edn lec week 1

• Disaster


  • Any occurrence that causes damage, ecological disruption, loss of human life, deterioration of health and health services on a scale, sufficient to warrant an extraordinary response from outside the affected community or area (WHO)
  • Occurrence that causes human suffering and creates human needs that victims cannot alleviate without assistance (American Red Cross)
  • Serious destruction of the functioning of the community or a society (United Nations)
• Main features of disaster


  • Unpredictability
  • Unfamiliarity
  • Speed
  • Urgency
  • Uncertainty
  • Threat
• When is an event a disaster?
• Criteria for an event to be considered a disaster

  • At least 20% of the population are affected and in need of emergency assistance or whose dwelling units have been destroyed
  • A great number or a least 40% of the means of livelihood such as bancas, fishing boats, vehicles ad the like are destroyed
  • Major roads and bridges are destroyed and impassable for at least a week, thus disrupting the flow of transport and commerce
  • Widespread destruction of fish ponds, crops, poultry and livestock, and other agricultural products
  • Epidemics
• Types of natural disaster

  • Biological (epidemic, insect infestation, animal stampede)
  • Geophysical (earthquake, volcano, dry mass movement)
  • Hydrological (flood, wet mass movement)
  • Meteorological (storm, cyclone, local storm)
  • Climatological (extreme temperature, drought, wildfire)
• Types of man-made disaster


  • Technological – malfunction of a man-made structure or "human error" (dam failures, transport failure, fire)
  • Industrial – caused by chemical, mechanical, civil, electrical
  • Warfare (war, terrorism)
• Phases of disaster


  • Pre-impact phase
  • Impact phase
  • Post-impact phase
• Pre-impact phase


  Initial phase of disaster, prior to actual occurrence, warning is given at the sign of the first possible danger to a community
• Role of disaster nurse in pre-impact phase


  • Assist in preparing shelters and emergency aid stations
  • Establishing contact with other emergency service group
• Impact phase


  Disaster actually happens, enduring hardship or injury, may last several minutes of for days or weeks, emergency operation center is established and put in operation (center of communication for health needs)
• Role of disaster nurse in impact phase

  • Care for direct victims (prioritization of nursing care)
  • Health promotion especially to vulnerable members of the community (children and elderly)
  • Responsible for psychological support to victims in the shelter
• Post-impact phase


  Beginning of recovery, return of normal community order and functioning, may last a lifetime
• Stages of emotional response

  • Denial – victims may deny the magnitude of the problem (may appear unconcerned)
  • Strong emotional response – victim is aware of the problem but regards it as overwhelming and unbearable
  • Acceptance – victim begins to accept the problem and focuses on how to solve them
  • Recovery – victims feel they are back to normal
• Disaster nursing


  Adaptation of professional nursing knowledge, skills and attitude in recognizing and meeting the nursing, health and emotional needs of disaster victims
• Goals of disaster nursing

  • Meet immediate basic survival needs
  • Identify the potential for a secondary disaster
  • Appraise both risks and resources in the environment
  • Correct inequalities in access to healthcare or appropriate resources
  • Empower survivors to participate in and advocate for their own health and well-being
  • Respect cultural, lingual, and religious diversity in individuals and families and to apply this principle in all health promotion activities
  • Promote highest achievable quality of life for survivors
• Levels of disaster nursing competencies

  • Level I - Any nurse who has completed a program of basic, generalized nursing education and is authorized to practice by the regulatory agency of his/her country
  • Level II - Any nurse who has achieved the Level I competencies and is/aspires to be a designated disaster responder within an institution, organization or system
  • Level III - Any nurse who has achieved the Level I and II competencies and is prepared to respond to a wide range of disaster and emergencies and to serve on a deployable team
• Areas of disaster nursing competencies

  • Mitigation/prevention
  • Preparedness
  • Response
  • Recovery/rehabilitation
• Domains of disaster nursing competencies

  • Preparation and planning
  • Communication
  • Incident management systems
  • Safety and Security
  • Assessment
  • Interventions
  • Recovery
  • Law and Ethics
• International Council of Nurses, 2019: 'Effective nursing practice during any disaster requires clinical competency and the application of utilitarian principle (doing the greatest good for the greatest number with the least amount of harm)'