Marilyn Pattillo, RN, Ph.D., is an associate professor of clinical nursing and co-chair of the Disaster Nursing Committee, and Trish O'Day, MSN, RN, CNS, is an instructor in clinical nursing in the School of Nursing.
What was your initial reaction when you heard about the earthquake in Haiti?
MP: Sadness. Sadness for those whose lives have been disrupted. Sadness because I know that many groups from countries all over the world are sending help. Unfortunately there is probably no command and control in Haiti to organize the response efforts. As usual, politics, influence and power will come into play.
TO: My initial reaction was how different this disaster is from a disaster in the United States. Even with the many challenges of Katrina in our country, the aftereffects of this earthquake in Haiti will not be remedied in five or 10 years. After Katrina, there was housing (imperfect, perhaps) for evacuees to transition to. That is not the case in Haiti, with no resources to rebuild. Where will survivors live?
How important is it for nurses to be mobilized into Haiti to help with triage and providing care?
MP: There are trauma and emergency room nurses who are trained to work in triage teams and assist in search and rescue efforts. Most nurses, however, will be needed to stabilize injured patients and to keep epidemics from happening. In addition, nurses can also help by:
- Mobilizing and keeping the families resourceful and intact to help with caring for injured family members.
- Preventing a "second disaster" by conducting good health assessment and disease surveillance.
- Organizing immunization and vaccination efforts.
- Identifying people at high risk for malnutrition and sickness.
- Identifying areas that need immediate assistance because of poor sanitation, lack of water, lack of good food, grief and psychological trauma.
- Setting up shelters that are safe and can provide respite.
- Training local nurses and physicians.
- Collecting data so resources can be appropriately allocated.
TO: Nurses are always an important part of the disaster response team. If nurses are already on-site, with non-government organizations (NGO) or other agencies, that would be the best and most quick response. However, if not, nurses arriving in disaster response teams will be invaluable in providing immediate and ongoing shelter care to survivors.
How do the circumstances of nursing change when working in a disaster, especially in an impoverished area such as Haiti?
MP: How does one provide care when:
- There is no running water.
- There is no road or communication lines to move food, clothing and shelter to those in need.
- Safety is not assured.
- People are hungry and cannot get food.
- When toilets don't work (or there are none).
TO: We hope that all nurses are prepared to offer assistance in their communities during times of emergency. When mobilizing to an extremely impoverished area, such as Haiti, survivors may be malnourished and in poor health. It is very evident that medical supplies are in short supply, and even bringing in supplies and health professionals will not offset the lack of electricity and clean water.
What are a few key things you teach your students about mass casualty disasters?
- The time to exchange business cards is not at the disaster site.
- Training is important. "Spontaneous" volunteers (nurses and doctors who show up untrained and unknown) take up time and can be unsafe.
- Responders need to be physically, emotionally, spiritually strong and ready. An injured or sick nurse is not much help.
- It is not enough to be an expert in your field; it is more important to know how you fit in the context and the multitude of players that make up the disaster response. One may be "big man on campus" on a normal day, but will be a worker bee during a disaster response. Get over it.
- The real work begins when the first responders, media and like-minded others leave. The real work comes with the rebuilding and making changes so that a better life can be had. Disaster nurses with the emphasis in their skill with working with communities, families and community/public health can help.
Is disaster nursing becoming more important for students to learn?
TO: Yes, disaster nursing is an integral part of the bachelor of science in nursing (BSN) curriculum. Future nurses need preparation for both natural disasters and man-made disasters (such as biological weapons).
As of now, do you know of any local involvement and/or deployment of medical staff to Haiti?
MP: I have been called to determine my availability from International Medical Corps. Also, I am sure that those in the military reserve are on call. American Red Cross Central Texas Chapter is involved in fundraising and helping link Texans in Haiti back to the families in the Central Texas area.
TO: I understand paramedics from Austin have deployed.