Dyson College of Arts and Sciences
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ground? What is the responsibility of a nurse when there is a call for aid after a terrorist attack? In these scenarios, all nurses may respond to the call. Box 2 provides a vivid example of how one nurse has assumed such responsibility and responded to this call. Nurses work with individuals across the lifespan and provide care, within diverse environmental contexts, to individuals who present with a vast array of health conditions. As a profession, nurses have the capability of enhancing the responsiveness and resiliency of a community, state, or government. According to the U.S. Department of Labor Statistics (2009), registered nurses account for 2.6 million jobs, with a projection of 3.2 million by 2018. As the profession grows in numbers, there is potential to expand and enhance nursing's contribution to the disaster management cycle and, most certainly, in the event of a disaster, to increase the surge capacity. The U.S. Department of Health and Human Services/Agency for Healthcare Research and Quality (AHRQ) defined surge capacity as the "health care system's ability to expand quickly beyond normal services to meet an increased demand for medical care during a large-scale public health emergency" (2009, par.1). Is nursing ready to contribute to this surge? Are we personally and professionally prepared? Some have identified several issues and suggest there is need for improvement. Preparing a Profession As Peterson (2006) noted, "Disaster response—at the best of times—is orchestrated chaos" (par.5). To avoid this chaos, preparation is necessary, from both a personal and a professional perspective. All nurses need to be willing to acknowledge that disasters, even with prevention plans in place, may occur. To this end, how prepared are nurses individually? Do they have personal plans to address potential issues with regard to their own personal life and their family? Are they professionally and educationally prepared to respond? Are they listed on registries of emergency responders? These registries have been developed to enhance capacity by creating a mechanism to identify health professionals at the ready (Peterson, 2006). All nurses have the basic knowledge, competencies, and skills, developed through their education and experience, to respond in the event of a disaster, but the complexities of disaster scenarios raises the question: Does nursing education provide the basic competencies for disaster nursing, and are practicing nurses really prepared? Some professional bodies have addressed this issue by looking at whether nursing students receive the basic knowledge, competencies, and skills relevant to disaster management. The Nursing Emergency Preparedness Education Coalition (NEPEC), previously known as the International Nursing Coalition for Mass Causality Education (INCMCE), was founded as a "response to the recognition of the need for nurses to be more adequately prepared to respond to mass casualty events" (n.d., par.1), and its vision is to "prepare every nurse to serve people and communities in a disaster or emergency" (n.d., par.3). Members include nurse academicians, as well as government, military, and specialty organizations from the United States and Europe. In 2003, this organization conducted a survey of deans and directors of nursing schools, searching to identify the role of emergency preparedness within nursing curricula. The survey found limited specific content in nursing curricula; in fact, the mean number of hours devoted to disaster preparedness content was four hours. In addition, the deans and directors expressed a concern that nursing faculty were not prepared to deliver this content (Weiner, Irwin, Trangenstein & Gordon, 2005). Since then, many nursing programs have responded, adding emergency preparedness to nursing program curricula. The effectiveness of the new content remains uncertain. Is the content integrated throughout the curriculum or is it an add-on assignment in the community 50