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What Is Disaster Nursing?

Oct 20, 2020
Kaithlyn Rojas MSN, RN, CCRN

Nurses have been and continue to be essential frontline soldiers in the COVID-19 pandemic. In March of 2020, Gavin Newsom, the governor of California, sent out a request for all medical professionals, including upcoming graduates and retirees, to assist in the state’s COVID-19 response:

“Health professionals, California needs you!” With that, the California Health Corps was born, and thousands of health care professionals mobilized to help in the pandemic.

I have been an active member of the California Health Corps, as well as the California Medical Assistance Team (CAL-MAT), since April 2020. My first mission involved deploying to what was, at the time, California’s hardest-hit county for coronavirus cases. I worked as a registered nurse at an alternative care site, which was essentially a gymnasium that had been turned into a covid “hospital.”

two side-by-side pictures of alternative care sites during disasters disaster nursing
Alternative Care Site for the Spanish Influenza, 1918 (left). Alternative Care Site for the COVID-19 Pandemic, 2020 (right).


Since then, I have had the opportunity to use my nursing skills at a fire evacuation shelter to provide free coronavirus testing in remote areas of California. Every month, I provide my availability, and if there is a need for nurses in the dates I provided, I receive a phone call with information on the mission as well as to see if I am interested in deploying. 

It has been a way for me to feel like I am contributing to my community during such an unparalleled time in the state’s history. 

From pandemics to natural disasters—such as hurricanes, earthquakes and fires—nurses have been consistent in responding to the needs of not just hospitalized individuals, but groups and communities in times of crisis as well. 

Fast forward to the present – with fires raging throughout California, hurricane season still ongoing, and the pandemic still affecting our country, there is a strong desire from nurses all over to provide relief in any way possible, and one of the ways to do that is through disaster nursing.

What Is Disaster Nursing?

Disaster nursing is the adaptation of professional nursing knowledge, skills, and attitude in recognizing and meeting the physical and emotional needs of disaster victims.

The origin of disaster nursing can be traced back to the founder of modern nursing herself, Florence Nightingale, whose service and dedication during the Crimean War influenced many to follow in her footsteps as a nurse.

The Role of a Disaster Nurse

The role of a disaster nurse begins long before catastrophic events even occur. Different agencies offer disaster training and preparedness for nurses. They then form response teams that can be prepared to deploy to affected areas in a timeframe as short as 24-hours.

Kathi Harvey, DNP, FNP-BC, NHDP-BC, APRN is a certified National Healthcare Disaster Professional who had deployed to Puerto Rico after Hurricane Maria and described her deployment as “austere”: The only food and water available to her were the food and water she brought herself for the deployment.

Karen Hamilton, RN-C, CEN, CCRN, CFRN, MICN, PCCN, NREMT-P, CCEMT-P is a member of the Disaster Medical Assistance Team (DMAT) and describes the need for flexibility as a disaster nurse. “In eight days, I put in 120 hours of work after Hurricane Katrina… You may be a nurse, but they might have you work in supply for a day. You have to be extremely flexible to help out in other areas.”

Nurses who have had experience in disaster relief nursing care have described it as “exhausting,” and “overwhelming,” but ultimately “very rewarding.” Susan Stelton, a nurse who volunteered after an earthquake disaster in the Caribbean, describes four things to consider prior to becoming a disaster nurse:

Physical Health

The first thing to consider is your own personal health. When deployed, nurses usually work long hours without days off, and accommodations can vary from hotel rooms, if you are lucky, to personal or shared tents with or without cots. 

You can be subject to harsh weather conditions or be staying in an area where diseases such as TB or malaria are rampant. Food is not typically plentiful in these areas, and there can be a lack of running water and flushing toilets.

Financial State

Most organizations pay for the volunteer’s travel, food, and lodging, but often there is no salary for volunteer work, so it is important for individuals deploying to have a financial cushion prior to joining missions.

Psychological Impact

Deployments can make it difficult for people to keep in touch with their loved ones back home, posing a strain on mental health, especially when you find yourself in an unfamiliar environment. Nurses can be overwhelmed by the environment and often express disappointment or guilt when they take breaks or upon demobilizing, often due to the feeling of “wanting to do more.”

Practicality

Resilience, being a team player, and the ability to make things work with minimal resources (akin to Wilderness Nursing) are vital for nurses volunteering to help in disasters. Stelton urges disaster nurses to ask themselves, “Do I have something specific to offer this situation?”

boat on shore amidst debris following hurricane disaster nursing


How Do You Become a Disaster Nurse?

Establishing yourself with an organization that provides disaster relief services is the number one step to becoming a disaster nurse. As mentioned earlier, specific training is essential prior to deploying. Below are some organizations that are recruiting and providing training for those interested in disaster nursing.

The Red Cross

The Red Cross is probably the most iconic presence amidst disasters, both locally and internationally. The Red Cross mobilizes nurses nationally for natural disasters like earthquakes, hurricanes, tornados, fires, floods, etc.

The Federal Emergency Management Agency (FEMA)

FEMA is a federal agency whose mission is “helping people before, during and after disasters…” FEMA is activated in two situations:

  1. When disasters occur in a state, the governor submits a formal request for aid from the President of the United States
  2. When disasters occur on federal property or to a federal asset

International Medical Corps

The International Medical Corps is a voluntary service agency that delivers “emergency medical and related services to those affected by conflict, disaster and disease, no matter where they are, no matter what the conditions,” and deploys volunteers around the globe. 

National Disaster Medical Teams (NDMS)

NDMS is similar to the military reserve system. They are activated, usually 14-days at a time, for disasters by the U.S. Department of Homeland Security. During deployments, volunteers become federal employees and receive federal salaries. Nurses can join the Disaster Medical Assistance Team (DMAT) which provides medical assistance during federal disasters and emergencies. California has its own state medical assistance team, CAL-MAT, which was modeled after the DMAT program.

Médecins sans Frontières (Doctors without Borders)

Doctors without Borders is an independent organization providing medical aid on a global scale. Committed to independence, impartiality and neutrality, this organization prides itself on the ability to provide assistance to areas where other organizations cannot access due to political or social issues.

Nurse Response Network (RNRN)

RNRN is a program under National Nurses United (NNU) that deploys direct-care registered nurses to disaster-stricken areas.
 

As you can see, there are many ways to get involved. If you don’t know where to start, it’s always a good idea to begin locally. Check your city or state’s emergency services to see if there are any volunteer opportunities available.

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