss Disaster Response isn't a disaster the same thing as an emergency I'm really glad that you asked that question because that is a common belief among non-disaster responders so to explain the difference an emergency is anything that that um
• 01:00 - 01:30 someone who is prepared to you know respond in the field has to respond to but when an emergency overwhelms the local Response Team the EMS team then it becomes a disaster and there are times when in actual fact a disaster for a local area may not be for a larger entity for example you may have a disaster in your small town and call in the the um County to help you and it's
• 01:30 - 02:00 not a disaster for them it's an emergency but it's a disaster for you but then it overwhelms the county and they call in the state and then it becomes a disaster for you and the county but not the state so you can see that there are there's a bit of fluidity to how we Define the term but they are two very different entities in a small town there's nothing to worry about with disasters or terrorist attacks right
• 02:00 - 02:30 I personally wish there were areas within the United States which did not have to worry about disasters or terrorist attacks but unfortunately this is not so in regards to disasters they happen everywhere you can experience natural disasters such as hurricanes tornadoes earthquakes the pandemics such as influenza in both small rural areas to your larger Metropolis areas with higher populations you can also
• 02:30 - 03:00 experience man-made disasters in cities as well as small towns through examples such as fires or acts of terrorism but small towns are unique to a terrorist attack for what it represents psychologically let's take Springfield Illinois for instance known as The Land of Lincoln representing emancipation freedom for terrorism is not about the physical destruction but the psychological effect of what they d
• 03:00 - 03:30 destroy so no matter where you reside small town or large Metropolis you need to be prepared for a disaster event this will allow you to know how to help when a disaster strikes have the emergency kit in place with strategies to support all members of your household as well as your pet what happens in a disaster Health Care response that depends on how one enters the actual disaster if you're a person walking down the street a nurse a
• 03:30 - 04:00 nurse practitioner walking down the street and you see an explosion and you respond to it you immediately provide health care and as other responders arrive Your Role will vary if you work with a volunteer organization such as the Red Cross you will be called out to the Disaster Response you will be given an orientation as to what has happened and what is needed and then you will participate as they ask you to
• 04:00 - 04:30 participate if you work with a dmat which is a disaster action medical team you would be called out and given assigned roles based on your lure and the needs in the area what is important is that your skills are what are needed and most times you won't be just jumping in without some preparation you will be providing disaster care
• 04:30 - 05:00 triage and that level of care you will not be providing the type of care you've given an emergency room a clinic a hospital or your office you would not for example give start CPR if a patient has no respirations no breathing or a victim you would reposition the head twice if they don't start breathing spontaneously you mark them as dead and go on because the next victim down may have a bleeder that you can put some
• 05:00 - 05:30 pressure on and save their life versus starting CPR and not being able to stop it so understanding that disaster Health Care is a bit different does help you with responding what types of roles might an NP have in a Disaster Response thank you for that question as an NP myself as well as an educator of MPS I'm really excited to talk about how the MP is involved in disaster preparation as well
• 05:30 - 06:00 as in Disaster Response as a result of their Advanced education and clinical skills they're very they're uniquely positioned for for their involvement in all aspects from preparedness to Disaster Recovery their role in community and acute care settings as well as their expertise in collaboration puts them in a very good position as well as how the role has evolved in the past four to five decades
• 06:00 - 06:30 as you see now MPS working in acute care you see them working in primary care you see them working in extended care psychiatric intensive care emergency rooms so if with the Cornerstone of their practice focusing on holistic care of individuals of families of community and health promotion and disease prevention when you look at the MP's role there are part participating in
• 06:30 - 07:00 emergency operation centers they're participating on boards and disaster planning committees at the hospital level at the state level at the federal level can and the the when disaster strikes they're caring for victims and they're ready to work with patients with the community and they're ready to work in Integrated Health Care teams as well as policy to improve the health care of all effectiv during the disaster preparedness efforts the MP provides
• 07:00 - 07:30 information and education to the public as part of their everyday primary care practice or any practice therein they're implementing strategies to improve disaster care delivery by incorporating their knowledge of of the relationship between Health Care issues and social determinant of Health based on their scope of practice the MPS will be able to work alongside of their medical colleague
• 07:30 - 08:00 assessing victims physically psychologically looking at their status looking at their chronic conditions also a typical presentations that they may occur with exposure to toxic substances they also may be focusing on making decisions regarding available resources for the victims and as um Deborah mentioned before Also regarding life and death um interventions that may have to do either star resuscitation or not
• 08:00 - 08:30 there also may be performing procedures suing they may be casting they may be splinting they may be giving first they may be first success or even performing minor surgery then during the post Disaster Recovery uh phase they are very well positioned in assessing and placing interventions for the for coping mechanisms and for adaptation of the individuals in the communities to the
• 08:30 - 09:00 new environment as well as Contin care for their for their chronic and acute conditions disaster nursing competencies are just NP competencies right they are very close the disaster nursing competencies want the nurse to be prepared to work with um it to work with data to work with communities to work with their advanced practice skills so they've really there is a congruency
• 09:00 - 09:30 between disaster competencies for all nurses and the NP competencies based on their Education and Training what happens with nursing and NP licenses in a disaster NPS provide Health Care Services according to their scope of practice in times of disasters resources and qualified healthc care providers may be scarce NPS responding to a disaster
• 09:30 - 10:00 event may be called upon to perform Services outside their normal scope of practice the NP scope of practice will continue to evolve in a disaster based on adequacy of resources and availability of licensed Personnel for example an NP may be called upon to perform surgery when there is no physician or surgeon available even a veterinarian may be called upon to provide care to humans when no one else
• 10:00 - 10:30 is available in Illinois when a disaster is serious enough the director of the Illinois Department of Public Health May request the governor to suspend Licensing Laws of Health Care Professionals in order to expand the scope of practice of all Health Care Professionals if needed therefore it is important that you know how this works in your state or states of lure I would just like to reiterate the the importance of knowing your state
• 10:30 - 11:00 laws governing your response the experience of those Health Care Providers working alongside you during a disaster event the adequacy of resources all which will support your professional practice when responding to disaster event how do the responders communicate in a disaster I've included some thoughts as the NP considers the role of communication in a disaster or D terrorist attack back the US has
• 11:00 - 11:30 recently experienced devastating hurricanes and fires plus we all remember 9/11 control over the disaster scene must be achieved as rapidly as possible in order for an effective response and to ensure the safety of the team members to achieve this goal accurate and timely communication among and between the team members and others is essential throughout the response to a disaster or terrorist event however this is complicated because of the
• 11:30 - 12:00 variability in the expertise of the team members responsibility order in the hierarchy the many different telecommunication tools procedures and terminology used by the teams additionally telecommunication infrastructures and services are often the first severely impacted by disaster including cell towers in the internet thereby impacting the flow of information consequently the rest restoration of communication is a
• 12:00 - 12:30 critical priority with all the advances in technology there are more and more new information communication tools available to restore communication however cost is a significant issue because many of the relief and government organizations are unable to purchase these do these tools due to budgetary constraints fortunately in many instances responders still can rely on lowcost walkie-talkies in view of the many issues impacting communication it is
• 12:30 - 13:00 essential the nurse practitioner participate fully in disaster training such as offered by FEMA so he or she can function effectively as a team member what happens when the disaster is over many people think when a disaster is over we all just go home and everything goes back to normal but it doesn't really work that way it doesn't even matter how you participated in the disaster whether you walked up a on it or you were there as part of an official
• 13:00 - 13:30 response or part of the Red Cross when a disaster is over one needs to go through debriefing and to understand that there are possible situations where you may experience PTSD and accept the fact that you may need to see someone for that I I wanted to bring this up because for me personally I thought being a disaster nurse and having FEMA and Red Cross training made me immune from what
• 13:30 - 14:00 happened after a disaster was over and I learned after responding to 911 that that was not the case I came home and people started telling me you know you can't just return to normal you just can't come home that night and cook dinner for your family and I was like no no no I understand um but I was having nightmares I wasn't eating I was um very irritable and I finally realized that I did need to see someone and even years later hearing a song that was played on
• 14:00 - 14:30 the radio at that time can could sometimes throw me back to that situation so be ready when the disaster is over and you've participated in it to be part of a debriefing to speak with others and to share your experiences so that you can start processing what happened how can I learn more about Disaster Response for NPS there are many Avenues through which you can learn about this it will start with learning about
• 14:30 - 15:00 Disaster Response for nurses in general and then into the specialization the American Red Cross chapter near you will offer disaster Health Care types of classes to help train you in that they will give you an overview of what all the different teams do when they respond M Mass Care Health Care all those kinds of T responses they um there's also FEMA training it is is free it is online and
• 15:00 - 15:30 there are some basic ones that you would need to take like is 100 um is-200 is 800 and is700 but there are specific FEMA trainings that are for Health Care Professionals for nurses and then for NPS and I would just like to leave you with this the way to learn more about Disaster Response for MPS is to read our Series where we will go into more depth on that this podcast does not constitute
• 15:30 - 16:00 medical advice and should not be taken as such and does not replace professional judgment or advice the ideas and viewpoints expressed in this podcast do not reflect the official position of the speakers authors Affiliated organizations the nurse practitioner journal or Walter's cluer