The Competencies of Disaster Nursing

The to believe that it is the strongest on the planet. We create megalopolises, build factories, power plants, and dams, subjugate animals, and so on and so forth. Actually, we can control and predict many things. Nevertheless, that is only a huge illusion. There will always be one thing that is hard to predict and impossible to control. That is the nature. And a large number of disasters that regularly occur throughout the world is the greatest proof. Floods, hurricanes, tornados, earthquakes, volcanic eruptions, tsunamis they always happen unexpectedly, and all that remains for us to do is to recover from the consequences. In addition to natural disasters, there also are manmade ones. If floods or hurricanes can be predicted at least for some time before they happen, terrorist attacks, for example, are much less predictable (Gebbie & Qureshi, 2002, p. 49). As a result, they are harder to prepare for. According to a study conducted by Markenson, DiMaggio, and Redlener (2005), the majority of the who participated in it admitted that they felt more prepared for natural disasters than for terrorism (p. 518).

It is hard to define a disaster, and probably there is no single agreed-upon definition of it, but all definitions address the events that cause the widespread destruction, lead to human, material, economic or environmental losses and make people unable to respond adequately using their own resources ( and International Council of Nurses, 2009, p. 3). So, no matter if it is a natural disaster or a manmade one, it does have irreparable consequences. The most disturbing fact is that disasters happen more often presently. According to Birnbaum (2002), during the last fifty years, their number has been steadily increasing, and the biggest rise has happened in the last decade. In confirmation of this, World Disasters Report states that there have been 60% more disasters in the world in the last decade in comparison with the previous one (World Health Organization and International Council of Nurses, 2009, p. 3). The same report said that the number of victims increased by 20 percent, and the number of death almost doubled (World Health Organization and International Council of Nurses, 2009, p. 3).

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All of this confirms the need to have a well-prepared and skilled workforce that will be able to respond effectively when a disaster comes. And out of all health care workers, nurses are often the first medical personnel on site after disaster strikes (World Health Organization and International Council of Nurses, 2009, p. 4). They assist in providing first aid to sufferers, rescue lives, and help people to overcome both physical and psychological issues. They are the first responders, and that is especially true about the nurses of emergency department since EDs are overloaded with victims in times of disasters. That is why nurses should be aware of how to act at any stage of disaster management, starting with preparedness and ending with a recovery phase (Gebbie & Qureshi, 2002, p. 47). This paper examines the core competencies of disaster nursing, including competing issues in this matter, discusses those on a scope of an emergency department, talks about ethical practice and nurses ability to response and finally gives a conclusion with my own perspective on the problem.

Competencies and Competing Issues
Competencies in General
The to the behavior of an individual who performs a specific role in a certain situation (Loke & Fung, 2014, p. 3290). In other words, it can be defined as a combination of the knowledge, skills, abilities and behavior needed to carry out a job or special task (Loke & Fung, 2014, p. 3290).

In their article, Gebbie & Qureshi (2002) identify several core competencies to be followed by nurses and their departments. First of all, a , a department or a unit should decide what tactic to choose when a disaster strikes. In other words, it is necessary to determine if the range of provided services will change or if a unit will function as usual. For instance, when a disaster happens, nurses can either stay at the hospitals and perform their routine services or go to the hotspots, evacuate people and provide first aid. Secondly, well-orchestrated teamwork is necessary (Gebbie & Qureshi, 2002, p. 48). Everyone should know their role and place and be aware of the planning and logistics. Otherwise, it will be impossible to respond quickly and efficiently. Thirdly, every nurse should be familiar with the concepts of a disaster response plan and know where it can be found. Apparently, they should know all of the core aspects before a disaster happens.

The next step to think about is the gap between knowledge and practice. Nurses should not only be taught what to do if a disaster arises they should be taught that in practice. A disaster response plan has to be tested. For example, there is an issue of equipment. All nurses are already well familiar with the equipment, which they use from day to day, but in the case of a disaster they will probably be required to use another, unfamiliar one. To avoid the mistakes connected with this, nurses should be taught how to use it in advance.

Particular attention should be paid to communication equipment. Communication failures are crucial, and they have already made the consequences of many disasters even more complicated. The prime example is Hurricane Katrina. The communication systems failed, which is why local and state governments could not deliver the resources to the places where those were needed: for example, they had buses to evacuate people, they just did not have those in the right places. As a result, many people were not evacuated in time, and that caused more injuries and deaths. Another example is a terrorist attack on September 11, 2001. The evacuation orders were sent to both police and firefighters; police heard the order, but the equipment the firefighters used could not receive it (Peha, 2007, p. 61). Consequently, although they had enough time to evacuate (nearly half an hour after the first order was transmitted), they did not, and 121 lives were lost (Peha, 2007, p. 61). Communication failures cause a slow reaction, higher levels of stress, loss of critical thinking skills, an inadequacy of decision-making, and, as a result, the mistakes, which a person would have never made in other circumstances. An emergency department operates just like any other organization, and poor communication affects it as well. However, in this case, it will cost more peoples lives. Not all nurses are familiar with the communication equipment, which is why all of them should be taught how to use it beforehand.

Finally, no matter how well you are prepared and how well you know a disaster response plan, many things will go out of control, and many ethical issues will arise. That is why the most important competencies in the case of a disaster are the problem-solving skills and critical but flexible thinking. For instance, if communication systems have already failed, all that remains to do is to try to find the alternatives, up to use a runner to send a message.

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