Any nurses who have ideas on how to help in disaster - page 2

With all the talk about potential of terrorism in the country it makes me wonder what we as nurses and citizens can do to prevent and or intervene in cases of disaster in our communities. I want to... Read More

  1. by   betts
    Training for Disaster

    American Red Cross helps prepare nurses to respond to national emergencies


    Any nurse can tell you where she was when the first jet hit the World Trade Center on Sept. 11, 2001.

    I am the assistant head nurse of ambulatory surgery at Maine Medical Center in Portland, ME. That day I was leaving my office to grab the schedule from a nurse's desk when I noticed a group of staff huddled around the television. I will never forget the shocked looks on their faces.

    I stood in the back straining to hear what the newscasters were saying. I was beginning to absorb what was happening when the second jet hit. My American Red Cross pager, which I keep with me at all times, was going off. It was then that I knew history was being made. This was no accident, but a deliberate act of terrorism against our nation.

    I have been a nurse volunteer in Disaster Services for the Portland Chapter of the American Red Cross for about 3 years. A year and a half ago, I accepted a nationally appointed volunteer position as Red Cross nurse liaison for the state of Maine. I dedicate my time and energy to nurse recruitment, disaster training and educating nurses on the importance of being prepared and trained before disaster strikes.

    Nurses play an important role in the Red Cross mission of helping to save lives. Once nurses receive training in disaster response and gain experience at the local level, they may wish to serve on a national assignment. Disaster nurses provide health-related services and secure resources to meet the health needs of disaster victims as well as Red Cross relief workers.

    Disasters Down East

    How many true disasters has your area had? In Maine, we don't have to go back very far to remember the devastation of the 1998 ice storm. While there was not a large loss of life or structural damage, it was still a real "disaster." Living without power in the dead of winter can be quite serious. Sixty shelters were opened throughout the state to provide food and warm shelter as some families were without power and could not get back into their home for weeks. Each shelter required nurses on site.

    In 1998, Maine did not have enough nurses trained in disaster response to staff these shelters. State Red Cross leadership had to tap into the national supply of volunteer nurses through a national volunteer network. When a trained disaster nurse is placed in the network's database, he or she is committing to serve for at least 2 weeks wherever and whenever needed. It could be 2 weeks in the Carolinas after a hurricane hits the coast or in the Midwest after a tornado flattens a town. It might be in California where wild fires ravage dozens of homes or in Texas where floods force people into the streets.

    A Call to Serve

    Nurses were needed around-the-clock for more than 8 months at a Red Cross Service Center at ground zero in New York City. The call went out for trained Red Cross Disaster Services volunteers to respond immediately.

    The Red Cross has established procedures that allow a nurse to practice outside the state he or she is licensed in. The Portland Chapter received a call from national headquarters in Washington, DC, asking how many trained nurses (among other disaster volunteers) were available.

    Since airports were closed in the days following the attacks, there was a need for people who could travel to New York City in a matter of hours. Only three trained disaster nurses were available from Maine. I received more than 200 calls from health care professionals wanting to head to ground zero to help. All had impressive health care backgrounds-but none had Red Cross training in disaster response.

    My point is this: Training needs to happen before disaster strikes. Trained disaster volunteers are needed.

    Training and Support

    The Red Cross provides classes to nurses who want to be trained in disaster nursing, including a 3-hour video-based course that provides an overview of disaster, the community response, and the role of the Red Cross. Another program gives the volunteer nurse basic information on the activities of the Disaster Health Services (DHS) function of the organization. The Red Cross also offers numerous courses that cover other aspects of disaster relief, including managing a shelter, meeting the needs of those displaced and damage assessment.

    If responding to disasters across the country does not fit into a nurse's lifestyle, there are plenty of opportunities to volunteer at the local level. Another option is to join a Red Cross Disaster Action Team (DAT), which provides disaster services such as shelter, clothing, food and medications to victims. Nationally, the Red Cross responds to more than 67,000 disasters each year-the majority being single-family fires.

    Educating Others

    Nurses can also play a major role in educating the community on ways to effectively prepare for disasters, including terrorist attacks.

    A nurse volunteer can help people prevent, prepare for and respond to emergencies by becoming a Red Cross Health and Safety instructor. Courses offered include first aid/CPR and HIV/AIDS prevention, among others. Red Cross instructor qualification guidelines acknowledge the professional knowledge and skills of the registered nurse so the time it takes to become an instructor is shortened for these and other Red Cross courses.

    With additional training, volunteer nurses can also provide assistance at first aid stations during community events, such as fairs, walk-a-thons, races or large corporate gatherings.

    The American Red Cross also invests in the nurses of tomorrow through its Student Nurse Initiative. By working with the Red Cross, student nurses are able to exercise newly acquired nursing skills while at the same time delivering lifesaving services to their communities. A student nurse may obtain college credit for independent study programs in Community Service. Red Cross Biomedical Services uses student nurses on blood drives to help take blood pressure and monitor donors after giving blood.

    During a large-scale disaster, student nurses are eager volunteers and make up for the shortage of those acute-care nurses who are torn between responding to the disaster with the Red Cross and responding to the health care facility where they are employed. And best of all, a volunteer student nurse becomes a volunteer RN after graduation.

    Managing Disaster

    In these uncertain times, it has become clear that training nurses in disaster response is vital. But recruiting overworked, understaffed and stressed nurses can be a challenge. Once nurses have been trained in disaster, they are sometimes eager to apply their training on a Red Cross assignment.

    Some hospitals find it difficult to support nurses when a Red Cross assignment comes up because the nurse will be pulled away for at least 2 weeks, and often on very short notice (less than 24 hours). Nurses do not get paid to go on assignment, although the Red Cross covers travel expenses, room and board. Many nurses cannot afford to go without pay, nor do they want to take two weeks "vacation time," which is all some nurses are allowed for the entire year.

    I personally challenge health care facilities to make this process more manageable. One way to do so would be to set up a policy that allows trained disaster nurses to go on assignment by compensating them financially as a charitable donation. To ensure the facility's needs are met, a limit on how many nurses are allowed to respond per year could be set. Nurses serving on a disaster can be beneficial to a hospital in numerous ways. A nurse can return and write an article for a hospital newsletter, the local newspaper, or a nursing publication highlighting the facility.

    A nurse's first-hand disaster experience could be helpful in developing or refining a facility's disaster plan. Qualified disaster nurses are needed to educate and support their communities. Having them available to their community makes everyone feel a little safer.

    Prepared for the Future

    In November 2001, Paul Clark, assistant Emergency Services director of the Portland Chapter of the Red Cross, and I set up a 4-day training in Disaster Health Services seminar for 53 public health nurses. We now have a pool of trained disaster nurses to call on if disaster strikes. My mission as Red Cross state nurse liaison for Maine is to recruit, train and promote the use of nurses in preparation for disaster response.

    The world has changed dramatically over the past year. The need for nurses to volunteer their time and expertise for disaster response is now. The people of our nation are depending on it.

    * For more information on Disaster Health Services and volunteering as a nurse for the Red Cross in your community, contact your local Red Cross chapter. Local chapter contact information can be found at or the white pages of the local phone directory. Residents of Maine can contact Sharon Bagalio at

    Outside of Maine, you can contact Laurie Willshire, RN, American Red Cross Office of the Chief Nurse, at

    Sharon Bagalio is assistant head nurse of ambulatory surgery at Maine Medical Center in Portland, ME. She is also Maine state nurse liaison to the American Red Cross, and serves as disaster health services coordinator for the Portland chapter of the Red Cross.


    JCAHO Guide Addresses Emergency Management

    JCAHO's Joint Commission Resources (JCR) is now offering a Guide to Emergency Management Planning in Health Care. The book, released in June, gives health care organizations practical advice on designing, revising and implementing an emergency management plan that is flexible enough for a variety of disasters.

    The guide teaches: collaboration with community and governmental agencies and other health care organizations; creation of clear, effective communication channels both within organizations and with outside agencies; and the training and management of staff to handle a variety of emergencies.

    Readers benefit from case studies and lessons learned from organizations in New York City, Oklahoma City and Houston. Checklists, forms and examples are included for each organization to adapt to its own specific needs.

    Guide to Emergency Management Planning in Health Care also addresses the psychological impact of a disaster on staff, and how to work with the media. It supports applicable JCAHO Management of Environment of Care, Management of Human Resources, Management of Information, Leadership and Medical Staff standards.

    For more information, call 630-792-5800 weekdays, or visit Infomart on JCR's Web site at

    -- Timothy A. Mercer


    Prepare to Care

    National Nurses Response Team Readies for Disaster

    By Emily Todarello

    If a biological attack occurs, it is estimated that 200 personnel working 100 hours would be needed to deliver chemoprophylaxis to approximately 100,000 patients, according to the American Nurses Association (ANA). Smallpox, for example, is an agent that can be transmitted by person-to-person contact and can quickly affect millions of people.

    At its 2002 Biennial Convention in Philadelphia, the ANA announced a partnership with the U.S. Department of Health and Human Services (HHS) Office of Public Health Preparedness and the Public Health Service (PHS) to respond to presidentially declared disasters.

    The National Nurses Response Team (NNRT) is comprised of 10 regionally based teams of 200 RNs who will assist in a mass vaccination or chemoprophylaxis campaign in the event of a biological attack.

    The ANA will recruit RNs, provide ongoing education about disaster response, and serve as both resource and advocate of the program. The HHS will process and screen applications from nurses and manage daily operations.

    "Clearly, since Sept. 11 and the subsequent targeted release of anthrax, the need for this type of education and training for nurses is even more urgent," said Mary E. Foley, MS, RN, then-president of the ANA.

    A Nurse's Role

    "I think every one of us, as health professionals, as members of a caring profession, and as Americans, wanted to find some way to help our country after the attacks of Sept. 11 and the anthrax events," said Rear Adm. Mary Pat Couig, MPH, RN, FAAN, chief nurse officer of PHS. Nurses who decide to join NNRT will be federalized when deployed and receive umbrella coverage for licensure and liability. During their duty period, these nurses will also receive a salary, travel and housing reimbursement, and per diem expenses.

    RNs must complete an online continuing education course, and will receive additional education and training in emergency and bioterrorism response once assigned to a team. Team deployments occur quickly and last approximately 2 weeks. Nurses would also be entered into a central database for future call.


    A provision of the Public Health Security and Bioterrorism Response Act of 2002, which President Bush signed into law on June 12, ensures that deployed NNRT members will be able to return to their jobs. Employers are not required to release an NNRT member for deployment to an emergency, but employers are required to re-employ RNs who were released following duty. The ANA provides tools to guide employers in the event of deployment.

    The act was put into place to improve public health preparedness, enhance controls on deadly biological agents and protect the nation's food, medication and drinking water supplies.

    "As nurses, we always plan, anticipate and try to respond so that nursing as a profession will be ready" said Foley.

    The PHS is also looking to pharmacists, pharmacy students and nursing students for assistance.

    For more information, visit
  2. by   nursecheryl
    I'll check out our local red cross and see what they have with training for a disaster. THanks for the information. Cheryl
  3. by   nursecheryl
    I have already joined this but never heard back from them yet.
    I think this may be an avenue I'll be taking in the near future as I mentioned above.
    Thank you both for your response
  4. by   mikemw
    check in to the National Disaster Medical Medical system NDMS they have different types of teams and utilize both medical and communications perssoneel. It falls under the dept of Health and Human Services and Homeland Defense. During a disaster members become temporay federal employees for more info try this web site. URL= feel free to contact me at about disaster nursing.
  5. by   AngelGirl

    Thanks for the Website address. I went there and was very impressed at the amount of information provided. Adding it to my list of Website 'favorites' I intend to make many return visits. There's a lot to see there!
  6. by   AngelGirl
    Thank you, for the great list of
    Disaster Nursing Resource Websites.

    I also contacted Laurie Willshire at
    She sent an additional list of Websites for Disaster Preparedness.
  7. by   susanhrn
    Hello "Nurse Cheryl,"

    I am currently the Emergency Preparedness Coordinator for my county. The Homeland Security Act has changed how agencies admit and screen volunteers, so if you go directly to the Red Cross you may not get a reply. You will have to go through this route: Civil Corps.

    What you need to do to get into the CC is this, contact the Emergency Management Director (EMD) for your county of residence (go through your County Health Department to get the contact info if you don't already know who your EMD is).

    Once you contact your EMD, they should have instructions for you to follow on how to apply, which will include a thorough background check. Once you pass the background check, you will then be placed into whichever category you applied for: health, law, or general.

    I wish to personally thank you for your efforts in volunteering, you will be much needed when (God forbid) another disaster or terrorist act occurs.

  8. by   Sleepyeyes
    Radio? Did you say radio?

    Check out the Military Affiliate Radio Systems (or MARS) for ham radio licensees.

    DH and I were members of Air Force MARS. Great program, especially in times of disaster.
  9. by   The Bear
    Quote from nursecheryl
    With all the talk about potential of terrorism in the country it makes me wonder what we as nurses and citizens can do to prevent and or intervene in cases of disaster in our communities. I want to get involved but unsure in what way. I'm interested in emergency radio communication and would be able to help in that way with the help of my husband, but am more interested in the medical part of helping. One way is being part of the emergency response team with red cross. I've attempted to contact them with volunteering but they never got back with me. I guess they have enough help. Do any of you have any ideas about how you can volunteer in this area as a nurse.
    I just finished a CERT (Community Emergency Response Team) Training course, taught by the Rochester,NY Fire Department. Go online, and put CERT in and you will get different web pages about CERT training. Or call your local Fire Dept. to see if they have a program. I also wanted to someting like you mentioned, this is a beginning.
    I do feel that American Nursing Community should get together and form "private citizens (nurses) MASH like units in every community. When the next big disaster occurs, nursing needs to be ready to help out. After all, they might blow up the hospital where we work. So we nurses in the community need training in "Field triage" and in community diaster response!
  10. by   zacarias
    Quote from SHELLYBELLYRN

    Here is the link for the National Nurse Response Team.........including the application and lots of info about what is needed. Hope this helps
    So to get on this team, you have to send in all those applications on that page with "Applications for Federal Employment"?
  11. by   TMPaul
    Quote from CATHYW
    nursecheryl, the office of Homeland Security has formed a citizens' group that can be mobilized by that office under the auspices of FEMA and the Emergency Management Agency of hte state you live in.
    I have signed up for it, but cannot remember the exact name of the agency, I am sorry to say! I clicked on the site as a link from the site. You might try looking there. Sorry to be so vague, but I am at home, and the info is in my office at work. The most likely and most immediate thing I can imagine is the immunization against smallpox. That is the thing that is mentioned in the informtational site.

    Good luck, and good hunting!
    It's called a DMAT (Disaster Medical Assistance Team) through the Department of FEMA (FEMA is under the Department of Homeland Security). Check FEMA's web site for details.
  12. by   Brian
    just wanted to update this thread with the link to the National Nurse Response Team website