As I sat watching the horrific TV scenes of devastation from the surge and flood waters of Hurricane Sandy, I noted a message scroll across the TV screen: NYU medical center to evacuate patients due to a failure of a backup generator.
My husband asked me, "how does this happen?"
Fortunately, as nurses, we are provided emergency preparedness training on orientation and as part of the continuing education program. When emergency situations occur off hours, who are the administrators who will initiate the emergency response? They may be onsite nursing supervisors. Nurses play a crucial role in responding to emergency situations. The nursing supervisor or administrator will initiate the emergency management plan.
Each organization develops an emergency management plan that addresses mitigation, preparedness, response, and recovery. The plan identifies potential emergencies that could affect the organization and coordinates activities with outside agencies. The Hospital Emergency Incident Command System (HEICS) includes close collaboration with outside agencies -- first-responders such as police, fire, EMS personnel, and other healthcare organizations.
In the HEICS system, an incident command structure and control center is implemented with job-specific duties identified with names, roles, and telephone numbers of the individuals within the command structure. Resources such as manpower, supplies, transportation, and alternate care sites are identified. The plan addresses the management of the following activities:
- Patient care-related activities
- Procurement of supplies
- Security activities
- Family support activities
- Staff support activities
- Communication activities (i.e. external agencies including news media)
The plan includes policies for partial or total evacuation. It also includes plans for transportation of patients, supplies, and personnel to alternate sites as well as inter-facility communication.
When directed, staff nurses on each unit are expected to triage their assigned patients to identify care needs and possible disposition. Patient care priorities are established. Plans are made for those who may be discharged. Clear communication of patient care needs and patient safety are critical. Patient records and essential equipment accompany each patient.
The staff at Langone Medical Center performed as a well-prepared team to provide safe care to their patients in an emergency critical situation. Such performance is a direct result of a commitment to planning, ongoing staff education, and executed drills with external agencies.
Our organization emphasizes emergency preparedness education, participation in drills, and critical debriefing to ensure ongoing evaluation. So next time we are scheduled to attend a mandatory staff education program on this topic, let's not forget the vital role that nursing is expected to fulfill. Remember, knowledge is power, and we must be prepared because our patients are counting on us.
The following Internet resources can be helpful when considering disaster preparedness:
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