Community Emergency Preparedness and Response Paper
Kelly M. White
NUR/408
August 10, 2015
Amy Reagan

Community Emergency Preparedness and Response
The terms “preparedness” and“readiness” can be used interchangeably. Preparedness is defined as the existence of plans, procedures, policies, training, and equipment necessary at the Local, State, and Federal level to maximize the ability to prevent, respond to, and recover from major events (Katz, 2013). Emergency preparedness is essential in assisting with disasters and emergent issues that happen around the world. Media coverage of disasters across the globe occur in real time with an intensity level that makes one believe that natural or manmade disasters happen more frequently. Disasters, in all forms, is a part of life and how we deal with these events depends on how well we are prepared. It is of the utmost importance that all of the population be aware of what to do and who to contact when an event is about to happen or while it is unfolding. A community’s ability to recover and be self-reliant after a disaster also depends on how well the community prepares for and responds to these emergencies. This paper will discuss and examine how the resources and people of the chosen neighborhood responded to the emergency at hand, a forest fire ravaging for more than 5 days (Neighborhood 2.0-News).
The Neighborhood
There is an uncontained forest fire that has been burning for more than 5 days in a forest west of the Neighborhood. The fire has spread and destroyed several acres of land, and with every day that the fire continues, it causes irreversible damage. Fire fighters are trying to control the wildfire but, the early arrival of the windy season makes this task more difficult. In fact, it causes the fire to be less predictable and helps it to spread rapidly. City officials have stressed that the citizens are not in any direct danger and will be notified if there is any chance that the fire’s direction will shift toward town. Due to the poor air quality secondary to smoke, officials have also urged the citizens to stay inside unless it is absolutely necessary, particularly those with chronic respiratory conditions. Officials have warned residents that the haze should be regarded as a risk but not life-threatening (Neighborhood 2.0 News).
The Hospital Meanwhile, firefighters battle the blaze, healthcare workers battle to keep patients breathing. James Gordon, MD., Neighborhood Hospital Emergency Department physician, states “the smoky air conditions affect everyone, but especially those with pre- existing problems, such as chronic lung conditions” (Neighborhood 2.0 News). The number of patients seen in the ED and local physician offices has increased due to the effects of the smoke. With too many patients, the hospital was not able to accommodate everyone and many patients had to be discharged from the hospital units to make room for new admissions. The emergent situation, at hand, is causing an increase in stress and anxiety levels, not to mention a decrease in the morale of the health care team at the hospital. Pat, Nurse Manager of one of the units in the hospital is frustrated because the emergency department keeps calling for beds even though there are no beds readily available. The staff members are doing everything within their limitations to make sure accommodations are made. Zainah, one of the staff members, finds herself admitting new patients just as soon as other patients are discharged and or transferred. In an effort to ensure there is enough staff during this trying time, administration has decided to institute mandatory overtime at the hospital beginning with the next pay period, a decision that adds to the frustration of the already frustrated staff (Neighborhood 2.0 News).
The Senior Center
Neighborhood Senior Center Nursing Clinic, like every other organization in the community, is experiencing the effects from the forest fire. One of the employees of the center, Mr. Jackson (just getting over pneumonia), has been advised to stay home instead of coming out in the smoky air conditions. Karen, a seasoned nurse at the senior center, has seen an increase in the amount of oxygen needed by the seniors during this week. Nurse Karen has educated and advised them to adhere to the recommendations of the city officials by avoiding respiratory irritants and stay inside unless it is absolutely necessary to be outside (Neighborhood 2.0 News).
The Middle School
The middle school in the neighborhood has an annual Science Fair scheduled for this weekend. The annual science fair usually draws a crowd and has over 50 participating children from the school. The children get to showcase their projects and compete for prizes. The available prizes include gift certificates and the chance to enter their projects into higher-level regional, statewide, or nationwide science fairs. With the conditions of the air quality at this time, it has not been determined whether or not the science fair will go on or be canceled. Kelsey Young, a primary school student, who suffers from asthma, is experiencing changes in her breathing. She notifies the School Nurse (Violet-suffers from asthma and allergies) of her difficulties, who in turn suggests to Kelsey’s mother that Kelsey be taken to her doctor. Violet also encourages Kelsey’s mother to send her inhaler to school so in times like these the inhaler is readily available. Violet notices that Kelsey’s mother is reluctant to receive this information at this time. She decides to wait a few days and present the information with a different approach, which in turn is received well and a plan is developed for Kelsey with the help of her mother (Neighborhood 2.0 News).
The Bley Household
Jimmy and Cecelia Bley, residents of the Neighborhood, are experiencing inconveniences due to the blazing forest fire. Jimmy, who suffers with COPD but still smokes, has decided to follow the advice of city officials and stay indoors unless absolutely necessary. Their dryer has broken, yet again, but Jimmy refuses to go out and get the parts needed to repair the dryer until the quality of the air allows him to do so without exacerbating his COPD. Cecelia, on the other hand, is in good health except her osteoarthritis. She is very much frustrated that her dryer is broken and she can’t complete her laundry like she likes. Her daughter comes and picks up Cecelia and takes her home with her to do the laundry. Cecelia has to talk herself through her own frustration with Jimmy. She reminds herself to be patient and forgiving, remembering he has significant limitations, and show understanding that even though Jimmy denies having difficulty at this time, he is having more and more difficulty breathing when he exerts himself. Cecelia has stopped nagging Jimmy and allows him to do things in his timing. Jimmy understands his limitations and thought he won’t quit smoking, he still tries to accomplish what needs to be taken care of in a timely manner (Neighborhood 2.0 News).
Actions of the Health Care Workers
The role of the public health care team in emergency preparedness includes knowing the basic concepts in emergency preparedness and management. These concepts include risk assessment, mitigation, preparedness, and response and recovery. For preparedness in wildfire situations, a system known as Incident Management System (IMS), also known as “Firescope” was developed to address difficulties managing California wildfires during the 1970s, and was identified as a high priority in 2004, in the National Framework for Health Emergency Management.IMS has since been widely adopted by many North American emergency and disaster response agencies to include most Canadian police, fire and emergency medical services (EMS) first responders (Christian, Kollek & Schwartz, 2005).
The Neighborhood public health care teams are responsible to know who their supporting organizations and resources are and work together to develop a plan in the event of a disaster, have a chain of command and teams already in place so everyone already knows what their role and responsibility is during a disaster, and when to implement the plans already developed or change plans as needed during the disaster. The role of the public health care team in The Neighborhood 2.0 is to assess, plan, implement and evaluate the process of delivering the care needed during the disaster. There were several nurses from different sites that initially responded to the neighborhood emergency. The nurses made sure that the clients that were before them received care according to their individual needs and based on priority.
The emergency room nurses, worked with other members of the healthcare team to respond quickly and assess the needs of the patients arriving in the emergency department. Upon evaluation, patients were dispersed to the proper departments for care if not discharged with proper instructions for self-care. The nurses on the units in the hospital worked relentlessly to provide the care needed for patients staying, being admitted and to discharge patients in a timely manner so beds could be made available to clients coming in through the ER or transferring from other units within the hospital. The nurses in the community senior center and schools, made assessments and provided treatment with in their scope of practice, while educating, encouraging, and suggesting that clients seek medical assistance from their doctors or local hospital.
While the focus was on the hospital, senior center, and school nurses, these are not the only types of nurses that should monitor the effects of this emergency on the community health. All nurses should be monitoring the effects of an emergency and disaster because emergencies and disasters affect everyone with all types of conditions. Home health nurses, mental health nurses, and department of health nurses are just a few of the other types of nurses that should monitor the effects of this emergency on the community for obvious reasons. The home health nurse can go to the home of their clients and ensure that the members of the household has enough food, water and medications. The mental health nurses can monitor their client to ensure that their condition is not exacerbated to a condition of despair. The department of health nurses can treat the clients that seek medical treatment from the department of health (DOH), provide them with the proper resources needed to get through this emergency situation and or direct them to the proper agency that can help them.
Public Health Agencies
There are public health agencies on every level with different types of responsibilities but each has a common goal to ensure an optimal level of health of the public. Some of the public health agencies that could have been of assistance with the Neighborhood 2.0 Forest Fire, to help reduce some of the stress and frustration of the health care teams, are the local DOH, state DOH, the American Red Cross Association, the Community Emergency Response Team (CERT), and the National Emergency Response Team (NERT).
The local department of health, as stated earlier in this paper, could have provided clients with proper resources needed or directed them to the proper agency. The state DOH, could have provided additional resources (ie; medications) as necessary and staff to the local DOH during this emergency. The American Red Cross, a nonprofit organization, helps people after a disaster by providing needed resources immediately such as, food and water, clothing, and shelter (American Red Cross, n.d). There is a division of FEMA called the Community Emergency Response Team (CERT). CERT assists in training people to be better prepared to respond to community emergencies by educating the community members on what to expect in an emergency and their role and responsibility in an emergency. This training improves the community’s response to emergencies which is helpful for the first responders. CERT also provides critical support by assisting victims of emergencies immediately and organizing volunteers at the emergency site (FEMA, 2015). The National Emergency Response Team (NERT), is a response team that is a volunteer-driven organization. Hundreds of Americans volunteer for this organization to help others during times of emergencies when they are in need. NERT develops and implements the disaster response services and educational programs that coordinate publicly available resources during a crisis situation (National Emergency Response Team, 2009).
With the assistance of CERT and NERT, the levels of frustration and stress that the health care team at the Neighborhood Community Hospital experienced, would not have been so high. These agencies would have been able to assist with staffing needs by finding volunteers from a range of any needed background, to include additional doctors and nurses. CERT and NERT would have been able to assist with finding other facilities to accommodate the medical needs of the community and ensure the patients were transported accordingly.
Collectively, all the public health agencies mentioned could help and enhance public preparedness by educating the community on how to prepare for different emergency situations, the supplies that will be needed, the resources available with telephone numbers and radio stations to tune into.
In the Bley household, Mrs. Bley and her daughter could have made sure Mr. Bley had a face mask on hand just in case the situation became worse and he needed to wear it. The public health care teams could have assessed the Bley household to see if there was a need for an oxygen tank or and provided it temporarily, at no charge to the client. With Mr. Bley being unable to go out of the house due to poor air quality during these times, it is essential that public health agencies provide education regarding self-care, proper nutrition and cessation of smoking. It is also important that Mrs. Bley be educated regarding the care her husband needs and the numbers she can call in an emergency.
Conclusion
Emergencies and disasters can happen at any moment and it is always when it is least expected. Although some events are uncontrollable, we have the ability to predict risk factors and prepare for potential emergencies. Communities have various resources that can be used in the wide range of possible emergency events. The Public health sector is essential in performing theirs roles in emergency preparedness and disaster mediation. In the event of forest fires, residents with poor health and existing respiratory conditions stand a greater chance of exacerbations of their conditions. Ensuring that there is an emergency preparedness and disaster plan in place is the responsibility of the entire community. First, residents are responsible to ensure that their own households are ready for potential emergencies with can goods, water, batteries, flashlights, resources numbers and anything else that they deem essential for immediate assistance. Second, the community officials and their designated agencies are responsible to develop a plan that can be employed when disaster strikes. Next it is the responsibility of state and national officials to ensure there is an updated Emergency Preparedness and Disaster Plan in place that is appropriate to be implemented in any given emergent situation that may take place.
Education on all levels to all personnel of the public health sector, as well as to the members of the community, is essential to carrying out the developed plan. Providing training and conducting mock drills is in no way close to what will be experienced during a real emergency and disaster but, it does allow participants the opportunity to get a feel for what they will need to do I and when the time comes. It is through knowledge, preparation, and collaboration between community, state, and national levels of public health organizations that lives can be saved and property loss minimized when disaster strikes. A community’s ability to recover fast depends on the proactive planning by public health organizations when assisting the community.

References
American Red Cross. (n.d.). Retrieved from: https://www.redcross.org/donate/index.jsp?donateStep=2&scode=RSG00000E01 7&itemld=prod10001&subcode=paiddonationsbrand&gclid=CMWVuMHXmbY CFQexnQodbhsAuw
Christian, M. D., Kollek, D., & Schwartz, B. (2005). Emergency preparedness: What every health care worker needs to know. CJEM : Journal of the Canadian Association of Emergency Physicians, 7(5), 330-7. Retrieved from http://search.proquest.com/docview/195787013?accountid=458
FEMA, Community Emergency Response Teams. (2015). Retrieved from: http:www.fema.gov/community-emergency-response-teams
Katz, R. (2013). Essential of Public Health Preparedness [University of Phoenix Custom Edition eBook]. Burlington, MA: Jones & Bartlett Learning.
National Emergency Response Team. (2009). Welcome to NERT. Retrieved from http://www.nert-usa.org/