Monthly Archives: July 2018

Are Mass Shootings A Disaster

by Cole Edmonson, DNP, RN, FACHE, NEA-BC, FAAN

Mass Shooting Events (MSE) are a public health crisis in America. “We are on track in this country to have more mass shootings this year than in 2017 (, 2018). That is clearly unacceptable. Although, it’s not about the numbers, it’s about people, and people are not statistics. The numbers speak to the ever-increasing plague of gun violence on individuals, families, communities, and our country. Thirty-four mass shootings ( in the first month-and-a-half alone of 2018”. Lack of effective gun control measures, mental health resources in this country along with extreme political views, extreme religious views, racism, hate are a deadly combination. Of course, these are not the only factors in the epidemic we are facing. If we can get upstream in this epidemic, perhaps we will need less reactive measures or even be able to prevent mass shootings.

2017 Gun Violence Statistics 

  • 61,507 Active Shooter Incidents
  • 15,592 Deaths
  • 3,996   Children / Teens killed or injured
  • 19 days in the year without a mass shooting.

Mass shootings represent a clear disaster event for public servants, the health care system and the nursing profession among many others. “Schnur makes several recommendations as a nurse researcher in her article ‘Is there a cure for gun violence’ for the nursing profession ultimately assisting in the prevention of mass shooting.

  1. Increase access to mental health programs for individuals, families, and students from elementary school through college:
  2. Include a gun safety assessment as part of routine health screenings for all patients:4
  3. Several states continue to propose legislation to ban practitioners from documenting gun ownership in the patient’s record.
  4. Develop and implement Evidence-based Hospital Violence Intervention Programs focusing on:
  5. Improve Community engagement/outreach and education programs with initiatives targeting:
  6. Gather more data, conduct research and educate families on how to best protect themselves and their families from gun injuries”

“We can’t solve a wicked problem with naïve eclecticism. An epidemic of this proportion will take all sectors, public, private, non-profit and governmental, working together to solve this crisis. We, as nurses, some 3.9 million strong in the U.S., can be a powerful voice. Those with greater expertise will propose possible solutions including universal background checks, raising age limits, making bump stocks illegal, restricting certain types of guns from the general population, mandatory waiting periods, database reporting and many more.” We have the knowledge and wisdom to work from local, state, and national levels, from grassroots advocacy to legislative action. Prevention and mitigation should be our first priority along with preparedness, readiness, response, and recovery.

I can continue to applaud the bravery of those advocating for change, especially our youth – as small passionate groups of people can make a change, that can grow into a tsunami of moral virtue to do what is right!


Edmonson, Cole (2018) TONE Newsletter. Retrieved from

Gun Violence Archive (2018). Retrieved from

Kodjak, A. (2018).What if we treated gun violence like a public health crisis. Retrieved from

Schnur, M. (2016). Retrieved from

Hurricane Season—Are You Ready?

by: Lavonne Adams, PhD, RN, CCRN

How ready are you for a hurricane? Even if you don’t live along the coast, you are not immune to hurricane effects, since remnants of major storms can produce widespread damage from heavy rain, flooding, and tornadoes. Such conditions pose risks to health and safety, so prior preparation is crucial. As I write this entry, we are well into hurricane season, which runs June 1st to November 30th for the Atlantic, and May 15th to November 30th for the Pacific. If you haven’t already done so, consult for many helpful recommendations and links so you can prepare your family, home, and vehicle before a storm and learn how to act in the event of a storm.

Highlights include:

  • Know if you live in an evacuation area.
  • Become familiar with National Weather System watches and warnings
  • Have a weather radio
  • Establish a communication plan in case your family isn’t together when hazardous weather strikes
  • Develop an emergency plan that includes your pets and includes locations away from home
  • Keep an emergency kit—including food and water—on hand in the event power goes out or roads are impassable
  • Check on elderly or disabled family and neighbors
  • Get your home ready for a storm. Be aware of what to do in case of power outages. Make sure you consider:
    • Clearing the yard of anything that could blow around and damage your home
    • Covering windows and doors
    • How to turn off your power
    • Filling clean containers with drinking water; filling bathtub and sinks for washing
    • Emergency charging options for devices like cell phones
    • Alternatives if home medical equipment uses electricity
  • Ensure your vehicle is travel-ready and has a full tank of gas
  • Keep an emergency kit in your car
  • Consider whether you need to shelter in place or evacuate
  • Be ready to leave; if you need to evacuate, follow instructions by local officials
  • Be careful while evacuating; watch for:
    • Flying debris
    • Broken objects
    • Downed power lines
    • Flooded roads
    • Tornadoes
  • Wait until the area is declared safe before you return home

The American Red Cross also has a useful Checklist for hurricane preparedness.

Lavonne Adams is an Associate Professor at TCU Harris College of  Nursing and Health Sciences

Disaster Preparedness and the Difference Health Care Providers Can Make

by: Charleen C. McNeill, PhD, MSN, RN

The United States (US) approach to managing risks associated with disasters has historically relied on governmental intervention (FEMA, 2011).  However, population shifts, the growing number of people living with chronic conditions and/or disabilities, and the growing number of older citizens living independently have forced a change in the focus of disaster preparedness efforts. To improve the nation’s resilience, the US government has shifted more preparedness responsibilities on to individual citizens (FEMA, 2011).  Because of this shift, significant access and service gaps exist.

Despite the launching of the Citizen Preparedness Campaign in 2003, the levels of emergency preparedness in the US have not increased (Citizen Corps, 2009; Al-rousan, Rubenstein, & Wallace, 2014; McNeill et al., in press).  Disaster preparedness levels among individuals in our society are even more in the forefront after the 2017 hurricane season and the devastation left after Hurricanes Harvey, Irma, and Maria.  During the months of August and September of 2017, Hurricane Harvey and Irma caused the death of over 200 people; thousands were left without water, food, shelter, and medical care (Moravec, 2017;, 2017; Texas Hospital Association, n.d.). On September 20, 2017, Hurricane Maria hit Puerto Rico leaving in its wake an official death count of 64 (Kishore et al., 2018).  However, an increase in subsequent fatalities as compared to historical patterns of death in Puerto Rico suggest the death toll may be greater than 70 times the official estimates (Kishore et al., 2018).  The devastation caused by Hurricane Maria is still acutely impacting its residents to this day.

We must consider our part in the disaster management cycle and the interventions we can undertake to improve patient outcomes during the direst of times.  To prepare members of our society for emergent events, improve access, and decrease service gaps, we must consider how we, as nurses and health care providers, can educate our clients and assist them in becoming more prepared.  Recent research highlights the strong, positive relationship between health-care provider education of patients with chronic conditions regarding emergency preparedness and that patient’s emergency preparedness level, indicating a pathway for effecting change in preparedness levels among such vulnerable populations (Al-rousan, Rubenstein, & Wallace, 2014; McNeill et al., in press).  According to these studies, patients with chronic conditions who received emergency preparedness education from their health care provider were three to four times more likely to be prepared for emergencies.  It is imperative that we arm ourselves with the knowledge to educate our patients on how they can be prepared, inclusive of their medical needs, to facilitate better health outcomes after disasters.  I urge each of us to do just that.  The 2018 hurricane season is upon us.  Let us all take action and routinely include disaster preparedness education for our patients and clients starting today.


Al-rousan, T., Rubenstein, L., & Wallace, R. (2014). Preparedness for natural disasters among older US adults: A nationwide survey. American Journal of Public Health. 104(3). doi: 10.2105/AJPH.2013.301559

Citizens Corps. (2009). Personal preparedness in America: findings from the 2009 Citizen Corps national survey. Retrieved from http://www.citizencorp.gove/ready/researchshtm.

Federal Emergency Management Agency (FEMA). (2011). A whole community approach to emergency management: Principles, themes, and pathways for action [FDOC 104-008-1].  Retrieved from

Kishore, N., Marques, D., Mahmud, A., Kiang, M., Rodriguez, I., Fuller, A., … Buckee, C. (2018). Mortality in Puerto Rico after hurricane Maria. New England Journal of Medicine. doi: 10.1056/NEJMsa1803972. Retrieved from

McNeill, C., Killian, T., Moon, Z., Way, K., & Garrison, M.E. (in press). The Relationship Between Perceptions of Emergency Preparedness, Disaster Experience, Health-Care Provider Education, and Emergency Preparedness Levels. International Quarterly of Community Health Education. doi: 10.1177/0272684X18781792

Moravec, E. R. (2017) Texas officials: Hurricane Harvey death toll at 82, ‘mass casualties have absolutely not happened.’ Retrieved from (2017, September 27). Hurricane Irma death toll rises to 72 in Florida. Retrieved from

Texas Hospital Association. (n.d.). Special report: Texas Hospital Association Hurricane Harvey analysis: Texas hospitals’ preparation strategies and priorities for future disaster response. Retrieved from

Charleen McNeill is an Assistant Professor at East Carolina University, College of Nursing