Disaster Management Of A Community

In a world full of disasters, it is of vital importance that community members know when and how to respond when disaster strikes.  Tornadoes can happen anytime, anyplace, and can affect many or none.  Planning and preparation for tornadoes or disasters of any sort are two keys items for successful disasters. This paper will explore the various agencies that come together before, during, and after disaster to help community members to be prepared for when a tornado or disaster strikes.  Preparing community members with a plan for any disaster will assist community members to stay calm, so they react in a safe manner.  Agencies such as American Red Cross (ARC) that is a vital partner when it comes to all phases of a disaster.  Federal Emergency Management Agency (FEMA) supports the ARC along with being a vital player in recovery efforts of a disaster.  We will also be discussing Incident Command System (ICS), Emergency Operations Center, (EOC), Emergency Medical System (EMS) along with the role of nurses in the event of a tornado or another disaster was to strike.

The importance of these agencies, roles, and places are vital in the event of a tornado or another disaster striking.

American Red Cross

American Red Cross is made up of donors, volunteers, and employees.  The American Red Cross steps up when disaster strikes big or small.  “The American Red Cross (ARC) defines a disaster as “a threatening or occurring event,” either natural or man-made, “that causes human suffering and creates human needs that victims cannot alleviate without assistance” (ARC, 2008)” (Mauer & Smith, 2013, p.553). “American Red Cross was founded on May 21, 1881 in Washington, D.C., by Clara Barton and her colleagues” (ARC, n.d).  They aid in disaster relief, lifesaving blood, training and certification, international services, military families, and nursing and health.  “The American Red Cross prevents and alleviates human suffering in the face of emergencies by mobilizing the power of volunteers and the generosity of donors” (ARC, n.d). 

On average there is an emergency every 8 minutes with 90% of disasters being from a house fire.  Roughly, 91 cents of every dollar spent is for services provided to the people in which they are serving.  With almost 5.6 million donations of blood by 3.3 million blood donors this makes for roughly 8 million transfusable blood products per year (ARC, n.d).  Along with saving lives with blood products they teach courses to save lives.  Courses such as first aid, CPR, AED, babysitting and caregiving, swimming, CNA, and BLS.  Along with teaching members of society how to save lives the ARC assists service members and their families from day of enlistment in many ways.  Along with helping those in need on the home front the ARC has over 17 million volunteers with nearly 200 countries with red cross or red crescent society (ARC, n.d).  The ARC website provides a link to contribute a monetary donation.  Besides donating money, the public can also apply for jobs online along with signing up to be a volunteer online at www.redcross.org or connect with a local chapter.

Tornado

When a disaster like a tornado strikes the ARC will set up overnight stays in a shelter along with a hot meal and support from various trained volunteers.  They are also available to distribute supplies when emergencies arise.  They offer comfort kits along with other supplies to aid in the cleanup of a disaster. Red Cross health and mental health volunteers travel to help those affected.  They are assisting community members with coping with the disaster along with the devastation after the disaster.  They do not judge or ask question.  They help everyone.  Volunteers and employees deploy within hours of a disaster to help support communities devastated by a disaster.  All American Red Cross Disaster assistance is free.  But, disasters like tornados do not always give time for warnings.  If time allows, the Emergency Operations Center (EOC) will be opened during this phase with high attention to clear communication. Normal communication of an impending tornado is that the sirens will alarm, and News channels will have new flashes.

Three phases of disaster

Pre-impact Phase

This is the phase prior to the disaster with focus on planning and mitigation.  Nurses can help improve the community awareness regarding Tornado preparedness through community activities is the first step. Public health nurses can put on community awareness clinics at any time.  They can partner with local emergency personnel to help educate the public for tornado along with any disaster that is possible in the area in which they live. It is important that the public know the difference between a tornado watch which mean that a tornado is possible and a tornado warning which means that a tornado has already developed or will be occurring soon.  During the pre-impact phase it is vital that community members have a plan for that if a tornado does occur.  This way they know what they need to do along with what not to do to stay safe.  In the event of a tornado or disaster strikes nurses are to respond if they can safely but without putting themselves or others at risk.

Impact Phase

The impact phase is when the disaster is occurring.  “The impact phase continues until the threat of further destruction has passed and the emergency plan is in effect.” (Mauer & Smith, 2013, p. 557).  Community members need to seek shelter away from windows during this phase.  A disaster such as a tornado can cause injury to man, damage to property, and possibly can be fatal. Though the time frame may be short lived while it is happening tornados can do a great amount of damage in a brief period. The devastation can also be a neighborhood to a whole community wiped out by the destruction of a tornado.  During this phase it is the nurse’s role to assess health needs and provide support to those in the shelter.  During this phase, triaging the injured along with search and rescue missions are implemented.  Those designated with for search and rescue will need to communicate with ICS for further details.  It is important that everyone be accounted for.  There should be a buddy system in place.  This way if something happens someone can get help.  Never enter a scene that has not been deemed safe. Safety first.

Post-impact Phase

The post-impact phase is the phase following the actual impact of the tornado.  The post-impact phase entails emergency and recovery phases.  “The emergency phase it the time of rescue and first aid.” (Mauer & Smith, 2013, p. 557).  During the emergency phase is when recovery starts and does not end until the community is back up and running.  “Nurses working across the health system at all levels respond to and lead the recovery phases of natural disaster management. (Usher et all, 2015, p. p.69). Nurses are vital in all phases of a disaster but with their training they can assist in more ways than most during the recovery phase.  Nurses not only can do first aid, but we can be there to help members of the community cope with loss in the days, weeks, and months to come following a disaster. Most people that encounter a disaster do not necessarily have coping problem right away following a disaster. This could happen months down the road once they are trying to pick up the pieces and live a normal life.  This is also time for evaluation and good debriefing of a community emergency management plan.  Always a good plan to talk about the things that went well and those that need improving.  It is best to do this while things are fresh on the mind.

Federal Emergency Management Agency

The Federal Emergency Management Agency (FEMA) was created on April 1, 1979 by President Jimmy Carter with a declaration to serve the American people during all phases of a disaster.  “The Federal Emergency Management Agency (FEMA), part of the Department of Homeland Security, has the responsibility of coordinating the federal government’s response to natural and manmade disasters.” (Nowak, Ashton, & Sayers, 2015, p. 19).  Depending on the severity of the damages will determine FEMA’s assistance level.  FEMA works closely with state and local governments by providing funding for emergency programs and training.  Together FEMA and the American Red Cross developed the National Shelter System.  The purpose of the NSS is that disaster relief groups would have a directory of possible shelter locations along with giving disaster relief managers some tools to help more people. “FEMA and ARC work closely together on a broad range of that include disaster response and recovery, as well as readiness and preparedness for disasters and other emergencies.” (FEMA, 2010, para 1).  This memorandum outlines the support and cooperation between the two entities.

FEMA will assist ARC in disaster response, organizational capacity development, and will engage in joint projects with ARC to aid in efficient and effective public service in a time of disaster.

Incident Command and Principles of Disaster management

The importance of Incident Command is so that everyone knows what is required of them in the event of a disaster striking.  “The Incident Command System (ICS) is a management system designed to enable effective and efficient domestic incident management by integrating a combination of facilities, equipment, personnel, procedures, and communications operating within a common organizational structure. “(FEMA, 2017).  The incident command is activated when there is warning.  If there is not a warning for a disaster it is initiated during the post-impact phase. This gets all emergency personal on board.  Each department or group work in autonomy and know what is expected of them.  This is where having mock drills comes into play and are vital to a community getting through a disaster.  Effective communication is needed for the command center to work the best for all involved.  Along with the collaboration of all different departments of the community and emergency departments.  Everyone needs to work together for the good of the community.

It is vital that everyone knows the principles of disaster management.  These are vital components to a disaster management plan. “According to Garb and Eng (1969), there are eight fundamental principles that should be followed by all who have a responsibility for helping the victims of a disaster.” (Mauer & Smith, 2013, p. 562).  Prevent disaster, minimize casualties, prevention of further casualties, rescue, provide first aid, evacuate injured, provide medical treatment, and promotion of normalcy are the fundamental principles.  These need to be done in sequence by all rescuers or it could be detrimental to some.

Emergency Operations and Emergency

Medical System’s roles in disaster management

Emergency operation center is an actual physical place. This center of all communication with other government agencies, local EMS, the ARC, and local public safety agencies. Both the EOC and ICS are key pieces to provide efficient coordination and reduce things being done twice. Emergency Medical Services (EMS) personnel will be on call to respond and treat on scene but also to transport when needed.  It is up to the EOC to communicate with the local hospital with number of victims and the seriousness of the situation.  It is at the time that the hospital would initiate their own disaster management plan.  At that time, the nurse that receives that phone call would be the acting incident commander for the hospital until properly relieved.

When disaster strike with Meditech

The hospital in Carrington, ND. utilizes an electronic health information system called Meditech 6.0.  Nurses use Meditech 6.0 information system for medication administration, charting assessments, physician orders, laboratory results, radiology results, clinical findings, diet, physical therapy assessments, along with intake and output.  Though we are supposed to be fully electronic we do keep certain items on a cardex if we have scheduled downtime or a disaster would happen. Meditech 6.0 is an internet-based information system.  We have generator back up that hopefully will reboot within a certain period if we were to lose power at the hospital in the event the hospital was to lose power.

Though we may get power back with the generator the guarantee of internet connectivity is not always a guarantee.  We have what is called “Meditech 6.0 Downtime Protocol”.  This would be initiated if we lost internet connectivity once the generator gives power back to the hospital.  What this protocol means is that we go back to paper charting and charting everything by hand.  Everything gets charted on old forms that are in the drawer at the nurse’s station. This is later scanned into the medical records. To prevent mass confusion, we have a file that tells us everything that we need to be doing in the event of non-scheduled Meditech 6.0 downtime. 

Nurses have specific items that need to be charted and that is all laid out for us in the file so that nothing gets missed among the chaos of the disaster.  Luckily for our facility we have scheduled Meditech 6.0 downtime just about every month. We also have mock disaster training once a year that we do everything on the paper charting so that it is not forgotten. It is part of our protocol that if there is a weather alert we are toprint off own “downtime” MAR.  This way we always have what medications they are currently taking or have been on in the last 24 hours.  This also gives us their allergies in the event we need to give a medication when our electronic medical record is unavailable.

Conclusion

Having a multi-step comprehensive plan in place when disaster strikes is key to ensuring the best outcome that is possible for the community members and the community itself. When disaster strikes a community, efficient communication, collaboration, and comradery among the emergency relief groups are essential to prevent issues that may arise during the disaster.  Working together in an efficient manner helps to make the best of a bad situation. Shelter, Food, medical treatment, and safe drinking water are some of the resources that are provided to help provide relief for victims of disaster.  The public health nurse helps with community preparedness by making sure they know what to do in the event of a disaster. 

But not only is the public health nurse there to help prepare they are available to get assistance for those that may need some assistance making sure that their house is safe for them to be in there.  Public nurses are advocates for community education and preparedness.  Each time a disaster happens big or small we need to be assessing the emergency disaster plan and making changes as needed.  No two disasters will ever happen in the same way.  That is why it is imperative that the those working in the field of public nursing be well trained by professionals from FEMA and ARC.