Monthly Archives: June 2019

Disaster Nursing: From Theory to Practice

By: Cole Edmonson DNP, RN, FACHE, NEA-BC, FAAN

It’s been just over two and a half years that the SADN Practice workgroup has been meeting monthly under the guidance of the SADN organizational structure.  The Practice workgroup has included a consistent and engaged team of a dozen nurse colleagues, who have dedicated not only their time but their talents as well. Many of the members have experience responding to major disasters, teaching disaster education and are compelled to communicate their experience in ways that strengthen and support our national nursing workforce in preparedness, response, and prevention to various disasters.

As described by a collective group of disaster nursing experts (Veenema et.al 2016), the focus of the Practice workgroup is to achieve actionable steps towards the following recommendations:

Practice 1.1 Health care and related organizations support clinical nursing practice during disasters to reflect crisis standards of care and address common barriers to the willingness of nurses to respond to a disaster.

Practice 1.2 Establish a collective effort among nurse leaders to advance the practice of disaster nursing and public health emergency preparedness and response.

Practice members have delivered 7 presentations during the past two years for the national, county and local audiences on a range of topics that include; a disaster nursing call-to-action, personal preparedness, psychological resilience and the role of information technology in disaster preparedness. Six of our members were invited by the Emergency Nurses Association (ENA) to provide the evaluation for a mass casualty disaster drill during the 2017 ENA annual convention in St Louis, MO. We are currently working with the Girl Scouts to develop a disaster preparedness badge that could be integrated into the activities of the Girl Scout STEM camps and disseminated nationally. The promotion of personal preparedness serves as the cornerstone of most of our activities and we have identified the following website to use as a resource: https://dallascityhall.com/departments/officeemergencymanagement/Pages/Make-a-Plan.aspx

This past year we welcomed five new members: Including the transition of the chair position.

Cole Edmonson, D.N.P., R.N., FACHE, NEA-BC ( Chair ), June 2018

Chief Clinical Officer, AMN Healthcare

Kimberly K. Hatchel, DNP, MHA, RN, CENP, August 2018

Market CNO/Senior VP, Lexington One Health

Melinda Hirshouer, DNP, RN, MBA, MHSM, June 2018

Director of Inpatient Rehabilitation at Texas Health Presbyterian Hospital Dallas

Laurie G. Combe, MN, RN, NCSN

President-Elect, National Association of School Nurses

Nicole “Nikki” M. Ward, Maj, USAF, NC

HAF Junior Nurse Executive Fellow

Office of the Surgeon General

Medical Force Development (SG1/8AN)

We are honored to be part of the larger SADN group.  The work and success of each workgroup excite and motivates us to accomplish more.  We are all driven by a common purpose to assure nurses are prepared to competently and safely respond and lead in disaster scenarios.

 

Kimberly Hatchel

The experience of Kimberly Hatchel, Chief Nursing Officer

My name is Kimberly Hatchel and I was the Chief Nursing Officer at Sunrise Hospital and Medical Center – a Level II Trauma Center when the October 1st, 2017 Mass Casualty Incident – Active Shooter event occurred in Las Vegas. The event officially announced a little after 10pm, produced 24 hours full of actions aimed at saving human life.

At approximately 2225 the first private vehicle arrived at Sunrise carrying patients. This notation is significant as the number of patients shot in this event thrust those not injured into the immediate role of the first responder. Arrival patterns of patients were also uncertain as there was no ability to announce their arrival. At 2229 the first ambulance arrived carrying patients.  At 2300 the first patient was triaged to the ICU and by 2330 a code triage was called as the magnitude of the event was both being felt and understood. By 2359 five surgeries had been completed.

By 0112 over 100 physicians had responded and by 0200 over 200 nurses had responded. This number proved to be significant as the severity of patient injury required 1:1 nursing care of patients in the initial stabilization and transfer to surgery or ICU. By 0247 the Emergency Department had 228 patients in various stages of treatment in a 52-bed Emergency Department. By 0451 we had 167 patients discharged/transferred from the hospital. By 0545 the Clark County Corner arrived to clear the release of the non-surviving victims of the mass casualty shooting. By 1100 Emergency Department Operations had returned to normal. By midnight on 10/2 – 56 surgeries had been completed. There were 212 known victims treated and an additional 30 who elected not to remain and allow the more severely injured patients to be treated in the first few hours after the event.

The Level I trauma center had been put on diversion. This was the catalyst for the Level II to take twice as many patients.