Floods, earthquakes, hurricanes, or environmental catastrophes almost seem like foreign occurrences. Think about it, what would it be like working as nurse on a natural disaster? Would you and your colleagues know what to do? Obviously there are training manuals, but when a disaster strikes, would you really know what to do? Let’s be honest, most people including nurses have the perception that an environmental or natural disaster will never happen to them. So what guidelines have facilities set in place? And, do we really know them?

First, what defines a “disaster"? Well, a disaster can be a natural occurrence (i.e. a fire, a hurricane, a tornado, etc.) Or a disaster can be man-made. Consider a terrorist attack or shooting, they are man-made disasters. Essentially, a disaster is defined as, “an event causing widespread destruction.” What makes “disasters” so “disastrous” is the fact that these occurrences can come with days of prior warning or can happen without any warning at all.

What do we do in such an event?

Hospitals in the United States are required to have a plan in place in the event of a disaster - this is mandated by the Joint Commission - and employees are required to complete training as to how to react in such an event. The key question concerning these plans is: “Do they meet the needs of the facility and the community?”

Too often, they do not, and when time is of the essence and the adrenaline has kicked in, how effective are we, as first responders? Hopefully, these guidelines, along with those of the respective institution, will serve to effectively foster “disaster” preparation.
1.Form a Committee: A committee consisting of medical professionals, administration, and security is instrumental in this process. Each department should have an input into the process of disaster prevention. It is essential for us, as nurses, to be involved, and to share the experience with our colleagues.
1.The Campus: The committee could assess the campuses premises. Note that this does not have to solely reflect a hospital - this is applicable to a primary care center, too.
2.Problem Areas: This committee could assess potential problem areas and other concerns that demand attention. For instance, the committee could assess the presence of generators and/or air handlers and wells.
3.Assess the Equipment: Are there adequate supplies? Are the generators up to date and functional?
4.Consult with the Staff: It is also noteworthy to see where the majority of the staff resides. If a disaster strikes is it possible that staff will not be able to come into work? Are there precautions outlined to assure adequate staffing in the event of such an event?
2.Consider the Patient’s Needs: Our patients are complex, indeed. If there is a natural disaster whereby electricity is lost and the generators are exhausted, how will patient care be maintained? These considerations demand attention from all disciplines. Nurses, environmental services, and dietary staff all need to know how to respond so that patient care is not compromised.
3.Considerations outside of the Hospital: Home health agencies also need to have a disaster plan in place. There should be an outline of the location for shelters that provide temporary care. But, the patients acuity also needs to be considered in such an event - agencies need to know how to prioritize care. In this event the critical thinking capabilities of the nurse and her colleagues are imperative.
4.Implement a “Buddy System”: Hospitals or urgent care systems should have agreements with vendors in the event that a catastrophe occurs. These signed agreements affirm that the vendors in the community will network with the hospital to provide necessary supplies.
5.Conduct Practice Drills: Practice drills can be especially helpful in coaching staff of their roles and response efforts.