PUBLIC HEALTH NURSES: Leaders and Partners in Assuring Care During Emergencies

Foundational Principles Guiding Public Health Nursing Practice in Emergencies

1. Public health nursing roles in emergency preparedness are generally consistent with the scope of public health nursing practice.
2. The components of the nursing process are in alignment with the phases of all – hazards emergency preparedness.
3. Competencies provide a framework for defining public health nursing roles and actions in emergency preparedness. Competencies are directly linked to education, training and practice events.
4. Public health nurses bring leadership, policy, planning and practice expertise to emergency preparedness and response.

Emergency Preparedness Competencies Applied to Public Health Nursing

1: Describe the public health role in responding to a range of likely emergencies.

Knowing in advance exactly what is expected of the organization during an emergency or disaster gives the public health nurse the opportunity to acquire pertinent knowledge and to practice the necessary skills beforehand (Gebbie 2002).

2: Describe the agency's chain of command in emergency response.

Each public health nurse needs to be familiar with and be able to describe the lines of authority and communication used in emergency response that is based on the Incident Command System (ICS) (FEMA 2006b).

3: Competency 3: Identify & locate the agency's emergency response plan (or its pertinent portions).

Every public health nurse needs to know where the emergency response plan can be found and be familiar with its contents before an emergency arises (US Dept. of Homeland Security 2006).

5: Demonstrate the correct use of equipment (including personal protective equipment) & the skills required in emergency response during regular drills.

Identifying the settings to which public health nurses may likely be dispatched affords them the opportunity to learn how to use such equipment in advance.

6: Demonstrate the correct use of all equipment used for emergency communication.

Public health nurses need to be familiar with and practice how to operate all emergency communication devices in their agency’s emergency plan before an event occurs (e.g., two-way radios, satellite phones, cell phones).

7: Describe communication role(s) in emergency response.

During an emergency response, public health nurses need to use established systems within the agency, with the media, with the general public (including patients and families) and with personal contacts (one’s own family, friends and neighbors).

When disasters and emergencies occur outside of normal work hours, the public health nurse needs to know what is expected in terms of checking in with their supervisor and/or others for an initial assessment as well as for periodic updates.

Each public health nurse should make certain that the agency maintains current and complete contact information.

8: Identify the limits of one's own knowledge, skills & authority, and identify key system resources for matters that exceed these limits.

Public health nurses need to be flexible about types of assignments and duties they take on during a disaster without going beyond their knowledge, skills and authority.

9: Apply creative problem-solving skills and flexible thinking to unusual challenges within one's functional responsibilities & evaluate the effectiveness of all actions taken.

Creative problem solving entails addressing a situation with whatever resources are available at the moment (Gebbie 2002).

Public health nurses need to provide leadership and share their ideas and solutions during a disaster to improve disaster plans and response activities.

10: Recognize deviations from the norm that might indicate an emergency and describe appropriate action.

Public health nurses use assessment skills to detect deviations (e.g., time, place, person) from the norm that may need to be investigated.

Public health nurses may be the first persons or among the first persons to identify something is out of the order and report it through established channels of communication.

11: Participate in continuing education to maintain up-to-date knowledge in areas relevant to emergency response.

Public health nurses need to participate in continuing education programs to assure that they are adequately prepared to serve in any phase of the disaster cycle.

As technology changes and as plans are reviewed and updated, public health nurses need to keep abreast of new developments, protocols, policies and practice guidelines that are pertinent to the agency’s current emergency and disaster plan.

12: Participate in planning, exercising and evaluating drills.

Public health nurses should actively participate in evaluating emergency preparedness and response activities, including disaster drills, exercises and training programs that are relevant to their local agency and role.