INTRODUCTION TO DISASTER NURSING

 Nursing encompasses autonomous and

collaborative care of individuals of all ages, families,
groups and communities sick or well and in all
settings. It includes the promotion of health, the
prevention of illness, and the care of ill, disabled
and dying people
 Disaster nursing is the adaptation of professional
knowledge, skills, and attitude in recognizing and
 To identify the potential for a secondary disaster
meeting the physical and emotional needs of
 To appraise both risks and resources in the
disaster survivors
environment
 To correct inequalities in access to healthcare or
appropriate resources
Historical Perspective
 To empower survivors to participate in and
advocate for their own health and well being
Florence Nightingale
 To respect cultural, lingual, and religious diversity in
 Lady with the lamp
individuals and families and to apply this principle in
 Left a formidable legacy for nursing and healthcare
all health promotion activities
 In 1854 Nightingale arrived in Scutari, Turkey,
 To promote the highest achievable quality of life for
during the Crimean War with a group of 38 nurses
survivors
to take charge of a British military hospital

Jean Henri Dunant

ICN Framework of Disaster Nursing Competencies
 Was a Swiss social and peace activist and recipient
of the First Nobel Peace Prize in 1901 for his role in
 Nurses constitute one of the largest groups working
founding the International Red Cross Movement
in difficult situations with limited resources
and initiating the Geneva Convention
 They are the frontline workers that provide a wide
 1859- battle of Solferino, Italy
scope of health services; which include promotive,
 1862- publication of the “Memory of Solferino”
preventive, curative, rehabilitative, and supportive
 His wartime experiences inspired Dunant to
care to individuals, families, and groups
propose:
o A permanent relief agency for humanitarian aid
ICN Framework ver. 1.1 highlights:
in times of war
 Addition of Mental Health Area
o A government treaty recognizing the neutraility
of the agency and allowing it to provide aid in
ICN Framework ver. 2.0 highlights:
warzone
 Over 150 nurses and three major international
nursing groups
Clara Barton
 Identified three levels of nurses needing
 Angel of battlefield
competency in disaster nursing with increasing
 In 1881 provided aid during the American Civil War,
levels of complexity
and resulted in the founding of the American Red
Cross. It was her idea to incorporate natural disaster
Three Levels of Nurses:
relief into the core mission of the American Red
 Level I
Cross
o A nurse with program of basic and generalized
nursing education, authorized to practice by the
regulatory agency of his/her country
Goal of Disaster Nursing
o Ex: Staff Nurse in hospitals, clinic and public
health centers and Nurse Educators
 To meet the immediate basic survival needs of
 Level II
populations affected by disasters
o A nurse who has achieved Level I and aspires to
be designated as disaster responder within an
institution
o Examples: Head/Supervising Nurse, a nurse
designated with leadership on hospital
emergency planning committee
 Level III
 o A nurse who has achieved Levels I and II
competencies and is prepared to respond to a
wide range of disaster and to serve on a
deployable team
o Examples: Nurse responders, EMTs, military
nurses, and nurses conducting comprehensive
disaster nursing research
Core Competencies of a Disaster Nurse
 Effective Nursing Practice during any disaster
requires COMPETENCY and application of the
UTILITARIAN and DO-NO-HARM PRINCIPLES
 Utilitarian Principles- “Doing the Greatest Good for
the Greatest Number with the least amount of
Harm”
4 Areas
 Prevention and Mitigation
I. Policy Development and Planning
II. Risk Reduction, Disease Prevention, and Health
Promotion
 Preparedness
I. Fundamental Attitudes toward disaster nursing
A. Ethical Practices: Respect for Human Dignity
and Rights
B. Professional responsibility and accountability
(awareness of responsibilities as a
professional during disasters)
C. Legal Practice: Understanding & following
laws and regulations
o Nurse Practice Acts: describe and define
the legal boundaries of nursing practice
within each state
o Standards of Care: legal guidelines for
nursing practice. Guidelines and standards
help you maintain quality of care
Consent
 A signed consent form is required
for procedures and care
 *Battery if a first aider touches the
victim without permission
 Gaining Consent:
o During this conversation, it is
important to identify the
following key points:
 Who you are
 Why you are with them
 What you are going to do
o Expressed Consent
 Voluntary given (oral or
written)
o Implied Consent
 Is unconscious
 Has a very reduced level of
consciousness
D. Building supportive human relationships with
understanding toward disaster victims’
diversity and individuality
E. Supporting disaster victims’ decision-making
 Response
I. Systematic Assessment and Provision of
Disaster Nursing Care
A. Basic knowledge about disasters and
assessment of disaster situations
B. Providing nursing care for initial relief
C. Providing nursing care in the mid and long-
term phases
D. Knowledge and practice for disaster
preparedness
E. Providing mental health care in times of
disaster
F. Providing care for bereaved families
G. Maintaining care providers’ own health
II. Care provision for vulnerable people & their
families and communities during disasters
A. Care for mentally and/or physically disabled
persons
B. Care for children and their families
C. Care for pregnant women, child-rearing
mothers & their families
D. Care for persons with mental illnesses
E. Care for elderly
F. Care for chronic disease patients
III. Care management in disaster situations
A. Understanding the local emergency
management system, and the roles and
functions of health services/medical
services/nursing in the system
B. Sharing information appropriately during
disasters
C. Grasping local medical/health service needs
during disasters
D. Coordinating health/medical support
activities in and outside disaster-stricken
areas
 Recovery and Rehabilitation
o Long term recovery of individuals, families and
communities
A. Preventing or reducing stress-related illnesses
and excessive financial burdens
B. Rebuilding damaged structures
C. Reducing vulnerability to future disasters
8 Domains
 Domain 1- Preparation and Planning
o Actions taken apart from any specific emergency
to increase readiness and confidence in actions
to be taken during an event
 Domain 2- Communication
o Approaches to conveying essential information
within one’s place of work or emergency
assignment and documenting decisions made
 Domain 3- Incident Management Systems
 o The structure of disaster emergency response
required by countries/organizations/institutions
and actions to make them effective
 Domain 4- Safety and Security
o Assuring that nurses, their colleagues and
patients do not add to the burden of response by
unsafe practices
 Domain 5- Assessment
o Gathering data about assigned
patients/families/communities on which to base
subsequent nursing actions
 Domain 6- Intervention
o Clinical or other actions taken in response to
assessment of patients/families/communities
within the incident management of the disaster
event
 Domain 7- Recovery
o Any steps taken to facilitate resumption of pre-
event individual/family/community/organization
functioning or moving it to a higher level
 Domain 8- Law and Ethics
o The legal and ethical framework for
disaster/emergency nursing

Roles and Responsibilities of a Disaster Nurse

(“NURSE ACTS during DISASTER”)

 Nurses’ plans should be integrated and coordinated

along with the other health team members
 Update physical and psychological preparedness
 Responsible for organizing, supervising and teaching
 Stimulate community participation
 Exercise competence

 Adaptation of nursing skills to situation

 Continues awareness
 Teach auxiliary personnel
 Selection of essential nursing care

 Disseminate information on environmental health

hazards
 Interpret health laws and regulations
 Save yourself
 Accept directions and take orders
 Serve the best for the most
 Teach meaning of warning signals
 Exercise leadership
 Refer to appropriate agencies