Abstract
In light of ongoing threats to homeland security, nursing students must be introduced to content related to disaster nursing and the management of mass casualties. The author describes course content and activities to help nursing faculty teach this material.
The world has not been the same since the catastrophic attacks on September 11, 2001. The terrorist events in New York City, Washington, DC, and Pennsylvania made us realize that we are vulnerable. The nursing profession has also changed, and our teaching priorities must likewise change. What was once the purview of nurses in the military and emergency departments (patient evacuation, weapons of mass destruction [WMD], forensics, and public fear) now must be considered by all nurses in practice. Also, nurses need to take the time to understand that chaos reigns in mass disasters. On-the-job training at disaster sites is not an optimum way to learn. The public recognizes the importance of nurses to patient care. The government depends on nurses to ally anxiety, educate the community, and play our part in the defense of our homeland.
The nursing profession is positioned to adapt to our nation's changing priorities. We are reminded of Maslow's Hierarchy of Needs; that "safety" is just above "basic" physiologic needs. 1 When thinking of surviving a major disaster and helping out as nurses, our priorities have to descend from their usual lofty goals of meeting "self-esteem" and "self-actualization" needs to the basics (eg, washing our hands and making sure we have clean water and sufficient light). Nurses understand these relationships and can prioritize accordingly. Because nurses touch the lives of many, in all age groups, in various settings, and are some of the most trusted health professionals, the impact of an informed, reassuring, and skilled nurse is great.
Two years ago, disaster management was seen as specialty training for nurses in emergency rooms, public health, and the military. Now, disaster nursing is considered as a basic competency for the generalist nurse in undergraduate programs, especially with the newly acquired focus on WMD content and mass casualties. 2
A mass casualty disaster is characterized by significant loss of life and/or injury and often exceeds the ability of normal local community resources to effectively manage the response. For some communities, 10 fatalities or a large number of injuries at once may require assistance from other resources. In communities with sufficient personnel, equipment, and facilities, the community may have the capacity to handle a much larger mass casualty incident. 3