Year : 2021 | Volume
: 22 | Issue : 1 | Page : 1--2
Biological Disaster: Roles of Nurse Managers
Editor in Chief, IJCNE.Professor & Head, Department of CNE & Research, College of Nursing, CMC, Vellore, India
Dr. Vinitha Ravindran
Editor in Chief, IJCNE. Professor & Head, Department of CNE & Research, College of Nursing, CMC, Vellore
|How to cite this article:|
Ravindran V. Biological Disaster: Roles of Nurse Managers.Indian J Cont Nsg Edn 2021;22:1-2
|How to cite this URL:|
Ravindran V. Biological Disaster: Roles of Nurse Managers. Indian J Cont Nsg Edn [serial online] 2021 [cited 2021 Sep 25 ];22:1-2
Available from: https://www.ijcne.org/text.asp?2021/22/1/1/320824
With the second wave of COVID-19 infection hitting India hard, the biological pandemic disaster has revealed its true nature. A disaster is a sudden calamitous event that causes serious disruption of the functioning of a community or a society causing widespread human, material, economic or environmental losses which exceed the ability of the affected community or society to cope using its own resources. This definition accurately fits the current situation in India, and therefore, COVID-19 in India is a biological disaster. Biological disasters, when compared to other disasters, tend to linger causing prolonged and sustained disruption in waves. Therefore, they tend to be lethal, taking people by surprise, changing its face and phases, slaughtering people in its way, turning routines, changing environment and leaving people perplexed, broken and vulnerable. This is the state we are in now in India.
As health-care professionals nurses have taken a central role in responding to the needs of people in this country during this disaster and have rendered the utmost support in relieving suffering. However, the response to a bio disaster is much more than caring for the sick in the hospital or a clinic. A national disaster response in the form of national emergency although is a needed discussion it is beyond the scope of this editorial. What would be appropriate is to question ourselves as nurse managers and supervisors whether we thought of this situation as a disaster and took disaster response approaches to combat COVID-19. Disaster response involves four components which includes mitigation (risk reduction), preparedness (education and skill development), response (implementing rescue/management interventions) and recovery (restoration of physical, psychological and social health).
We have been in a disaster mode for over a year now and we need to evaluate our course of actions to identify if any or all of these components of disaster response have been effectively implemented in activities that are within nurses' zones of influence. First, in terms of risk reduction-did we take steps to reduce the spread of infection by ensuring and abiding with strict infection control protocols? Did we continue to enforce infection control measures specific to COVID-19 in our units and hospitals? What protocols were in place? Was there continuous monitoring, audit and feedback on following protocols? Were there periodic updates on policies and protocols (for nursing at least)? Was there a representation from nursing for the nursing work force and as advocates for patients and families in the administration level to inform decisions of the organisation? Was adequate nursing work force planned and ensured? Was a vaccination plan for nurses established and processed to ensure 100% vaccination status against COVID (except those who fit exclusion criteria)? Were there outreach initiatives to emphasise infection control in our communities? Are ethical and legal issues related to the current situation discussed and clarified with nursing work force?
Second, with regard to preparedness was any inventory and planning done on materials needed (PPE, oxygen delivery equipment, monitors and ventilators) in our units or hospitals since the disease outbreak? Were the supplies increased and stocked as needed? Was there a plan for managing resources in case of emergency/second wave? Was there a strategic plan for deploying nurses to COVID area? Is it functional now? Did we address staff shortage after the initial wave? What policies and protocols have been placed for mobilising nursing personnel as work force? Were the levels of care needed for patients integrated into the training and skill development of nurses to prepare them for providing care? Did the skill development sessions of infection control procedures and also the management of patients needing different levels of care continue in the organization? Were there training on team work? Are the nursing concerns represented at the administration and policy level? What contingency plans were in place for handling/managing potential surge of patients? Is there a COVID command team to oversee, evaluate and give feedback on the nursing activities (may or may not be a part of organisational team)? Were there safety related plans in case of emergencies such as fire, supply storage, waste disposal, preserving and preparing the dead for proper burial? Is there a plan for promoting safety for those who are waiting in the out-patient or emergency units or even outside the ICUs? Are there continuous monitoring of these safety issues? Is there privacy and safety at work place?
Third, in terms of response- was a disaster triage system established? Is there a protocol for triage for nurses working in fever clinics or emergency units? Is it functional and are executed without delay? Are the nurses trained in triage? Is there an incident command person in the triage area where final decisions are checked? Are there nurse co-coordinators who ensure the transport of patients from triage area to the different levels of care is prompt and smooth? Are there care coordinators for different levels of COVID care? Are there skilled nurses to provide care in different levels of care settings? Is the training continuously provided to upgrade skills as needed? Are the nurses up to date with the care protocols? Are there ongoing feedbacks to improve functioning? Is team work constantly encouraged? As care is delivered, are measures for reducing waste in terms of material and supplies used for care, in place? Are efforts being taken to use all possible resources such as auxiliary staff, senior nursing students and health care assistants in combating the disaster?
With regards to the fourth step recovery- was there any debriefing sessions on caring for COVID patients to get feedback as well as provide support? Is it happening now? Is there access to counseling services? Is the information on counselling passed on to every nurse who is in fight against COVID? Are the physical needs of the health professionals taken care of in the work place? Is grief counselling available for the professionals as well as patient relatives who have lost their loved ones? Are there methods of appreciation established for those who work in COVID areas? What lessons have we learnt? What are the mitigation plans for the 3rd wave?
I hope the above questions will stimulate our thinking and process of planning for this bio disaster. The ICN core competencies for disaster would be an appropriate frame work to manage COVID situation and we should look at our competencies under the core domains of (1) Preparation and planning, (2) communication, (3) incident management, (4) safety and security, (5) assessment, (6) intervention, (7) recovery and (8) law and ethics.
Let us remember that COVID-19 may stay longer than we expect or presume. As nurse managers it is our calling to be prepared for the worst and do the best in the most difficult situations. Many managers may be able to answer yes to most of the questions stated above but many are not enough, all of us have to join forces to do our best to save lives.
|1||International Federation of Red Cross (IFRC). What is a disaster? 2021. Available from: https://www.ifrc.org/en/what-we-do/disaster-management/about-disasters/what-is-a-disaster/. [Last accessed on 2021 May 12].|
|2||International Council of Nurses. Core Competencies in Disaster Nursing Version 2.0. 2019. Available from: https://www.icn.ch/sites/default/files/inline-files/ICN_Disaster-Comp-Report_WEB_final.pdf. [Last accessed on 2021 May 12].|