A. Role of Public Health Personnel
The County Public Health Director (CPHD) may be called on to report to the media during a disaster. It is important that the CPHD reassures the public and avoids speculation when speaking directly to the media or the public. The CPHD will also attend an incident command briefing, where she will report her observations and concerns to the entire Disaster Response Team. The CPHD will focus the public health department’s efforts on identifying the needs of special populations, and addressing food and water safety and sanitation concerns. She will also call a meeting to establish a public health incident command system, and will appoint officers based on the special skills and talents of the individuals in the department.
The Public Health Nurse will play an instrumental part in getting out into the community and finding out what the citizens’ needs are, as well as providing education and referrals where needed. She may also be needed to communicate with the media concerning public service announcements about sanitation and safety. In the community, she will be trying to identify people with acute medical issues, and making sure everyone has the medications and equipment they need, as well as sanitary food and water. When she encounters someone that needs something outside her scope of practice, like mental health assistance or hazardous waste disposal, she makes the appropriate referrals and then follows up to make sure the needs were met. She will also be available to displaced people as they move back into their homes to help them deal with any health problems or issues that might arise.
The Environmental Health Specialist will conduct inspections of emergency shelters to ensure safety of the food and water supply there, ensure sanitary conditions, as well as inspections of restaurants and other commercial kitchen facilities upon reopening after a disaster. The Environmental Health Specialist will also assist with hazardous spills and contact the appropriate teams for those. He will be available to educate people on mold issues and cleaning up after a flood or disaster.
Overall, the role of the public health department in a disaster is to ensure the health and safely of the population by addressing food and water supply issues, sanitation issues, healthcare issues, and shelter/housing issues. B. Chain of Command
In the Franklin County simulation, the public health nurse answered directly to the County Public Health Director, who was directed by the Medical/Health Branch Director, Zachary Burke. Mr. Burke was under the command of the Operations Chief, Rebecca Brower, who answered directly to the EOC Commander, Chris Newhouse. C. Resources
The Community Health Nurse has several resources to turn to when she encounters a problem that is outside of her scope of practice. For example, people that are having problems dealing emotionally with the disruption of their homes and lives may be referred to a mental health counselor or a social worker. A social worker may also be important in helping a family with emergency financial needs. When people have concerns or issues with environmental hazards such as mold and chemicals, the Environmental Health Specialist is a vital resource. The CHN can refer people with housing issues or lack of adequate food and water to an emergency shelter. D. Actions of Community Health Nurse
In the Fugate household, the PHN was concerned about Mr. Fugate’s lack of blood pressure medication. She assessed his blood pressure and seeing that it was stable, arranged for someone to deliver a refill to him the following morning. She also gives him the option to transfer to the emergency shelter where he would have better access to assistance should he need it. If she had determined Mr. Fugate’s situation to be dire, the public health nurse would have called 911 to have Mr. Fugate transported to the hospital. If Mr. Fugate opted to stay in his home and wait for delivery of medication, the nurse would have followed up with him in the next day or two to make sure he had what he needed. E. Coping with Aftermath
Flood victims who were having trouble dealing with the aftermath of the flood, such as the woman who stated her husband had lost his job and was acting angry towards his family, were referred to resources that could establish a counseling relationship and follow up with them, such as a mental health counselor or social worker. Even when the problem was outside of the community health nurse’s scope, she reassured the victim and promised to help them find a solution to their problem, rather than “passing the buck” and telling them she couldn’t help them. Reassurance that they are not alone will go a long way to calm the fears of those affected by a disaster. F. Preparation of Nurses
In order to be prepared for a large-scale emergency, public health nurses should educate themselves on disaster preparedness and protocols, as well as acquainting themselves with all the resources that are available to them when they are assisting victims of a disaster. A nurse should have specialized education for each type of disaster, for a population affected by an earthquake, for example, will have different needs than those of a population affected by a flood. Disaster drills may be helpful in educating nurses in order to prepare them for a large disaster, as well as refresher courses on triaging patients during a disaster, and evacuation protocols. After a disaster is not the time to be pulling out policy manuals and trying to figure out what to do. Each nurse should have easy access to the health department’s disaster plan and be well-acquainted with it in the case of a disaster. Most facilities require annual updates and continuing education on disaster preparedness for the nursing staff.