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Disaster Management and Response
Nurs Clin N Am 40 (2005) xiii–xv
NURSING CLINICS OF NORTH AMERICA PREFACE
Disaster Management and Response
Judith Stoner Halpern, MS, NP, APRN, BC, Mary W. Chaffee, ScD (hon), MS, RN, CNAA, FAAN Guest Editors
D
isasters are a continuous part of life on earth. Thousands were injured and killed in the Johnstown flood of 1889 and the Galveston hurricane of 1900. The Great New England Hurricane of 1938 caused over 500 deaths and at least 1700 injuries. The Kobe, Japan, earthquake of 1995 killed more than 500 people and injured nearly 27,000 others (how many urban health systems could handle that?). Thirty thousand people were injured in the Bam, Iran, earthquake in 2003. The death toll from the Asian tsunami is over 150,000; the total number of injured and homeless remains unclear. The forces of nature are not the only cause of death and mass casualties. When the SS Mont Blanc, filled with munitions for the World War I exploded in Halifax, Nova Scotia, harbor in 1917, 9000 people were injured. The Hartford Circus Fire in 1944 sent about 480 burn victims in makeshift ambulances to Connecticut hospitals. The 1983 bombing of Harrod’s Department store injured 94 people. Over 100,000 people were evacuated after the Chernobyl, Soviet Union, nuclear plant explosion in 1986, and more than 5 million people were exposed to radioactive fallout. When three Italian Air Force jets crashed at an air show in Ramstein, Germany, in 1988, 70 people were killed, and 450 people were injured. When United Airlines Flight 232 crash-landed at Sioux City, Iowa, in 1989, 112 people were killed, but 172 injured victims survived
0029-6465/05/$ – see front matter doi:10.1016/j.cnur.2005.04.001
ª 2005 Elsevier Inc. All rights reserved. nursing.theclinics.com
xiv
PREFACE
and needed emergency care. In 1996, the bombing of the Khobar Towers in Saudi Arabia, home to US military personnel and their families, resulted in 372 injuries. Hospitals in New York City treated nearly 800 injured victims between Sept. 11 and 13, 2001 after the World Trade Center bombing. Rescue workers made thousands of visits to health facilities during the rescue and recovery work in New York. Intentional food poisoning sent over 400 people to Nanjing, China, hospitals in 2002. When two trains crashed in Ryonchang, North Korea, in 2004, over 1300 people were injured. Planning for the care of disaster victims is a challenge, because no one can predict where or when the next event will occur, only that there will be more. Disasters are by definition unpredictable, occur in different locations, are caused by different mechanisms, and, if they produce a large number of victims, they can place sudden and significant stresses on health care systems and health care workers. Despite a long record of diverse disasters, some people are surprised by each new occurrence, possibly because of limited personal experience. If they have not lived through a hurricane, does that mean they never will? If a hospital has never been bombed in a community, does that mean local citizens can avoid preparation for such an unheard of event? If they have not seen a tornado, flood, or a volcanic eruption, does that mean they can remain blind to the possibility? The apparent disconnect between personal perception and reality has been identified as ‘‘disaster apathy’’ and can lead to an emergency preparedness posture that resembles an ostrich with its head in the sand. Disaster preparedness requires resources: money, time, training, equipment, planning, exercise, and people. Many health care organizations find themselves squeezed in the center of dual pressures: preparedness versus profit. The right thing to do is not always the easy thing to do when finances are limited. All health care providers have a role in disaster preparedness, especially nurses, who comprise the single largest workforce in the health sector. Nurses care for vulnerable populations and have a great opportunity to strengthen the level of emergency preparedness in their daily practice. No matter a nurse’s specialty—clinician, educator, researcher, administrator, policy maker—each has the ability to provide direct input into how best to prepare for and provide disaster care. Disaster preparedness and response should be a part of every nurse’s knowledge and skills. This issue of Nursing Clinics of North America is designed to provide the reader with a variety of original articles that provide analysis and insight in many aspects of disaster health care. This issue is intended to assist in preparing nurses to respond effectively to disaster. The professional nurse needs to be
PREFACE
xv
a driving force in better preparing the nation, one patient, organization, and community at a time. Judith Stoner Halpern, MS, NP, APRN, BC University of Michigan, School of Nursing, RN Studies 400 North Ingalls Ann Arbor, MI 48109-0482 E-mail address: [email protected] Mary W. Chaffee, ScD (hon), MS, RN, CNAA, FAAN 8601 Lime Kiln Court Montgomery Village, MD 20886 E-mail address: [email protected]
NURSING CLINICS OF NORTH AMERICA PREFACE
Disaster Management and Response
Judith Stoner Halpern, MS, NP, APRN, BC, Mary W. Chaffee, ScD (hon), MS, RN, CNAA, FAAN Guest Editors
D
isasters are a continuous part of life on earth. Thousands were injured and killed in the Johnstown flood of 1889 and the Galveston hurricane of 1900. The Great New England Hurricane of 1938 caused over 500 deaths and at least 1700 injuries. The Kobe, Japan, earthquake of 1995 killed more than 500 people and injured nearly 27,000 others (how many urban health systems could handle that?). Thirty thousand people were injured in the Bam, Iran, earthquake in 2003. The death toll from the Asian tsunami is over 150,000; the total number of injured and homeless remains unclear. The forces of nature are not the only cause of death and mass casualties. When the SS Mont Blanc, filled with munitions for the World War I exploded in Halifax, Nova Scotia, harbor in 1917, 9000 people were injured. The Hartford Circus Fire in 1944 sent about 480 burn victims in makeshift ambulances to Connecticut hospitals. The 1983 bombing of Harrod’s Department store injured 94 people. Over 100,000 people were evacuated after the Chernobyl, Soviet Union, nuclear plant explosion in 1986, and more than 5 million people were exposed to radioactive fallout. When three Italian Air Force jets crashed at an air show in Ramstein, Germany, in 1988, 70 people were killed, and 450 people were injured. When United Airlines Flight 232 crash-landed at Sioux City, Iowa, in 1989, 112 people were killed, but 172 injured victims survived
0029-6465/05/$ – see front matter doi:10.1016/j.cnur.2005.04.001
ª 2005 Elsevier Inc. All rights reserved. nursing.theclinics.com
xiv
PREFACE
and needed emergency care. In 1996, the bombing of the Khobar Towers in Saudi Arabia, home to US military personnel and their families, resulted in 372 injuries. Hospitals in New York City treated nearly 800 injured victims between Sept. 11 and 13, 2001 after the World Trade Center bombing. Rescue workers made thousands of visits to health facilities during the rescue and recovery work in New York. Intentional food poisoning sent over 400 people to Nanjing, China, hospitals in 2002. When two trains crashed in Ryonchang, North Korea, in 2004, over 1300 people were injured. Planning for the care of disaster victims is a challenge, because no one can predict where or when the next event will occur, only that there will be more. Disasters are by definition unpredictable, occur in different locations, are caused by different mechanisms, and, if they produce a large number of victims, they can place sudden and significant stresses on health care systems and health care workers. Despite a long record of diverse disasters, some people are surprised by each new occurrence, possibly because of limited personal experience. If they have not lived through a hurricane, does that mean they never will? If a hospital has never been bombed in a community, does that mean local citizens can avoid preparation for such an unheard of event? If they have not seen a tornado, flood, or a volcanic eruption, does that mean they can remain blind to the possibility? The apparent disconnect between personal perception and reality has been identified as ‘‘disaster apathy’’ and can lead to an emergency preparedness posture that resembles an ostrich with its head in the sand. Disaster preparedness requires resources: money, time, training, equipment, planning, exercise, and people. Many health care organizations find themselves squeezed in the center of dual pressures: preparedness versus profit. The right thing to do is not always the easy thing to do when finances are limited. All health care providers have a role in disaster preparedness, especially nurses, who comprise the single largest workforce in the health sector. Nurses care for vulnerable populations and have a great opportunity to strengthen the level of emergency preparedness in their daily practice. No matter a nurse’s specialty—clinician, educator, researcher, administrator, policy maker—each has the ability to provide direct input into how best to prepare for and provide disaster care. Disaster preparedness and response should be a part of every nurse’s knowledge and skills. This issue of Nursing Clinics of North America is designed to provide the reader with a variety of original articles that provide analysis and insight in many aspects of disaster health care. This issue is intended to assist in preparing nurses to respond effectively to disaster. The professional nurse needs to be
PREFACE
xv
a driving force in better preparing the nation, one patient, organization, and community at a time. Judith Stoner Halpern, MS, NP, APRN, BC University of Michigan, School of Nursing, RN Studies 400 North Ingalls Ann Arbor, MI 48109-0482 E-mail address: [email protected] Mary W. Chaffee, ScD (hon), MS, RN, CNAA, FAAN 8601 Lime Kiln Court Montgomery Village, MD 20886 E-mail address: [email protected]