Role of the major public health personnel, including the public health nurse, involved in the disaster.
The key roles of the public health personnel including the community nurse include the assessment of the disaster, policy development, and provision of health care needs for the affected victims of Franklin County. The community nurse provides direct care to the patients, families, or a group of people that were affected by the disaster through the door to door visits. The community nurse is collaborating with experts from other disciplines such as the epidemiologist (Sharon Kong), Fire department (Jim Anderson), EMS department(Cory Sanborn), Police department(Jeff Stackhouse), public health officers 9(Lane Harris), Environmentalists (Seth Stattmiller), and many other social workers such as the bookkeepers and receptionists to enhance and make the emergency response effective. In Franklin County, the community nurse is seen engaging other people to assist in the Franklin disaster response such as in the case of Rosario Alvarez who is assisted to get the Spanish material on safe food and water (Department of Health Services, 2012).
The nurse provides services at the patients’ home and teachings to the patients regarding their treatment plans. Some of these teachings include demonstrations. E.g. On Day 5 Final EOC briefing, the nurse was required to be present so as enlighten the operation officer on the type of food that should be supplied to the affected people. The nurse has a role of providing information on the causes of the food borne illnesses and stipulates the measure the community should take to avoid the illness outbreaks (Qureshi, 2002).
It is therefore fair to conclude that the community nurse serves as the first point of contact in clinical issues. They have the necessary skills and competency to develop comprehensive plans and policies. The nurse evaluates the disaster response drills and conduct exercises and trainings to health services to the victims of the disaster (Qureshi, 2002).In Day four at 11 am restaurant inspection, the community nurse needed to be aware of the standard operating procedures collaborate with the public health officer.
Chain of command
The Acting Incident Commander (Jim Anderson).
He oversees and directs the entire response efforts. Ensure that the response effort is conducted in an effective, efficient and organized manner. He delegate roles to each team member and reviews what needs to be addressed.
Public health department
Public health department is responsible for addressing the immediate public health needs. Community health nurse together with the public health nurse are sent out to the door to door to assess the community needs. They follow up to make sure that those needs were addressed. This is the position of the community nurse who has a public health information officer who ensures that constant information is provided on demand and that the released information is accurate, consistent and timely. The community nurse provides information to the public health information officer, who updates the Public information Officer, who then updates the Incident commander (Department of Health Services, 2012).
The resources available to the community health nurse outside the nurses’ scope of practice.
The scope of practice for a community health nurse is promoting and protection of the population’s health by the use of knowledge leant in nursing, socially, and in public health sciences. The key resources of a community health nurse to deal with situations outside their scope of practice are the nursing skills which are outside the scope of practice for the community health nurse (Department of Health Services, 2012).
Other resources include their creative problem-solving skills which entail resolving the problem with whatever resources that is available. Day one after the chain of command had been established, at the first EOC briefing. Chris reported that 6 deaths and 14 injuries had reported. He also reported that temporary housing for 125 people were needed. The nurses in their role to establish had a role to identify the cases that needed tetanus vaccine. Matt westlund residence was reported to be flooded. All these are actions needed the application of the nurses’ resources to address them.
Actions taken by community health nurse when encountered with possible emergency situations during the door-to-door interviews
In cases of they are encountered with emergency situations during the door to door interviews, they provide the basic first aid and because they stay in contact with other physicians, they seek their quick interventions. The case of Jason Fugate is an emergency case that the nurses encountered in the door to door interviews. Because the nurses have the necessary skills to administer basic treatment medication and to staff congregate shelter which has basic health needs, the nurse contained the emergency situation. Day four of the door knocking task, they established that Eating establishment would be critically impacted by power outage and reduced access to safe water, the role of the nurse .Nutrition related illnesses was likely and this was an emergency intervention. The nurse had to provide dietary modifications and recommendations, then provide treatment and prevention guidelines. (Scutchfield, 2009).
Watery diarrhea is a fatal disease that can cause loss of life. The nurse role is to provide preventive medication. Though it was the role of the public health to control the situation, the community nurse had a role to determine the likelihood of ware borne diseases outbreak that was likely to occur because of hazardous environment such as cholera outbreak which may be another disaster. These are emergency cases the nurse’s encountered (Scutchfield, 2009).
Actions taken by the community health nurse to help the people
The community nurse conducted community education through a press conference on Day seven 7 pm at the town hall meeting to increase the awareness about ways of preventing infectious disease, so as to dispel the rumors of the outbreak in the community. The nurses had contacts with other service providers such as LIZ, ASAP whom the nurse contacted to follow up with in the cases of after-disaster effects. In Day 5 Final EOC briefing the nurse was needed to be accessible to the after-action reviews and debriefings were carried out on Day 30 to evaluate the quality of the community health services and lessons leant (Scutchfield, 2009). In Day 5 in the Final EOC briefing, community nurse was needed to be available to address the issue of food supply, and collaborate with the environmental health assistant to educate people on mold and the effects of the hazardous situation in the community.
Day 15 Subsequent Health concern a nurse to address the mental health issues and on post traumatic situations. This is a recovery measure where the nurse is involved in restoring health to the community.
The role of the nurse was to access the potentially dangerous situations that may arise due to food borne illness because of eating food contaminated with parasites and bacteria. (Scutchfield, 2009).
Techniques that could have been used
The technique that could have been used is the linking of the nursing practice with the each disaster phase so as to bring in the necessary expertise in each phase. However, in the case of Franklin disaster we see the various expertises being utilized. Though a record of each days activity is recorded, there is the lack of phases which includes the mitigation phase, preparedness phased, Response phase, and the recovery phase. The steps are the assessment, planning and implementation. These steps of nursing should be linked with the various disaster phases (Qureshi, 2002).
How other nursing personnel could be prepared to help in responding to a similar emergency
Other nursing personnel can be prepared in various ways. The nursing personnel need skills covered in core competencies in disaster preparedness (Gebbie, & Qureshi, 2002). This competency includes the ability of the nurse to;
Ascertain and describe their role in disaster response
Be able to describe the chain of command in the response.
Be in a position to identify the emergency response plan and knowledge on its contents
Ability to know their roles and how to do them
Demonstration of correct equipment use (both personal protective tools and communication equipments).
Ability to identify their limitation and identify system resources for assistance.
Application of creative skills to solve the problem and ability to evaluate effectiveness being experienced.
Ability of the nurse to identify deviation from norm that may cause emergencies and describe suitable actions
Participation in continued education to keep abreast with new emergency response developments.
Participation in planning, evaluation drills and exercising (Scutchfield, 2009).
Gebbie, K.M., & Qureshi, K. (2002). Emergency and Disaster Preparedness: Core
Competencies for Nurses: What Every Nurse Should But May Not Know.
American Journal of Nursing.102:46.
Reck, C. & Scutchfield, F. (2009). Principles of public health practice (3rd ed.). Clifton Park: Delmar, Cengage Learning.
U.S. Department of Health Services. (2012). Retrieved from http://www.hhs.gov/about/
http://www.cdph.ca.gov/Pages/DEFAULT.aspx
