Disaster Mortuary Operational Response Team’s Activity

The responsibilities of the Disaster Mortuary Operational Response Team (DMORT) are highly significant as they identify deceased people and store their bodies in the unit. Furthermore, DMORT is commonly activated during large-scale disasters to ensure the proper identification of all victims. By and whole, DMORT operates after severe incidents with a high number of casualties, which considerably overwhelms forensic, local, or mortuary resources in the specific area. However, the functioning of DMORT is also strongly connected to the duties of funeral directors. To be more particular, such experts are responsible for arranging logistics of funerals after DMORT recognizes the dead bodies. In addition, they consider the wishes of victims and their families to organize the event in terms of location, date, memorial services, and buries. Overall, funeral directors and DMORT together form a team responsible for the arrangements concerning the burial of the deceased after severe incidents or disasters.

Furthermore, working in DMORT seems to be significant as experts need to have appropriate skills to be able to identify the person with an incredibly injured body. Sometimes, in severe accidents, people lose body parts vital for determining the deceased, and, consequently, such damages make the responsibilities of DMORT even more challenging. However, people in mortuary services play a pivotal role in ensuring a calm burial of victims for their families, considering that relatives do not need to stress over the possibility of identification mistakes. Overall, I would be honored to work in DMORT to help victims’ families after such disasters by adequately analyzing the bodies and ensuring accurate results. Still, it seems crucial to spend a considerable amount of time studying the specifics of such an occupation to become a professional in this field.

Contemporary History: Hindenburg Disaster of 1937

Introduction

Films and novels exist in large numbers that try to cash in the fame and expound on the proposed theories of the causes of one of the greatest air accidents not in the number of deaths or casualties but the controversies surrounding it. In global history uncommon or rather queer accidents such as this attracts the audience of all the big players in the world, either politics religion, or the experts in such an industry.

The Hindenburg was one of the largest airships built in the history of man. Measuring over 240 meters in length, it was only a few meters shorter than the Titanic and almost three modern Boeings placed end to end. The aircraft was initially named after Zeppelin but the name Hindenburg was adopted in recognition of the German general by the same name in the First World War. The history surrounding the possible cause of the accident has at times bordered on creating conflicts among the involved nations. Such historical events have come to play a great deal in shaping and creating modern history in that these past events are being related and likened to many past events and in this case the Hindenburg air disaster. This air crash is famous for the controversial theories proposed to explain the cause of the accident. In one of the theories fancied by many as sabotage, we compare the position of Germany as a country in modern times against the fact the country secretly suspected the US government of destroying their trophy innovation.

The accident

The company that owned the airship, Zeppelin boasted one of the safest records in air transport as not any of their many airships had been involved in an accident or harmed or injured a passenger. So it came as a surprise when the LZ 129 Hindenburg exploded into flames as it landed on the Lakehurst Naval Air station in Manchester Township, New Jersey in the US on 6th May 1937. The airship caught fire as it descended though not among the many cameramen on the ground filming the airships coming captured the source of the fire on the body of the plane that engulfed the whole airship within 34 to 37 seconds. Despite the intensity of the fire, most of the crew and passengers survived. Of the 36 passengers and 61 crew members on board, only 13 passengers and 22 crew died.

The making of the airship had begun earlier in 1931 but due to financial constraints, the project was shelved for a few years. In the making of the plane, the original plan was that the plane was to use helium gas to increase its buoyancy. The helium gas was at the time being sourced from the US. However, the US government had banned helium trade with Germany. As a result, there was the option of using hydrogen gases instead of helium only that hydrogen was more flammable and thus dangerous and expensive too. The project owners sought assistance from the German Government led by Hitler then. In receiving the assistance the company pledged to include signs of the Swastika which by then had no negative connotations with the Nazi. (Feigenbaum, 2007).

Sabotage theory

At that time there had been some movements in Germany mainly by Communists who were against the Nazi teachings. Some of the anti-Nazi members viewed the success of the Hindenburg and its display of the Swastika as a threat to their campaigns. It was, therefore, no wonder that some of the people with anti-Nazi inclinations were accused of sabotaging the plane. At the center stage was one of the air ship’s riggers named Eric Spehl. (Feigenbaumn, 2007).

Hugo Eckner a former head of the Zeppelin Company was the first man to propose this theory. His theory drew high levels of credibility due to his experience in the airship industry. He reasoned that the airship had in its many trips to south America withstood more fierce weather than the one prevailing at the time of the accident in Lakehurst thus to him there was no way the weather could be blamed for the accident. His sentiments were echoed by the air ship’s commander who was very familiar with the practical performance of the airship had flown it for its entire life before the accident.

Historians and investigators of the accident who favored the sabotage theory cite some facts that support this theory. These facts are directly related to the main suspect Eric Spehl who happened to be aboard the airship as a rigger.

  • His girlfriend was an anti-Nazi and was reportedly a communist something it would be suspected Spehl supported her in.
  • The fire’s point of origin was near Spehl’s duty station.
  • After the accident, it was rumored that the Gestapo was investigating Spehl’s involvement in the accident something that added fuel to sabotage suspicions.
  • Spehl had prior to the accident developed affection for amateur photography which used flashbulbs. A flashbulb-looking kind of ignition was witnessed in the airship seconds the airship caught fire. Again a dry cell battery used in flashbulbs was discovered in the wreckage.
  • A flash or a bright reflection that crew members near the lower fin had seen just before the fire (Lace 2008).

The proposers of this theory point out that Spehl was initially aiming at destroying the plane and not killing the people in it. However, his suspected plan was thwarted by the bad weather which had delayed the plane’s landing by 12 hours. It therefore would mean that the flashbulb had been set to ignite the hydrogen when the plane was docked and unoccupied. His positioning as a rigger denied him time to reset the detonator and thus it ignited prematurely. Spehl’s death in the fire prevented further investigations that could prove this theory true.

The Hindenburg was more than just a German airship. It was a symbol of German power and technical prowess. Hitler’s government, which had helped pay for the Hindenburg’s construction, had employed it for such jobs as making propaganda appearances over the 1936 Olympic Games in Berlin. Each of the huge tail fins of the Hindenburg wore the swastika emblem, the symbol of Hitler’s Nazi party (Clay 2007). Officials had been concerned even before the ship reached New York that someone opposing Hitler might make a terrorist attack upon the craft. At that time though there was nothing negative that could be said of the regime which was rising first.

However, in the period after the First World War, the issue had to be revisited and more so during the cold war. The aggressiveness with which the US treated the German and the Nazi rise to power was thought not to have been triggered by the war but something that had been in existence only triggered by the war. During the First World War Hindenburg looking planes had been used by the Germans in war. The British and French armies were behind technologically and only survived the war against Germany due to weather conditions that ailed the German army as it made its way into occupying the USSR. It’s no wonder that people and historians, in general, speculate that the US must have been envious of Germany in its technological advancements in the name of the airship. Further advancements in Germany created an arrogant state that rubbed many countries among them the US and Britain the wrong way. The teachings of the Nazi party deteriorated the already bad situation.

Many scientists, artists, educators, and scholars followed the Nazi doctrines without much protest. The teaching leaned on portraying Germans as a superior race that was meant to rule the world. As a result, many Germans welcomed what they considered the rebirth of German strength which the regime made their belief had been there but contamination by other races had weakened them. After the death of Hindenburg (1934), the offices of the president and chancellor were combined in the person of the Führer leader of the Nazi party. In 1935, the Nuremberg Laws deprived Jews of citizenship, forbade marriage between Jews and non-Jewish Germans, and barred Jews from the liberal professions. In order to coordinate cultural affairs, the radio, press, cinema, and theater came under the control of propaganda minister Goebbels who was responsible for the harassing of Jews which developed into the Holocaust.

With the US and the world strongly against the teachings of the Nazis, Anti Nazi proponents had found a partner in stamping out the authority of the party in Germany. The climax of the Nazi hostility was reached by the German invasion of Poland that marked the beginning of the Second World War. With the defeat of Germany in this war, its hostility and capacity towards other nations were significantly reduced. In the process of lying low and the death of Hitler, the country was warming up to US friendship. With the end of the cold war and the reunification of Germany which had split into two during the cold war, the relationship between the two countries improved and earlier hostilities and suspicions were forgotten. The growth of the country’s economy has also helped in its relationship with the US as there were chances of making trade partnerships that enhanced mutual friendship between the two countries.

Conclusion

The exact cause of the Lakehurst crash has never been established. Given the strained relationship that existed between Germany and the United States at the time, sabotage was the popular theory though some extremists believe in it at the present. It seems likelier, though, that a lightning strike, or sparking on the hull that ignited leaking hydrogen, or other possible technical hitches were to blame for the accident.

Such an event in history has contributed a lot in creating awareness in that developing regimes and governments which happen to be so ambitious as to challenge the status quo in the balance of power in the world can attain. The Hindenburg disaster has been linked to being the trigger factor that brought about the Second World War. In subscribing to this probability it is proper to say that handling of incidents that have international implications by professionals and historians alike should be made with the consequences in mind. In my view then I would think of a situation where a similar incident involving let’s say the US and one of the hostile regimes in the world such as Iran could trigger something bigger if irresponsible comments like the ones made about the Hindenburg were to be made. A great deal of responsibility and caution should be taken by those in the limelight to avoid creating international conflicts by making irresponsible comments (Lawson 2008).

References

Clay, David (2007). Nazi games: The Olympics of 1936, New York: W. W. Norton, pg 34-56.

Feigenbaum, Aaron (2007). The Hindenburg Disaster, New Jersey: Bearport, pg 25-67.

Lace, William (2008).The Hindenburg Disaster of 1937(Great Historic Disasters) 1st ed London: CHP, 68, 89.

Lawson, Don (2004). Engineering Disaster: Lessons to be learned, New York: ASME. pg 389.

Chornobyl Nuclear Plant Disaster as Historical Event

The historical context surrounding the historical event

The major historical context surrounding the Chornobyl Nuclear Plant Disaster is the political one. The Soviet Union, which had been trying to keep its dictatorship regime, was gradually losing its power. However, at the time of the explosion, the Kremlin was still trying to hold to its power as much as possible. The major process going on in the world affairs of the time was the Cold War, the main players of which were the Soviet Union and the USA (Ball, 2019). Sports events’ rivalries, the Space Race, military dominance, cultural development, and many other aspects were involved in the ongoing non-military competition. This geopolitical tension in numerous spheres between the two countries made the Soviet Union try to disguise its problems, including the ecological ones.

The key historical figure or group’s participation in the historical event

The key historical figure in the context of the Chornobyl Disaster was the leader of the Soviet Union, Mikhail Gorbachev. His participation in the chosen historical event is the main and most infamous one. Instead of realizing the volume of the catastrophe and doing everything possible to save the lives of people both in the Soviet Union and abroad, the Kremlin’s leader was attempting to cover up the true facts about the accident (Rodgers, 2021). Only on the second day after the explosion, about 30 thousand people were evacuated from the town located near the reactor. However, Gorbachev’s attempts to hide the truth failed when several days after April 26, reports from Sweden announcing a nuclear leak in the Soviet Union were published (Rodgers, 2021). Therefore, instead of acting as a wise and caring leader for his people, Gorbachev behaved cowardly and irresponsibly. Despite his own initiation of the politics of ‘glasnost,’ meaning ‘transparency and openness,’ Gorbachev failed at providing the people of his country and the world with truthful information. He tried to conceal the real scale of the tragedy, which only led to more losses of innocent lives and the deterioration of numerous people’s health due to radiation exposure.

The key historical figure or group’s motivation to participate in the historical event

The motivation of Gorbachev to act as he did could be explained by his willingness to retain power and remain an equal competitor of the USA in the Cold War. The two countries had been competing for several decades in terms of who was the best in various areas of development. Gorbachev could not let the Chornobyl explosion nullify the achievements the Soviet Union had gained by then. Unfortunately, such intentions played a very bad trick on innocent people who were far from being involved in politics and were just modestly living and working in Soviet republics.

How the historical context caused or influenced the historical event

The disaster could have been, if not avoided, then at least eliminated if the Soviet Union leader and the ruling party were not concerned with the Cold War implications so much. The rulers of the Soviet Union, to which the Chornobyl Nuclear Plant belonged in 1986, were both unable and afraid to evaluate and admit the full scale of the tragedy. Eventually, as a result of the Chornobyl disaster, the Soviet Union’s collapse neared (Coumel & Elie, 2013). Hence, the two events were interconnected: the Soviet Union’s reluctance to react to the disaster led to innocent people’s suffering, and later, the people who revolted against their rulers managed to gain independence from the regime.

Connecting the historical event and current event

The understanding of the topic becomes easier once one connects the historical context with current events. In the case of the Chornobyl Nuclear Plant Explosion, the invasion of the Russian Federation to Ukraine has a twofold link with the historical background. For one thing, Russian president, Putin, is trying to prove his power. However, this time, he is doing that not against the USA and not in a non-military way but against a neighboring country that has never opposed Russia in any way. For another thing, Putin is putting people’s lives under threat by endangering Chornobyl and Zaporizhzhia nuclear plants (Borger & Henley, 2022). Thus, by understanding historical context, it becomes evident that no historical event occurs in a vacuum.

References

Ball, P. (2019). The New Statesman. Web.

Borger, J., & Henley, J. (2022). The Guardian. Web.

Coumel, L., & Elie, M. (2013). The Soviet and Post-Soviet Review, 40(2), 157-165. Web.

Rodgers, J. (2021). How the Chernobyl Nuclear Disaster shaped Russia and Ukraine’s modern history. Forbes. Web.

Disaster Response Training for Saudi Nurses

Introduction

The present paper discusses the development of a disaster response lesson plan for the nurses of the metropolitan hospital in the Kingdom of Saudi Arabia. Disaster can be viewed as a natural or human-made event, which results in a disruption of the normal flow of life (1-2). The key competencies that the nurses are expected to demonstrate in the case of such events include coordination, teamwork, and leadership skills in addition to decision-making and clinical skills (3-4). Unfortunately, nurses tend to report being uncertain about their education and training in the area (1, 5). As a result, it appears necessary to resolve this issue by providing additional training.

The present paper is devoted to a detailed discussion of the lesson plan, including its components and the implementation strategies. The lesson employs a simulation, has a distinct active learning approach, and focuses the learners’ attention on patient-oriented care. It is concluded that the lesson can be of use for clinical government because it has the potential of improving the quality of the service at the hospital. A table with a summary of the lesson and a figure with a force field analysis is also incorporated.

Teaching and Learning Plan

For the proposed plan, the learners are assumed to have varying levels of baseline knowledge and skills. In general, there is evidence to nurses experiencing difficulties in acquiring appropriate knowledge and experience concerning disaster response in a variety of countries (4, 6), including Saudi Arabia (1). In particular, recent studies show that Saudi nurses demonstrate a moderate level of competency, which varies from hospital to hospital, and they tend to report being insufficiently prepared (1, 5).

In other words, they have limited confidence in their abilities, which also tend to require improvement. As a result, the educator’s goals for the proposed lesson include the improvement of the learners’ knowledge and skills as well as the enhancement of their self-confidence. The role of nurses in disaster response is crucial (1, 4, 7), which highlights the significance of the proposed lesson.

The effectiveness of simulations in increasing various nursing competencies, including those related to disaster management, is well-documented (2, 8-12). However, it is noteworthy that some studies may demonstrate the relatively low effectiveness of simulation activities (13). While the reasons for this inconsistency is not apparent, it can be suggested that the specifics of the lessons can have an impact. As a result, it appears particularly important to provide a detailed plan for the proposed lesson to improve the efficiency of the method.

Set-body-closure: a table

Table 1 offers a detailed overview of the activities of the learners and teacher, as well as the assessment techniques used and the timeline suggested. It should be pointed out that up to ten learners are supposed to be engaged in the lesson. In general, the set of the lesson is expected to include the discussion of the key terms with an emphasis on the learners’ experience and their ability to provide critical analysis and synthesis of the notions of disaster management and patent-oriented care. The body involves the work with the simulation, including relevant instruction, facilitated participation, and critical self-assessment.

The closure presupposes the final evaluation and a reflection on the lesson; the teacher is supposed to draw the learners’ attention to the key outcomes and conclusions that they have achieved during the lesson. Also, the teacher will ask the learners to provide some feedback on the lesson while considering the effectiveness of its methods, which should be performed in the form of a questionnaire. This feedback will be used for the teacher’s evaluation of the lesson; it might also provide ideas for the improvement of the plan. To sum up, the lesson emphasises active learning activities like discussions, and group work views the teacher as a facilitator (which is also typical for active learning) and provides several assessment methods throughout the lesson (including questions, simulation performance, and self-assessment).

The Behavioural Learning Objectives (BLO) for the lesson can be described as follows. The learners are supposed to critically review and enhance their knowledge and understanding of the topic, learn to apply the theoretical knowledge about disaster management in practice, and acquire and improve their skills in the critical areas required of a nurse in the case of a disaster. The latter skills predominantly include decision-making, teamwork, leadership, and patient-oriented approach use (3-4).

Finally, the nurses are supposed to boost their self-confidence with respect to their skills and knowledge. The improvement of knowledge can be visible through discussions, simulation activities, and question responses. The application of the knowledge and skills performance are demonstrated predominantly through the simulation, but the learners’ self-assessment can also be of importance for this objective. The final BLO can be reviewed during the nurses’ self-assessment. Thus, the BLO is observable, specific, learner-oriented, and tangible, which should make them appropriate (14). The teaching and learning activities can be found in Table 1.

Table 1. The set, body, and closure of the lesson.
Learner’s Activities Teacher’s Activities Evaluation of Learning Time
SET

BLO: review and enhance the knowledge on disaster management.

  • Individually list and analyse their disaster-relevant experience.
  • Discuss and make conclusions about the critical nurse competencies in disaster management.
  • Discuss the idea of using simulation for disaster management training. Apply their knowledge of the specifics of the event to their knowledge about the learning approach.
  • Asks learners about their experience in disaster management.
  • Disaster management nurse competencies discussion (facilitates the discussion; uses blackboard to pinpoint the most important ideas). Steers conversation towards a patient-centred perspective.
  • A short discussion of simulation as a learning approach and its appropriateness for disaster management training.
Teacher reviews the learners’ ability to analyse the topic of disaster management from various aspects, including patient-centred care. Up to 20 minutes.
BODY

BLO: learn to apply the knowledge in practice; acquire and improve critical skills (decision-making, teamwork, leadership, patient-centred care skills).

  • Listen to the teacher’s instruction.
  • Ask for clarifications.
  • Participate in the simulation.
  • In simulation: practice nursing, decision-making, communication, teamwork skills. Apply theoretical and practical knowledge. Use the patient-centred approach.
  • Critically assess and reflect on their actions.
  • Identify key challenges and discuss achievements.
  • Critically assess the effectiveness of the simulation.
  • Provides simulation-related instruction. Points out the importance of patient-centred approach. Ensures that every learner understands the instruction (invites questions).
  • Responds to questions.
  • Checks every learner’s progress; offers required guidance and help.
  • Asks every learner to assess their actions with a focus on achievements and difficulties. Reminds about the patient-centred approach. Encourages them to use the information for change plan development.
  • Asks two-four volunteers to make a conclusion about the simulation and its contribution to their understanding of the topic.
  • Simulation performance (progress; the application of the key ideas; patient-centred approach).
  • Learner self-assessment.
Up to 1 hour and a half; should involve a short (10-15 minutes) break (before the change of the roles).
CLOSURE

BLO: boost the self-confidence of the nurses concerning the topic; also, all the three BLO mentioned above.

  • Respond to and ask questions.
  • Perform a short reflection exercise in groups of three-four people.
  • (Optional) provide feedback on the course.
  • Responds to and asks questions.
  • Provides appropriate guidance for the reflection assignment. Encourages self-reflection through instruction.
  • Distributes and collects the course assessment questionnaire.
  • The teacher asks random learners key questions. Other learners can add relevant information.
Up to 20 minutes

Conditions, resources, physical requirements, and teaching aids

The key teaching aids of the proposed lesson are going to be connected to the simulation, and it can be either virtual or non-virtual depending on the provided funding and technical equipment (10). For the present lesson, a non-virtual simulation is offered, but the plan can be easily adapted to correspond to a virtual one. In particular, a role-play simulation is suggested: it has proven to be a rather low-fidelity (12), but a still effective type of simulation, which has been used for disaster management training in nurses with noticeable success (2). The proposed equipment for the simulation includes the forms for the evaluation and assessment of the victims as well as “victim tags,” that is, the tags, which provide the information on the injuries of the people role-playing as “victims” (2).

Other requirements for the lesson include a classroom with enough space for the activities of a ten-people group and a blackboard, flipchart, or another similar piece of equipment that can be used for writing down key information. Finally, the nurses and the teacher need to be provided with a sufficient amount of time off. If they have a whole day off, they are likely to be more focused and less tired. Thus, the proposed lesson does not require many resources, which makes it particularly feasible.

Patient-Centred Elements: A Discussion

The patient-centred approach refers to the type of care that does not focus on treating diseases and conditions; instead, it provides the care for the patient, which typically presupposes the development of holistic solutions in collaboration with the patient (15-16).

Dwamena provides an overview of 43 randomised trials, which show varying levels of the effectiveness of the approach. In general, this study indicates that the approach is likely to be beneficial for different outcomes of care, including patient health. As a result, the proposed lesson incorporates the patient-centred approach as the key method and works to contribute to the development of this approach in the participants. In particular, the role of the teacher as a facilitator is used to steer the learner’s discussion and practice towards a patient-centred approach, which is reflected in Table 1.

Strategies for Implementation

Timeline and communication

Table 1 contains information on the timeline of the lesson. It is meant for a class with no more than ten people, which is why the proposed timeframe seems quite generous. It is also relatively flexible and is supposed to include a break at the point when the simulation implies the change of roles. In the lesson, the information is going to be communicated in a mixed way that will be oriented towards several styles of learning, including auditory, visual, and kinaesthetic ones (17). Indeed, much of the information is supposed to be provided verbally, but key points are going to be written down. Also, the process of simulation is appropriate for visual, auditory, and kinaesthetic types of learning. Thus, the lesson takes into account the different needs and preferences of the learners.

Force Field Analysis

Force Field Analysis (FFA) is a tool that was developed by Lewin to assess the forces that either help or hinder the change (18). The forces are multiple phenomena, and they can refer to factors of very different origin: from financial ones to those related to people’s attitudes (19). The former can be termed as enabling forces, and the latter are barriers to the implementation of the teaching and learning plan. FFA is critical for understanding the process of change and using this knowledge to reduce barriers and employ enabling forces to the benefit of the situation (19).

When applying the method of analysis to the lesson, one can suggest that some multiple enablers and barriers should be considered. Some of them can be paired: for example, the lack of hospital approval is an apparent barrier while the approval of the management of the hospital is likely to provide multiple benefits for the lesson, including the preparation of resources. Similarly, engaged learners are enablers, but the learners who exhibit resistance to the lesson (for example, to the method of the simulation) are going to create barriers.

Both pairs of factors should be managed in a way that allows avoiding or reducing the barriers; as a result, management approval should be found, and learners need to be motivated. Concerning the simulation issues, it can be suggested that the Set discussion on the method can resolve such a problem if it appears.

Figure 1. Force Field Analysis for the lesson, which is loosely based on Shirey’s figure (19).

Learner experience and knowledge are enablers, and they are employed in the plan during the set. It is also noteworthy that the nurses have various levels of experience and expertise, which implies that the processes of co-creating and sharing knowledge can be particularly beneficial for younger and less experienced learners as well as the learners who have had less training in the field of disaster management (14).

This enabler is employed in group activities. In contrast to these factors, the possibility of varied learner needs can result in obstacles. For example, the lesson takes into account different types of learning styles, but some are favoured, especially the auditory one. Also, the lesson is an active learning one, which can be viewed as a challenge by less active and particularly modest learners. The lesson tries to engage everyone in conversation and assessments. It offers learners the opportunity to discuss the simulation in smaller groups, which can be viewed as a solution to this particular issue. Other issues should be addressed when discovered.

Finally, the challenge of resources, including time, funding, equipment, can be mentioned. It should be pointed out that the lesson has a rather generous timeframe for the proposed number of learners and that the non-virtual simulation does not require expensive equipment. As a result, this issue can be avoided to an extent. The final version of FFA is presented in Figure 1.

Key stakeholders and their roles

The key stakeholders in the process include the nurses and the teacher. The nurses are a group of both male and female specialists who currently work at the metropolitan hospital in the Kingdom of Saudi Arabia. Their key role in the process of the lesson consists of engaging in active learning as the learners. Active learning can be opposed to didactic learning, and it is a learner-centred technique, which presupposes engaging learners in their learning and the development of their knowledge (20). In other words, instead of passively absorbing the information provided by the instructor, the nurses are expected to actively develop their knowledge in a meaningful collaboration with the instructor and each other. The features of the proposed lesson that are directly related to active learning are group activities, discussions, and reflection (self-assessment) exercises (20).

While learners are expected to play a critical part in the learning process, the role of the teacher in active learning is still rather important. In particular, Millis demonstrates that the engagement of learners depends on a notable extent on the activities of the teacher. These activities include the setting of clear goals, consistent planning of active learning elements, and tracking the forces, especially resisting ones, that can affect the process of the plan’s implementation (20). It is also noteworthy that appropriate instruction is capable of prompting learners to employ higher-order thinking: that is, the thinking of higher levels as suggested by Bloom (23).

While lower levels of thinking are not to be disregarded (such as remembering, understanding, and using knowledge), higher levels (the ability to analyse and synthesise as well as evaluate) must be achieved through appropriate goal-setting and approaches to learning. In other words, the role of the teacher in active learning can be described as that of a facilitator who plans, implements and continuously monitors the process, helping the learners to develop their knowledge. Some of the teacher’s and learners’ activities in the plan directly refer to higher levels of thinking in Table 1; also, the table contains other facilitator actions in the teacher’s section.

Other stakeholders can also be mentioned; in particular, the management of the hospital has a vested interest in training their nurses, and its collaboration can be of use for the lesson. For example, the hospital can offer help in providing the environment for the lesson, ensuring that the nurses are provided with time off for their training, and, possibly, facilitating the acquisition of some of the equipment. As it was mentioned, the achievement of the approval of the management can be a great enabler for the proposed lesson.

Clinical governance

The notion of clinical governance refers to the system which both demands that health service providers proceed to improve the quality of their service and provides the frameworks and tools for doing so (22). The development of clinical governance is viewed as critical for modern healthcare, and so is the notion of quality improvement (23). The improvement is supposed to be guided by evidence and continuous review of the changes (24).

While the content of the lesson is directly concerned with the improvement of quality in the field of disaster management, the lesson in itself can be viewed as an element that is capable of improving the quality of disaster management in the nurses of the metropolitan hospital and, potentially, other hospitals. From this point of view, the fact that the lesson has an inbuilt mechanism for self-improvement (the questionnaire), is particularly beneficial because the implementation of this plan allows developing and customising it (24). Thus, the introduction of the lesson plan into the regular disaster management drill of the hospital can be viewed as a change, which has the potential of improving the quality of service in the facility.

Conclusion

The present report provides a lesson plan, which is aimed at reducing the self-doubt and improving the knowledge and skills of the Saudi nurses working at the metropolitan hospital. In particular, the lesson targets disaster management, which is reported to be a difficult and typically underdeveloped area of nursing expertise, and patient-centred approach, which is viewed as very important for modern nursing. The teacher goals and the learning objectives include the knowledge, skills, and self-confidence improvement. The plan focuses on the active learning approach, and it utilises several relevant techniques, including discussions, group activities, and self-reflection.

The latter is also one of the forms of assessment; other assessments that the lesson uses include the simulation performance and questions. The implementation plan shows that the teacher should pay attention to FFA, and it also demonstrates the plan’s ability for self-development and quality improvement. The current paper uses several tools (the Set-Body-Closure structure, FFA) to discuss, analyse, and improve the proposed lesson plan; to produce a more customised version, a couple of implementations are required.

References

  1. Alzahrani F, Yiannis K. Emergency nurse disaster preparedness during mass gatherings: a cross-sectional survey of emergency nurses’ perceptions in hospitals in mecca, Saudi Arabia. BMJ, 2017;7(4): 1-10.
  2. Burke R, Goodhue C, Berg B, Spears R, Barnes J, Upperman J. Academic-community partnership to develop a novel disaster training tool for school nurses. NASN School Nurse, 2015;30(5): 265-268.
  3. Florida Health. 2013 Hurricanes “Kirk and Lay” full scale exercise. Department of Health. Web.
  4. Seyedin H, Abbasi Dolatabadi Z, Rajabifard F. Emergency nurses’ requirements for disaster preparedness. Trauma Mon, 2015;20(4): 1-4.
  5. Al Thobaity A, Plummer V, Innes K, Copnell B. Perceptions of knowledge of disaster management among military and civilian nurses in Saudi Arabia. Australasian Emerg Nurs J, 2015;18(3): 156-164.
  6. Jasper E, Berg K, Reid M, Gomella P, Weber D, Schaeffer A, et al. Disaster preparedness. Am J Med Qual, 2013;28(5): 407-413.
  7. Kako M, Ranse J, Yamamoto A, Arbon P. What was the role of nurses during the 2011 great east earthquake of Japan? An integrative review of the Japanese literature. Prehosp Disaster Med, 2014;29(03): 275-279.
  8. Franklin A, Lee C. Effectiveness of simulation for improvement in self-efficacy among novice nurses: a meta-analysis. J Nurs Educ, 2014;53(11): 607-614.
  9. Gul M, Guneri A. A Comprehensive review of emergency department simulation applications for normal and disaster conditions. Computers & Industrial Engineering, 2015;83: 327-344.
  10. Farra S, Miller E, Timm N, Schafer J. Improved training for disasters using 3-d virtual reality simulation. West J Nurs Res, 2013;35(5): 655-671.
  11. Schubert C. Effect of simulation on nursing knowledge and critical thinking in failure to rescue events. J Contin Educ Nurs, 2012;43(10): 467-471.
  12. Aebersold M, Tschannen D. Simulation in nursing practice: the impact on patient care. Online J Issues Nurs, 2013 (2): 6.
  13. Aluisio A, Daniel P, Grock A, Freedman J, Singh A, Papanagnou D, et al. Case-based learning outperformed simulation exercises in disaster preparedness education among nursing trainees in India: A randomized controlled trial. Prehosp Disaster Med, 2016;31(5): 516-523.
  14. McMurtry A, Rohse S, Kilgour K. Socio-material perspectives on interprofessional team and collaborative learning. Med Educ, 2016;50(2): 169-180.
  15. Australian Commission on Safety and Quality in Health Care. . Australian Commission on Safety and Quality in Health Care; 2012. Web.
  16. Dwamena F, Holmes-Rovner M, Gaulden C, Jorgenson S, Sadigh G, Sikorskii A, et al. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database of Systematic Reviews, 2012;12: 1-85.
  17. Andreou C, Papastavrou E, Merkouris A. Learning styles and critical thinking relationship in baccalaureate nursing education: a systematic review. Nurse Educ Today, 2014;34(3): 362-371.
  18. Hayes J. The theory and practice of change management. Basingstoke: Palgrave Macmillan; 2014: 110.
  19. Shirey M. Lewin’s theory of planned change as a strategic resource. JONA, 2013;43(2): 69-72.
  20. Millis BJ. Active learning strategies in face-to-face courses. IDEA. Web.
  21. Kantar L. Assessment and instruction to promote higher order thinking in nursing students. Nurse Educ Today, 2014;34(5): 789-794.
  22. Prenestini A, Calciolari S, Lega F, Grilli R. The relationship between senior management team culture and clinical governance. Health Care Manage R, 2015;40(4): 313-323.
  23. Gauld R. Clinical governance development: learning from the New Zealand experience. Postgrad Med J, 2013;90(1059): 43-47.
  24. Institute for Healthcare Improvement. How to improve. Web.

Disaster Preparedness: Core Competencies for Nurses

Disaster preparedness is an important part of health care workers’ training that should be a priority for the medical community (Schultz et al., 2012). Nonetheless, there is still much need for establishing core competencies standards that would drive course development. This paper will explore the role of nursing competencies and scope of practice in disaster responding.

Organizations providing public health care have been concerned with the creation of education programs that would allow the provision of better care for disaster victims since the tragic events of September 11, 2001 (Schultz et al., 2012). To this end, numerous training instructions and curricula have been developed. Their emergence has been fuelled by the increase in federal funding over the last decade (Gebbie et al., 2013). However, taking into consideration that there is no consensus concerning requirements for health care education in case of mass casualty events, the effectiveness of those programs can hardly be established (Schultz et al., 2012; Gebbie & Qureshi, 2002). According to a recent study, no evidence would confirm that federal investment has brought positive results in the area of emergency response training (Potter, Miner, & Barnett, 2010).

Competencies based training of health care professionals need a broadly accepted set of standardized core skills, knowledge, and attitudes that would help to evaluate existing teaching methods (WHO, 2006b). It will also help to make federal spending on the nation’s health more effectively and will increase accountability for emergency preparedness (Gebbie et al., 2013). Therefore, developing such a set of standards would be a significant step forward and will benefit both academia providing medical education and the general public (WHO, 2006a). Moreover, the implementation of a unified program of core competencies would translate into making the community recovery process much easier thus helping the health care sector fulfill its community obligations (Gebbie et al., 2013).

The Competing Issue of Competencies

Competence is associated with the proper application of knowledge, psychomotor, technical, and interpersonal skills as well as judgment acquired by an individual during the continual performance of their duties (ICN, 2009). It can also refer to the set of personal characteristics and attitudes required for effective practice in the medical field (ICN, 2006). The set of predetermined competencies can help to measure whether students acquired particular skills allowing them to perform within a particular area at a level that has been predefined (Littleton-Kearney & Slepski, 2008). It also allows for controlling the achievement of stated education outcomes for nursing students.

There are approximately twelve million health care professionals in the US that need to be trained for an effective response in emergencies (Hsu et al., 2006). To this end, the American Nurses Association and the American Association of Colleges of Nursing suggested initiation of programs for basic education and continued education (CE) that would regulate the training of nurse professionals (Littleton-Kearney & Slepski, 2008). However, the specific content of those programs was not defined, thus creating an issue of competing for competencies (Disaster Information Management Research Center, 2016). Some scholars suggest that to achieve certain educational outcomes, core competencies allowing objective evaluation must be included in educational programs (Littleton-Kearney & Slepski, 2008).

According to other academics, emergency preparedness must be either requisite CE or become a required step in the accreditation process for medical professionals (Littleton-Kearney & Slepski, 2008). For example, the accreditation process of the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) includes an evaluation of emergency training (Littleton-Kearney & Slepski, 2008). In light of the lack of standardized criteria, JCAHO has developed its requirements necessary for the successful screening process. The Interprofessional Education Collaborative (IPEC) Institutions also developed their own set of competencies in 2009 (West et al., 2015). They were organized into four main groups: Value/Ethics for Interprofessional Practice Teams and Teamwork that were designed to guide their IPE performance (West et al., 2015).

IPEC also devised a curricular element called Disaster Day that governs a simulation exercise and includes medical professionals from the following fields: Nursing, Medicine, Pharmacy, Physical Therapy Assistants, Radiology, and Emergency Medical Technicians (West et al., 2015). The attempts to develop the standardized lists of competencies related chiefly to the nursing field have been made by the Columbia School of Nursing, the Association of Teachers of Preventive Medicine, and INCMECE/NEPEC (Littleton-Kearney & Slepski, 2008). However, the fact that no organization would validate the accuracy of competencies and establish one unified set of standards explains significant inconsistencies that exist between the competency requirements of each organization (ICN, 2015).

This problem creates substantial obstacles for planning that is necessary for appropriate resource allocation (WHO, 2006b; WHO and ICN, 2009). The competing issue of competencies also means that educational content for nurses and other health care professionals is not incorporated in all existing courses. According to a study conducted by the National Organization of Nurse Practitioner Faculties, there are many areas where nurses have to receive additional training such as decontamination, incident command system, and quarantine (Littleton-Kearney & Slepski, 2008). Moreover, the data from the same study suggests that the majority of educators are not able to teach emergency preparedness content (Littleton-Kearney & Slepski, 2008).

The role of nurse practitioners (NP) in Australia is being governed and regulated by the government (Chapman & Arbon, 2008). To improve health care delivery in the country, virtually all Australian states developed separate legislative arrangements designed to establish regulatory bodies for nurses. The Australian Nursing and Midwifery Council (ANMC) devised a set of competency standards that is common for all NPs. (O’Connell & Gardner, 2012). After their implementation in 2006, all curricula were guided by generic benchmarks thus creating a system for the assessment of nurse professional and their eligibility to work in the field (O’Connell & Gardner, 2012).

However, there is no unified set of measurements that would help to guide education or training assessment of emergency nurse practitioners (ENP). According to O’Connell and Gardner, Australian ENPs cannot adopt the system of the formal clinical competencies devised by the American Emergency Nurses Association because of the numerous legislative and practical differences between the two countries (2012). Therefore, it can be concluded that there is a pressing need for the development of the national competency standards for ENPs that would facilitate the evaluation of their performance.

The nurse practitioner title in Canada is protected by legislation. Achievement of specific competencies is controlled by accreditation bodies and organizations such as the Canadian Nurse Association (O’Connell, Gardner, & Coyer, 2014). However, in the United Kingdom, no legislation would guarantee the protection of the nurse practitioner title; therefore, there are significant variations in their training (O’Connell et al., 2014). A recent study reveals that there is no particular system regulating disaster nursing competencies in Japan (Kako & Mitani, 2010). The authors of the research discovered that disaster nursing in the country covers an extremely broad area making the need for comprehensive benchmarks for the assessment of NPs even more pressing. According to Kako and Mitani, the efforts of WHO committee members could help to develop a central competency core program for disasters; however, it would require significant resources from the professional community (2010).

Expanding Scope of Practice

The scope of practice is associated with strictly defined practice boundaries and restrictions related to decision-making and accountability within a particular medical profession (Fealy et al., 2015). A majority of developed countries have established regulatory organizations that are concerned with the creation of guidelines controlling the scope of practice of nurses and midwives (Fealy et al., 2015).

The Nurses and Midwives Act issued in 2011 by the Ireland government established a special organization having a role of regulatory authority for nursing practitioners—the Nursing and Midwifery Board of Ireland (Fealy et al., 2015). After conducting a comprehensive national consultation process, it created the Scope of Practice Framework that serves as a basis for establishing the professional competence of NPs (Fealy et al., 2015).

New South Wales established the traditional NP role in Australia in 2000 (Lowe, 2015). Even though there are only around 400 nurse practitioners in the country, their number is consistently increasing (Lowe, 2015). It can be argued that the role of NP is not static and fluctuates by various clinical demands (CRNBC, 2016). Taking into consideration the dynamic nature of the nursing profession, it is hard to establish a specific scope of practice. Even though ANMC has developed competency guidelines, there are significant variations in the ENP roles that are dictated by differences in clinical structures (Lowe, 2015). According to the Nursing and Midwifery Board of Australia (NMBA), “some professional colleges may establish professional programs that set benchmarks for their relevant nurse practitioner scopes of practice” (2015, para. 10).

It can be argued that the scope of practice is an ever-evolving measure that changes with each organizational structure. Nonetheless, there is a need for a system that would address “medico-legal aspects of clinical practice” and would help to expand its scope (Lowe, 2015 p. 75). Considering that the ENP role that was implemented in ED settings is largely successful, it is necessary to develop a model that would consider the following issues: flexibility that would allow natural evolution of the ENP role; clinical support for ENPs that have to cope with increased workloads; a clear demarcation of ENR clinical practice and care for those patients that do not fit current CPG model (Lowe, 2015).

Advanced Practice

Advanced practice can be described as an extension of the traditional scope of practice with the help of integration of nursing skills and knowledge aimed at maximizing professional development. It is associated with a high level of autonomy, authority, and accountability granted to a practitioner (Lowe, 2015).

According to Manley, Mantzoukas, and Watkinson, the advanced practice encompasses many medical roles such as practitioner, educator, researcher, and consultant on the multidimensional level (as cited in McConnell, Slevin, & McIlfatrick, 2013). That is, the advanced practitioner should distinguish between nursing and medical roles (McConnell et al., 2013). According to the review of the clinical practices in the UK, the role of ENPs is significantly influenced by the needs of stakeholders (McConnell et al., 2013). Moreover, Tye and Ross argue that the scope of practice of a nurse practitioner is determined by the ethos of the majority of clinical settings (as cited in McConnell et al., 2013). There is evidence suggesting that “acquisition of clinical skills” is the key element for Accident and Emergency practice (McConnell et al., 2013). The study conducted by Noris and Melby’s suggests that almost 97 percent of nurses believe that clinical experience is more important than mentorship, management, and research skills (as cited in McConnell et al., 2013).

It is a challenging task to develop a structural approach that would allow the slow and steady transformation of the existing clinical system. The issues such as the role of promotion and integration of practitioners as well as the creation of guarantees for both patients and medical care professionals have to be addressed to achieve the best possible health outcomes. To this end, there has to be a strong “nursing representation” during the process of developing a structured progression of the scope of practice for ENPs (Lowe, 2015, p. 81).

Ethical Practice

A code of professional conduct is a set of rules and norms regulating the nursing profession that establishes a standard of behavior and serve as a point of reference for numerous situations occurring during the care process (Dobrowolska et al., 2007). The members of the national organizations regulating the activities of NPs collect those standards and adjust them according to the expected norms of conduct in their societies (Dobrowolska et al., 2007). As a result, there are significant variations between the codes of professional conduct of different countries. Therefore, the opponents of professional ethics claim that codes of behavior for medical professionals can be considered as relative (Dobrowolska et al., 2007).

According to the ICN Code of Ethics for Nurses, all competencies should correspond with the set of norms that it describes as well as the employer’s code of conduct (ICN, 2009). It relays the main tasks that should be performed by nurses: promotion of health, prevention of diseases, alleviation of suffering, and improvement of health (Dobrowolska et al., 2007). It also mentions the concern for the principle of non-violation of human rights. Moreover, the ICN Code of Ethics for Nurses provides recommendations for the proper use of the ethical principles by managers and employees of health care organizations. The norms of the ICN code are very general and are designed to be a reflection of traditional values for the profession. Therefore, numerous ethics codes for nurses in other countries have been built on it (Dobrowolska et al., 2007).

The objectives of the NMC Code of Professional Conduct are two-pronged: informing the practitioners about specific standards of conduct that are usually associated with professional accountability and letting the public know the norms of professional conduct that guide the behavior of health care workers (Dobrowolska et al., 2007). The code emphasizes that nurses “must” uphold the following seven principles: respect for every patient; obtaining consent from clients or their families before initiating any treatment procedure; partnership with other members of a team; guarantying protection of personal information; maintaining the level of professional competence; trustworthiness; striving to identify and keep to a minimum all potential obstacles to the successful provision of patient care (Dobrowolska et al., 2007, p.174).

The Irish Code of professional conduct for each nurse and midwife describes its aim as the provision of a sufficient foundation for the decision-making process by practitioners (Dobrowolska et al., 2007). Other objectives include present nurses with a framework for responsible conduct.

Ethical Challenges

A code of ethics that every nurse must observe poses an ethical obligation on professionals providing health care. However, following this set of standards might become a challenge in a disaster setting (Hick, Hanfling, & Cantrill, 2012). The practical implications of ethical issues that might arise in the emergency setting are different from those in everyday practice. In a disaster situation the following problems have to be considered and dealt with: allocation of limited resources, working without supervision, impossibility to obtain informed consent, and keeping privacy (Aliakbari et al., 2014). Moreover, all nurses have to act within certain legal constrictions when responding to disaster situations (Aliakbari et al., 2014).

Therefore, not only do they have to know legal boundaries that regulate their professional conduct on a day-to-day basis, but they also have to be aware of national and international laws governing their behavior during a disaster (Aliakbari et al., 2014). Therefore, it is extremely important to ensure that nurses, who make an invaluable contribution to every disaster relief effort, should receive a sufficient amount of training that would allow the provision of the best possible care regardless of numerous constraints posed by natural and other types of disasters. According to the International Council of Nurses Position Statement on Nurses and Disaster Preparedness, the cross-disciplinary approach to disaster preparedness is essential for the reduction of life-threatening damage and sustainable community development (Yan et al., 2015).

Considering that nurses are critical for the provision of disaster response, it is necessary to provide them with sufficient professional and legal training that would help them to ensure that disaster outcome is the least harmful. Therefore, there is a pressing need for the collaborative effort of governmental organizations that would help to create a unified set of training programs and include them in nursing education (Yan et al., 2015).

Ability to Respond

The ability to respond to catastrophes defines the outcome of the victims’ health; therefore, the issue of nursing competencies plays a significant part in the disaster preparedness training (Loke & Fung, 2014). Many factors are influencing the results of emergency care operations; however, the most important are the nurse’s perception of clinical competence and personal safety (Al Thobaity et al., 2015). It is necessary to realize, that sometimes nurses have to respond to disaster events occurring overseas thereby exposing themselves to disordered and difficult situations. Moreover, they often have to perform operations that are beyond their usual scope of practice (Daily, Padjen, & Birnbaum, 2010).

Therefore, all nurses responding to disasters must have a sufficient level of knowledge and skills that would allow them to minimize the negative health consequences of a catastrophic event without causing significant damage to their physical and psychological health (Joes &Dufrene, 2014) To this end, it is necessary to ensure that training of health care professionals has a broadly accepted set of standardized core skills, knowledge, and attitudes that would help to evaluate existing teaching methods of health care practitioners.

According to a study conducted by Chapman and Arbon, the effects of both natural and made-made disasters could be significantly exacerbated by the lack of proper education of health care professionals (2008). The researchers argue that adequate disaster response training can improve communication and coordination between responding units (Chapman & Arbon, 2008). Moreover, they claim that proper implementation of disaster preparedness competencies will result in the increase of nurses’ confidence levels and improvement of their attitudes thus leading to the improvement of their capacity to cope with catastrophic events.

Conclusion

Disaster preparedness training is an important part of health care workers’ education that should be a priority for the medical community. Therefore, there is a pressing need for the creation of a unified system of core competencies that could drive health care course development. The establishment of a general set of core skills for nurses would help to evaluate the existing teaching methods and create new ones that would help to provide a more effective approach to disaster response training.

It can be argued that special regulatory bodies controlling the scope of practice could bring a significant improvement in the field of emergency nursing. The system able to increase the flexibility of the ENP role as well as guarantee provision of clinical support for health care practitioners would prove invaluable for managing hazardous results of natural and man-made disasters. Even though the expansion of the nurses’ scope of practice is a challenging issue requiring, the steady transformation of the existing clinical system, it can be accomplished by the concerted effort of the country’s health care organizations and medical community.

Various codes of ethics provide nurses with a framework for responsible conduct thereby guiding their behavior within and outside emergencies. Taking into consideration that principles presented in such codes are essential for the provision of patient care, it is necessary to ensure that all ethical challenges facing health care practitioners during a disaster response are addressed by them.

References

Aliakbari, F., Hammad, K., Bahrami, M., & Aein, F. (2014). Nursing Ethics, 22(4), 493-503. Web.

Al Thobaity, A., Plummer, V., Innes, K., & Copnell, B. (2015). Perceptions of knowledge of disaster management among military and civilian nurses in Saudi Arabia. Australasian Emergency Nursing Journal, 18(3), 156-164. Web.

Chapman, K., & Arbon, P. (2008). Are nurses ready? Australasian Emergency Nursing Journal, 11(3), 135-144. Web.

CRNBC. (2016). Scope of Practice for Registered Nurses. Web.

Daily, E., Padjen P., & Birnbaum, M.L. (2010). A review of competencies developed for disaster healthcare providers: Limitations of current processes and applicability. Prehospital Disaster Medicine, 25(5):387–395. Web.

Disaster Information Management Research Center. (2016). Disaster-Related Competencies for Healthcare Providers. Web.

Dobrowolska, B., Wronska, I., Fidecki, W., & Wysokinski, M. (2007). Moral Obligations of Nurses Based on the ICN, UK, Irish and Polish Codes of Ethics for Nurses. Nursing Ethics, 14(2), 171-180. Web.

Fealy, G., Rohde, D., Casey, M., Brady, A., Hegarty, J., Kuripski, L., & Kennedy, C. (2015). Facilitators and barriers in expanding scope of practice: findings from a national survey of Irish nurses and midwives. Journal of Clinical Nursing, 24(23-24), 3615-3626. Web.

Gebbie, K., & Qureshi, K., (2002). . American Journal of Nursing, 102(1), 46-51. Web.

Gebbie, K., Weist, E., McElligott, J., Biesiadecki, L., Gotsch, A., Keck, C., & Ablah, E. (2013). Journal of Public Health Management and Practice, 19(3), 224-230. Web.

Hick J.L., Hanfling, D., & Cantrill, S.V. (2012). Annals of Emergency Medicine, 59(3), 177–187. Web.

Hsu, E., Thomas, T., Bass, E., Whyne, D., Kelen, G., Hogarty, H., & Green, G. (2006). BMC Medical Education, 6(1). 211-221. Web.

ICN. (2006). Web.

ICN. (2009). ICN Framework of Competencies for the Nurse Specialist. Web.

ICN. (2015). International Classification for Nursing Practice. Web.

Joes, M., & Dufrene, C. (2014) Nursing Education Today, 34(4), 543-551. Web.

Kako, M., & Mitani, S. (2010). Collegian, 17(4), 161-173. Web.

Littleton-Kearney, M., & Slepski, L. (2008).Critical Care Nursing Clinics of North America, 20(1), 103-109. Web.

Loke, A. Y., & Fung, O. W. M. (2014). International Journal of Environmental Research and Public Health, 11(3), 3289–3303. Web.

Lowe, G. (2015). Scope of emergency nurse practitioner practice: where to beyond clinical practice guidelines? Australian Journal of Advanced Nursing, 28(1), 74-82. Web.

McConnell, D., Slevin, O., & McIlfatrick, S. (2013). Emergency nurse practitioners’ perceptions of their role and scope of practice: Is it advanced practice? International Emergency Nursing, 21(2), 76-83. Web.

NMBA. (2015). Fact sheet: Scope of practice of nurse practitioners. Web.

O’Connell, J., & Gardner, G. (2012). Australasian Emergency Nursing Journal, 15(4), 195-201. Web.

O’Connell, J., Gardner, G., & Coyer, F. (2014). Journal of Advanced Nursing, 70(12), 2728-2735. Web.

Potter, M. A., Miner, K. R., & Barnett D.J. (2010). The evidence base for effectiveness of preparedness training: a retrospective review. Public Health Report, 125(5),15-23. Web.

Schultz, C., Koenig, K., Whiteside, M., & Murray, R. (2012). Annals of Emergency Medicine, 59(3), 196-208. Web.

West, C., Veronin, M., Landry, K., Kurz, T., Watzak, B., Quiram, B., & Graham, L. (2015). Medical Education Online, 20(1), 19-37. Web.

WHO and ICN. (2009). ICN Framework of Disaster Nursing Competencies. Web.

WHO. (2006a). Web.

WHO. (2006b). The contribution of nursing and midwifery in emergencies. Web.

Yan, Y., Turale, S., Stone, T., & Petrini, M. (2015). International Nursing Review, 62(3), 351-359. Web.

Public Health Lapses in Dealing With Hurricane Katrina

Available literature demonstrates that the United States public health’s infrastructure is greater now than ever before as national attention has been focused on governmental public health capacity and capability (Madamala et al., 2011).

However, some sentinel events, such as Hurricanes Katrina and Rita, HINI outbreaks, and rapid advances in childhood obesity, have exposed weaknesses in specific occupational categories in the public health infrastructure (Mays et al., 2010). The present paper demonstrates how the health promotion and disease prevention categories within the public health infrastructure contributed to the degeneration of the public health situation immediately after Hurricane Katrina.

Eight years ago, in late August 2005, Hurricane Katrina hit the Gulf Coast area of the United States with raw force and vengeance, triggering one of the most horrible natural calamities ever recorded in the history of the country.

Prior to the Hurricane Katrina landfall in the gulf area, various federal and local agencies were engaged in concerted efforts to evacuate susceptible populations from high-impact areas. Despite these attempts, however, many individuals did not or could not evacuate, resulting in a situation where more than 1,300 people died unnecessarily for lack of basic care, support and protection (Logue, 2006). Those who did not die experienced untold suffering due to the flooding caused by the Hurricane.

Extant literature demonstrates that “public health professionals should have a significant role both before and in the immediate aftermath of any disaster, either natural or human-made” (Logue, 2006 p. 10).

In the United States, public health services are delivered to the population through the collective actions of governmental and private agencies that can be divided into 3 broad categories, namely personal health services, community health services, and administrative services (Madamala et al., 2011). The health promotion and disease prevention categories within the public health infrastructure fall within the realms of community health services (Logue, 2006).

After Hurricane Katrina hit the Gulf Coast, the right thing to do could have been to immediately avail public health leadership and public health presence to assist in the prevention of disaster-related mortality, consequent excess morbidity and underlying environmental health issues such as water pollution and mosquito infestation (Logue, 2006).

But this was not to be, hence triggering the perception among many people that the health promotion and disease prevention categories within the public health infrastructure failed in their cardinal duty of monitoring the health status of the affected population, with the view to identifying and solving community health challenges occasioned by the impact of Hurricane Katrina (Schneider, 2012).

The two departments also failed in their duties “to diagnose and investigate health problems and health hazards in the community, to inform, educate, and empower people about health issues, and to mobilize community partnerships and action to identify and solve health problems” (Logue, 2006 p. 10). Lastly, these departments, along with the surveillance and risk communication entities within the public health infrastructure, failed in their role to inform, influence, communicate, and collaborate with many other external agencies that to a large extent contribute to public health services in the United States (Schneider, 2012).

The aftermath of Hurricane Katrina is well documented in the literature (e.g., Logue, 2006; Schneider, 2012). More than 1,300 people lost their lives and thousands suffered unnecessarily due to worsening health conditions occasioned by excess flooding, mosquito infestations, and numerous water-borne diseases.

This paper has demonstrated how the health promotion and disease prevention categories within the public health infrastructure failed to not only move with speed to arrest the deteriorating public health situation immediately after Hurricane Katrina made a landfall near New Orleans, Louisiana, but also to collaborate with other external agencies to ensure minimal suffering of the affected populations.

Consequently, it is plausible for the government and public health leaders to re-examine national, state, and local health departments and agencies concerned with disaster preparedness and response, and to also train public health officials in disaster preparedness.

References

Logue, J.N. (2006). The public health response to disasters in the 21st century: Reflections on Hurricane Katrina. Journal of Environmental Health, 69(2), 9-13.

Madamala, K., Sellers, K., Beitsch, L.M., Pearsol, J., & Jarris, P.E. (2011). Structure and functions of state public health agencies in 2007. American Journal of Public Health, 101(7), 1179-1186.

Mays, G.P., Scrutchfield, F.D., Bhandari, M.W., & Smith, S.A. (2010). Understanding the organization of public health delivery systems: An empirical typology. The Milbank Quarterly, 88(1), 81-111.

Schneider, M.J. (2012). Introduction to public health (3rd ed.). Boston, MA: Jones & Bartlett Publishers.

Disaster Preparedness for Healthcare Facilities

Reports from the scene are spotty in terms of numbers killed or injured, and you do not know how many patients you may be getting

Effective disaster management in a health care setting relies on timely and accurate information to assist decision-making. Due to the nature of the emergency event described and the lack of credible information, initial response should be based on the assumption that the majority of injuries are traumatic unless new data is available. In case of an emergency event, the following sources of information can be used to estimate the number and the severity of casualties:

  • An emergency manager could be contacted to get relevant information from first responder organizations.
  • Twitter could be used to gather the latest information about the situation on the emergency scene. Twitter users provide firsthand accounts of the events as they unfold in real time, including photos and videos. In addition to regular users, major news outlets such as CNN use Twitter as a means of delivering the latest reports. Twitter has a feature called Twitter Alerts which is used by a number of emergency agencies, including American Red Cross and Federal Emergency Management Agency, to issue alerts in case of an emergency situation.
  • TV news reports typically include some footage from the scene which could be used to assess the severity of the emergency situation.
  • Emergency channel on the radio could be monitored to get information from the scene as it becomes available.
  • Call Detail Records data can be used to estimate the number of people at the scene of the emergency event (Gething & Tatem, 2011).

In order to manage an emergency situation with the minimum disruption to regular hospital functioning, it is necessary to develop emergency management plan (EMP) and provide relevant training to the health care personnel before the event (OSHA Best Practices for Hospital-Based First Receivers of Victims, 2005). Such plan should be initiated in case of an emergency situation in order to establish a chain of command, gather information regarding the nature of the disaster, prepare the hospital for patient surge, and “provide the best care possible given the resources and physical conditions” (Adapting Standards of Care Under Extreme Conditions, 2008, p. 18).

When faced initially with a disaster situation in a health care setting, what should be the first five steps? Why?

The following five-step plan is proposed to deal with a disaster situation in a health care setting:

  1. Initiation of the EMP. Incident command system should be initiated to establish a chain of command. Hospital staff should be notified about the nature of the disaster to start preparations.
  2. Establish a command center. A command center is a specific location used to monitor and coordinate hospital-wide activities in the case of a disaster. To minimize confusion, “communication should be coordinated with emergency communications structures at the local level.” (Adapting Standards of Care Under Extreme Conditions, 2008, p. 14).
  3. Gathering information about the nature of the disaster. All the available sources of information should be monitored to create accurate situational awareness.
  4. Preparing the hospital for new patients. Non-essential, routine care activities and time-consuming formal procedures should be eliminated for the time of the emergency situation to maximize human resources. In order to accommodate patients in critical condition, all patients in non-critical condition should be relocated or discharged. Patients should be informed about the reason of their discharge. A press room is to be set up in a hospital with clear directions marking a way to the room and designated parking spaces for media personnel (McLain, n.d., p. 5).
  5. Treating patients injured during the event. In extreme conditions, it is necessary to carefully monitor resource allocation to provide the best care possible for patients in critical condition.

References

Adapting Standards of Care Under Extreme Conditions. (2008). Web.

Gething, P., & Tatem, A. (2011). Can Mobile Phone Data Improve Emergency Response to Natural Disasters? PLoS Medicine, 8(8). Web.

McLain, S. (n.d.). The Oklahoma City Bombing: Lessons Learned by Hospitals. Web.

OSHA Best Practices for HOSPITAL-BASED FIRST RECEIVERS OF VICTIMS. (2005). Web.

Disaster’ Health and Medical Aspects: Hurricane Katrina

Introduction

The damage caused by Hurricane Katrina was a very serious one and an eye-opener to the emergency medical service providers and the fire department. Indeed it was the most powerful hurricane to have ever hit the United States. The fire departments are traditionally the first responders to many of such incidences of disaster and accidents.

The fire department not only responds to hurricanes but to all kinds of emergency circumstances, including bomb attacks, as the one the US experienced on September 11th, 2001. due to the fact that the fire department is the first responders to emergency calls, the medical emergency services have joined the panoply and are part of the fire brigade or come as a third party. During a disaster incidence, many governmental and non-governmental bodies turn out to assist in the management of the problem. This has stimulated the incorporation of public works departments into disaster response as the need for a combined effort, and coordinated operation is critical in the event of a disaster.

First Responder

It can be remembered that the fire department, along with its emergency medical service team, was the first organized group that responded to the bombing of the world trade center in New York City. Other responses were from individuals from police, security guards, and maintenance staff (Daniels 98). The organized response was more effective as the fire department and emergency medical services had brought protective gear, garments, and equipment. The organized response is usually very efficient because of the preparedness they portray in terms of discipline, Command, and the proper equipment for carrying out the job of emergency service provision (Christopher et al. 57).

The responsibility of first responders in the event of a disaster is critical and warrants some discussion here. In most cases, the EMS personnel come to the scene first when an emergency strikes. This emergency medical personnel, including paramedics, begin immediately trying to save lives by offering medical intervention. The reaction of the first response shapes the way the whole disaster response mission would be like (Daniels 103). Upon arriving at the scene of an emergency, the first responders should carry out a brief evaluation by use of a situation report. This report (SITREP) offers a standard format of the scene assessment, and this informs other responding organizations appropriately (Daniels 108).

The Emergency Medical Service

Hurricane Katrina of 2005 was the deadliest; hence an emergency medical service response was very important. As a requirement by any organized group that responds to a disaster and provide medical assistance, the emergency medical services, otherwise abbreviated as EMS, had to take a lot of precaution in handling the situation (Hogan& Burstein 78). Emergency medical services are designed to give pre-hospital and in-hospital treatment to victims of a disaster, just like hurricane Katrina. The treatment is to help the victims (ill or Injured) to reach the hospital and get the proper treatment that would enable them to attain the physical capabilities they had before the emergencies.

Emergency Medical service is the total combination of services and equipment that help provide medical assistance to the victims; it includes ambulances, paramedics, and other first-aid providers like the Red Cross (Hogan& Burstein 78). The hurricane Katrina victims greatly benefited from the services by the EMS, but the service was challenged by some operational problems that need to be improved (Chan 1230). Making a comparison with the situation in 2001 when the world trade center was bombed, the performance of the emergency service providers was quite improved in the 2005 Katrina disaster. This improvement could have resulted from the lesson learned from the previous.

Disasters are dynamic and unpredictable events that present threatening challenges to live and hence require critical management measures. In most cases, vital factors inherent to salvaging the situation are destroyed, like power loss, breakdown of communication, and destruction of transport means (Hogan& Burstein 78). Furthermore, the rescue could be restricted by jurisdiction disputes, economic limitations, and insufficient preparedness.

There are five critical elements that add up to the action to be taken and resources to be used for developing and adequately executing the rescue mission (Chan 1230). They are prevention, arrangement (plans), grounding, response, and analysis. Nonetheless, the EMS personnel are expected to remain calm, flexible, and realize that these elements are all equally important.

Prevention

Disaster concentrates its efforts on identifying the specific hazards and then taking the relevant preventive measures to mitigate the loss of property and life (Chan 1230). EMS plays a vital duty of preventing disaster escalation through their extensive interaction with the members of the neighborhood, offering insights into medical attention and providing the infrastructure as well as their knowledge of the area geography. Moreover, EMS personnel are responsible for initiating preventative community education on handling victims (Chan 1230). They also insist on communication and utilization of information like hospital contacts or standard operating procedures.

Preparedness

Thorough planning, together with practical training, is vital for preparedness and is one of the strong factors of effective disaster management. EMS personnel and the responders are required to be very innovative so that they can improvise things to use for rescue (Chan 1232). Nonetheless, devoid of a properly practiced framework within which to operate, the response activities can be ineffective and disjointed. There are some very articulate responder guidelines prepared by the DHS office of disaster preparation describing the degrees of performance and management training. Disasters are rare, but when they occur, they are usually very stressful and therefore need a very high degree of competence for handling the case (Christopher et al. 57). Dairy drills for the EMS and fire department should include disaster management skills

Deployment

The EMS has an Incident Command System (ICS) used for directing response operations. The ICS paradigm is vital for effectual disaster emergency response. The operations are categorized into Command, staging, medication, transportation, logistics, and triage. All the above functional elements are specific responsibilities for the EMS (Christopher et al. 58). Failing to perfume the duty properly in anyone of the can be very detrimental to the rest as well.

Conventionally, representatives of the fire department are required to have worked as Incident commanders (IC); however, regardless of who is the IC, the work has to be done within the ICS (Saqib 2). EMS also has a medical commander who is in charge of identifying casualties and organizing medical attention so that the injured persons can stabilize after treatment and that they are transported to a definitive healthcare facility. The success of the rescue mission greatly relied on the degree of training, facilities, and planning done by the EMS taking on the mission of rescue (Chan 1237).

The Response to Katrina

The national response plan of the United States identifies the response to any disaster incidence as the responsibility of the local government. In case the local government runs out of their resources, they can then request assistance from the county level, and similarly, the request proceeds to the federal government (Brinkley 123). Some disaster management of Katrina started some time before the hurricane, especially by the Federal Emergency Management Agency (FEMA). Other outstanding assistance teams were the coast guard who rescued over 33,000 people stranded in New Orleans, and the service of the armed forces.

The United States Northern command came up with a combined coordination program that helped to control and manage the operation of the Shelby camp in Mississippi (Brinkley 123). The joint task forces acted as military on-scene Command, and close to 60,000 security personnel were enlisted to deal with the aftermath of the storm. The troops were drawn from all over the 50 states of the united state (Saqib 2). Most of the assistance that was provided by the government was not an immediate one though it was of great importance to the survival of the victims.

The Federal Emergency Management Agency (FEMA) provided help to house more than 700,000 household which had been left without homes. It also paid hotel residence for 12,000 individuals and families. Law enforcement and public safety agencies have also played a crucial role after the disaster, especially in Louisiana and some parts of New Orleans, by providing manpower and equipment for house construction (Brinkley 126).

National Incident Management System

It’s a framework that the US uses to coordinate the way emergency incidences will be managed and also take of the incidents at various stages of government like local, state, and federal levels. NIMS is used by government and non-government bodies when responding to disasters or terrorist attacks. This system was initiated by President Bush in 2003 (Brinkley 129). Homeland security was made responsive to developing and implementing the program. The program works on two principles, which are the flexibility of service and standardization. Regarding flexibility, NIMS offers a steady, flexible, and modifiable nationalized structure within the government and non-government entities (Christopher et al. 59). The response can be made together despite the size, place of complexity.

For standardization, NIMS offers a benchmark framework and set the requirements for the rescue, processes, and systems intended to develop operability among authorities and disciplines in several areas.

The major components of NIMS include Command and management chain and preparedness. The nationally recognized systems of Command are the Incident command system – this is a system developed to enable effective and efficient management of emergency situations by the integration of personnel, facilities, and processes; other systems include the Multi-Agency Coordination System and Public Information System (Saqib 3).

The component of preparedness is a range of vital tasks and undertaking appropriate to develop, uphold and advance the operational capacity to avert, guard against, respond to and recover from household events within NIMS; the concept of preparedness is focused on creating guidelines and standards for training and certifying personnel and equipment (Saqib 3).

Resource management components require that there be an efficient system in place to identify the resources that are obtainable at every jurisdictional point so as to allow well-timed and unhindered right to use to resources that are needed for preparation, response, and recovery from an emergency (Saqib 4). This is how mutual aid agreements come into play, use of specialized personnel from the local, state, and the federal government.

EMS Mutual aid is a response policy program to ensure that the rescue mission in the event of a disaster is successfully accomplished in a well-timed and dependable manner. The EMS mutual aid appeal, has to be done with the intention of creating the closest obtainable EMS unit respond to the victim’s medical needs, at the moment when the resources of the agency making the request are temporarily not available or have been exhausted (Saqib 4).

Improving Performance of Emergency Response

The risk involved in the rescue of victims involved in a disaster is the first problem that hinders the effective performance of the emergency medical service. The sites of the disaster are always risky, and at times they may lead to the loss of lives of the paramedics and the firefighters. The major improvement that has helped improve the performance of the emergency health care service providers have been the introduction of specialized units in the department (Cottone 213).

Paramedics provide first aid services to the victims as other firefighters put out any fires that may endanger the rescue plan. The health hazard has also been reduced by the provision of safer garments and equipment (especially modified breathing equipment) the fire without endangering their lives. The safer equipment is systematized into engine, ladder, and dangerous material units; all these enable assignment specific work that allows effective utilization of manpower and the apparatus (Cottone 213).

The on-scene operation has been a serious problem with some individuals working independently and bringing out confusion, which is risky to the victims who are in need of medical service (Cottone 216). The fire department has to restructure the on-scene command system managing all the aspects of the operations taking place at the scene of the disaster.

The management of the fire department is another area of concern that needs to be restructured to allow easier administration of the departments involved. Staffing in the populated communities requires that the fire department operate larger machines and attend to incidences that they cannot simply handle on their own. Working together with other departments of firefighter becomes necessary as disaster management requires mutual collaboration (Christopher et al. 59). Such conformity would require that agreement be made and executed between elected bodies and managers rather than working directly within the departments.

The ambulance transport system offered by the private sector has been very inefficient, resulting in problems and loss of lives. The United States developed specialized pre-hospital health care units to replace these simple ambulances. These allow the paramedics to offers some form of treatment before the victims are loaded into the ambulance to be taken to the hospital (Cottone 217). All local hospitals are required to have emergency sectors to handle such occurrences.

Conclusion

Improving the provision of emergency health care to victims of disasters is very important, and is, therefore, the duty of each one involved to make sure that the service is efficient. Major improvements made include the use of standing orders or protocols as compared to the radio calls that unreliable, sponsoring specialized teams that include rescue operations, vehicle searches, and hazardous material units. In order to increase the chances of survival of victims of disasters, the emergency health care providers have included other activities such as blood pressure screening, healthy living education, or pulmonary resuscitation teaching. Another notable advance in the provision of emergency medical care came with the development of modern emergency management replacing the civil defense system.

Works Cited

Brinkley, Douglas. The Great Deluge: Hurricane Katrina, New Orleans, and the Mississippi Gulf Coast. New York, William Morrow. 2005. Print.

Chan, Theodore, Killeen, Jim, Griswold, William, and Lennert, Leslie. Information Technology and Emergency Medical Care During Disasters. Academic Emergency Medicine, 11.11(2004): 1229–1236, 2004.

Christopher, Farmer et al. Providing Critical Care During A Disaster: The Interface Between Disaster Response Agencies And Hospitals. Critical Care Medicine, 34.3(2005): 56-59, 2005.

Ciottone, Gregory. Disaster Medicine, 3rd Ed., Philadelphia, Elsevier/Mosby, 2006. Print.

Daniels, Ronald., Kettl, Donald., and Kunreuther, Howard. On Risk And Disaster: Lessons From Hurricane Katrina. Philadelphia; University Of Pennsylvania Press, 2006. Print.

Hogan, David and Burstein, Jonathan. Disaster Medicine, Philadelphia; Lippincott Williams & Wilkins, 2007. Print.

Saqib, Dara. Worldwide Disaster Medical Response: An Historical Perspective. Critical Care Medicine, 33.1 (2008): 2-6.

Disaster Preparedness and Emergency Services

Disaster preparedness is critical for every country because it provides an opportunity to secure the population and prevent enormous losses. Mainly, it is discussed in the limited framework of particular counties. Professionals develop the measures that need to be undertaken to ensure that the county can identify the upcoming disaster and mitigate its influence. Being prepared beforehand, they can act consistently, avoiding errors and misunderstandings.

Emergency services staff can also try to prevent the disaster even though it is not always possible. Still, having realistic and coordinated planning, they can reduce adverse influences and save community members’ lives. Disaster preparedness is a complicated process. It is maintained continuously and consists of a vast amount of risk reduction activities. Moreover, various professionals need to be involved in it to reach the best outcomes.

Cumberland County and Oklahoma are also preparing to manage possible disasters. The emergency management coordinator, Woodson “Gene” Booth (personal communication, July 27, 2016) was interviewed regarding those disasters his county is likely to face and ready to deal with. Considering this question, he mentioned that Cumberland County Emergency Services tend to pay the majority of their attention to such issues as the severe weather, technological hazards, and human threat.

Cumberland County Emergency Services align their actions with other facilities that are involved in the disaster management and follow the peculiarities of emergency preparedness and response highlighted by the Centers for Disease Control and Prevention (2016). It is emphasized that communities, providers of emergency services and healthcare systems need to cooperate when they are willing to improve the situation as quickly and effectively as possible.

Of course, they all have their personal plans of actions that are developed on the basis of facility’s purpose and goals. However, some procedures in the range of their tasks coincide. The coordinator underlined that particular actions are to be maintained before, during, and after the disaster but not only on a single stage. Thus, it can be concluded that that the process of management is rather long-lasting. When maintaining it, professionals need to develop both long-term and short-term goals and to consider the order, in which they will be undertaken. Still, first of all, it is critical to ensure that the local warning system is working decently (Centers for Disease Control and Prevention, 2016).

When dealing with severe thunderstorms, tornadoes, and hurricanes, professionals are to pay attention to the cleanup of water, which is not required when other disasters happen. This step is critical because the representatives of the general public can be injured while moving in the water. Moreover, it can serve as a vector of infectious diseases and chemical hazards. In the framework of technological hazards, Woodson Booth (personal communication, July 27, 2016) paid attention to the hazard materials release.

Centers for Disease Control and Prevention (2016) mention that waste may cause additional complications, as it can be corrosive, reactive, ignitable, or toxic. Finally, a human threat may be seen as threat provided by an active violent assailant, which is critical because one can injure many representatives of the county, making it unsafely.

Booth claimed that he and his team learned a wide range of lessons about managing a disaster (personal communication, July 27, 2016). Still, the coordinator was able to identify those three that are on the top of the list.

First of all, McLain (2010) emphasizes that the emergency plan plays the key role in the whole process of disease preparedness. Professionals also considered that it is important to continuously prepare, update, and protect the emergency plan (W. Booth, personal communication, July 27, 2016). It is critical not to underestimate the significance of this plan because it ensures that effective measures will be undertaken. Moreover, such things as sensitive issues that are not published publicly are mentioned in it. Thus, when referring to the plan, professional can minimize vulnerabilities.

The coordinator also mentioned that technologies can affect the situation greatly and provide the professionals with the opportunity to ensure safety for more people (personal communication, July 27, 2016). Technological development enters various areas, including disaster management. Providers of the emergency services can obtain more effective devices needed to prevent hazards and to deal with them if they stay up-to-date with technology.

Professionals may use search cameras to see if there are people under the rubble, or special lift bags to put it up and save people who are trapped. Still, it is also critical for them to be able to perform the same tasks without such technologies. In some cases, all these devices may be not available, which means that the representatives of the general public can die if these professionals are cannot work without particular technology in alternative ways.

Finally, Booth (personal communication, July 27, 2016) stated that all facilities engaged in the disaster preparedness and management should be able to meet the needs of all of the individuals within the community where they work. All people should be equally protected regardless of their characteristics. In this way, professionals should be able to reach all people of society. To achieve this goal they can cooperate with other facilities, phone companies, and the media (McLain, 2010).

In this way, they can spread information about the hazard and actions that are to be maintained very quickly. Moreover, it is also possible to look for people who are missing in this way and to receive community’s assistance. Professionals should be able to communicate with everyone. Non-English speaking people may also be in danger, but they are not able to understand what others are saying. Thus, the emergency services providers should cooperate with interpreters. It would be also beneficial if they learn basic phrases in the languages that are spread in the community, such as Spanish.

In this way, disaster preparedness is critical for the whole community because it ensures that it is ready to cope with possible hazards, created by both nature and human beings. All steps that should be undertaken to secure the general public are to be reflected in planning.

Emergency services should be provided timely, because the lives of the citizens can be affected adversely. It is critical for the professionals to minimize not only the amount of deaths but also the property damage, as there will be a necessity to restore the county and to make it appropriate for living as soon as possible. Those who survive but have no place to go will not be able to return to their previous lives. Moreover, paying attention to the property, professionals can ensure rapid recovery after the disaster. The amount of restoration will be minimalized so that people can get back to normal community life.

References

Centers for Disease Control and Prevention. (2016). Office of public health preparedness and response. Web.

McLain, S. (2010). The Oklahoma City bombing: Lessons learned by hospitals. Web.

Hurricane Katrina and Public Health System for the Future

Provision of primary care to the community and ensuring that people are empowered to take care of themselves are important aspects of the intervention outlined in the video. Therefore, it would fall under the Community Themes and Strengths Material.

The occurrence of natural disasters that prevent the delivery of health care to the community, such as Hurricane Katrina, ends up affecting the delivery of health care negatively. A hurricane disaster is a force of change. A particular opportunity created by such a disaster is the option to access the strengths of the existing health care delivery system and then work on strategies for improvement. This should eventually make the current system better in the provision of services and the ability to withstand future shocks from the same kind of disturbance.

There was a growing trend of the increased burden on the health system of New Orleans, which was not addressed adequately. This trend was a force of change, which would eventually manifest itself with a catastrophe such as a hurricane. Even if the disaster did not happen, there was going to be another incident that would expose the inefficiencies in the health system. The system was facing an increase in demand, yet there was no sufficient investment to make sure that it catered to the growing needs of patients.

The demographics were also changing. There was no access to primary health care, yet the population had a high poverty prevalence compared to the rest of the country. The population was already uninsured, and it would not access hospital services until it was an emergency. The population mainly accessed health care facilities at the charity facility. Shutting down of the charity as a hospital was another force of change.

One threat to change is rebuilding the facilities to their former state, which would present the problem once more. Recovering what was lost would lead to a repeat of a terrible health situation. Other trends were high rates of alcohol abuse and premature deaths.

Bill Rouselle mentions that leaders should be focused on. He also understands that getting the necessary talent will not be easy. Therefore, the support of the community is essential, which requires the recruitment of parents, community leaders, and other community members to sit on boards and committees. Lastly, leadership must consider the unknown factors, such as community retaliation, and, therefore, have a long-term picture of things (Bolman & Deal, 2013).

Stephanie Baile compares well with Bill Rouselle in the video. She understands that public health happens locally. She also understands that it is crucial to tell the health story through what the health service is doing. Having elected officials on board as part of the strategic planning ensured that the health plan was adopted and supported.

Other than considering the challenge as the recovery of the health facilities, the challenge was to use the opportunity to increase the public’s perception of health care so that public health provision of health care only became the last option for people. Providing preventive health care was the intention of rebuilding. Defining public health was an important step in reframing, with the prevention, primary care, and patients as the new focus of health care to move away from hospital care. Indicators of the process would be on the level and number of programs used to ensure that communities are no longer promoting health deterioration; instead, they support primary care.

The MAPP Community Themes and Strengths Assessment materials require the preparation of the local public health system assessment, discussion of essential services, and identification of areas of activity for an organization (MAPP, n.d.). There are discussions and the completion of the performance measurement instrument. Finally, a review of the results and determination of challenges and opportunities ensue. In the Katrina case, there was the use of the definition of public health services as indicators to use in addressing gaps before and after the disaster. The national, public health standard would then be used as a performance measurement instrument.

Reframing change under the political frame in the Katrina case required assessment, policy development, and assurance. The challenge of implanting the plan was that many people involved with the change were affected personally by the hurricane strategy, losing homes, jobs, and being relocated. The population was also scattered after the storm, which made it difficult to sustain community engagement as required in the forces of change assessment, where community members need to share ideas and identify new forces.

The state is expected to provide financing and infrastructure to enable an affected community to use the available opportunities to rebuild and strengthen its health services. Reframing change requires asking about future challenges and what is needed currently to mitigate those forces (MAPP, n.d.). This is part of identifying new forces. The relocation of victims of the storm presented an opportunity to use a multi-pronged strategy. It included the use of a PR firm to reach out to people and urge them to attend meetings. There was also the use of the web so that people located remotely would access information. Impromptu caucuses were also other instruments used for gathering concerns and solutions for a better health care system.

People used the storm and relocation effects to understand the need for self-sustenance. Therefore, they gave informed suggestions, often being creative in solutions for engagement and improvement of health care. The use of individuals with established networks, such as community leaders was an important strategy for beating the existing challenges (Roper, 2006).

References

Bolman, L., & Deal, T. (2013). Reframing organizations: Artistry, choice, and leadership (5th ed.). San Francisco, CA: Jossey-Bass.

MAPP. (n.d.). A strategic approach to community health improvement. Web.

Roper, W. L. (Director). (2006). After Katrina: Building a better public health system for the future [Motion Picture]. Chapel Hill, NC: Public Health Grand Rounds. Web.