SZT1 Community Health Practice Task 4
Disaster in Franklin County
Tracie Willis
Western Governors University

Franklin County was recently victim to a massive summer storm. The storm resulted in tornado, thunder storms, flash flooding, power outages, roads and bridges closed, and even a hazardous materials spill. To assess the damages that the towns and the residents suffered, and how to best deal with the aftermath, a task force was created.
The Emergency Operations Center (EOC) was set up and an Incident command briefing was called. The chain of command was established at this time. All members of the task force reported to the EOC commander. The community health nurse was called to join the task force as a member of the Public Health Group; this group was under the supervision of the Medical/Health Branch Director. The Director of the Medical/Health branch reported to the Operations Chief and she reported directly to the EOC Commander. One of the branches of the task force, the Public Health Group, was tasked with evaluating the health risks and needs of the community. This group was led by the Operations Chief; her responsibilities included developing and implementing strategy and tactics to carry out the objectives identified by the taskforce at the EOC briefing, as well as organize, assign, and supervise the tactical field operations. The Logistics chief supports the operation by acquiring things that are need to get the job done, such as supplies and equipment. The Liaison Officer was appointed to serve as a point of contact for the supporting agencies by answering their questions and providing briefings when necessary. He also is there to help keep the EOC Commander from being bombarded with requests and updates. The next person on the taskforce is the Planning Section Chief. Her responsibility is to gather, analyze and disseminate information. She manages the planning process by compiling the Incident Action Plan and tries to be prepared for what comes next. The taskforce finances are controlled by the Finance/Administration Section Chief. He is responsible for ensuring that proper contractual and financial processes are in place and tracks those resources that have been expended during the response. The Community Health Nurse is responsible for going door to door and assessing the immediate health needs of the community. She is also available to answer health related questions and will be setting up future referrals as needed. As the Community Health Nurse goes door to door, she is not only assessing medical needs, she is assessing the home situation and any safety issues that need to be addressed. When a need is identified that is outside her scope of practice the community health nurse will give the resident information on who to contact, steps that can be taken, and write a report for follow up to be given to the appropriate department for the specific needs that are identified during her interviews. While going door to door, the community health nurse encountered many emergencies that needed to be addressed. The Nurse notified the residents of the shelter that was open and offered to arrange transportation for those that wanted to relocate to the shelter. She identified safety hazards with drinking water and provided oral and written education on how to treat water prior to consumption to make is safe. She instructed those with wells that supplied their water of the dangers due to the pumps not running while the electricity was out. The Weslund residence had a basement that had flooded and a chemical spill that had occurred. The Nurse made arrangements for an Environmental Health Specialist to come and help with the clean-up of the hazardous waste because with an unknown mix of chemicals it could be dangerous for Mr. Weslund to attempt on his own. She also gave Mr. Weslund written education on cleaning up after a flood and advised him to contact his insurance company to report the damage. At the Alvarez home, the resident spoke only Spanish but the nurse was able to identify a family member that spoke English and she provided the son with education on the safe operation and ventilation of their indoor generator. She also arranged for a follow up visit that would include a translator. At the Fugate residence, Mr. Fugate informed her that he had just run out of his BP medication. After doing a focused assessment on him, she gave him the option of going to the shelter so that he could be closely monitor for his BP, or she could make arrangements for delivery of BP medication the following day. Mr. Fugate chose to go the shelter so transportation was arranged. Mrs. Fuhr was upset that she did not have electricity or adequate food and supplies to care for her elderly mother-n-law and infant. She also did not know where her husband was. The Nurse provided the necessary provisions and made arrangements for more to be delivered to the home. She also scheduled a follow up visit in one to two weeks for help with additional resources. This is the home that she should have provided additional assistance at. Mrs. Fuhr stated that she did not know where her husband was located and some of her statements did not support an ideal home life with her and Mr. Fuhr. The nurse first should address the question of where Mr. Fuhr was last seen or heard from. With the extent of the storms throughout the county, there is a possibility that he could be a casualty of the tornado or flooding. The second question that the nurse could have addressed is whether Mrs. Fuhr feels save in her relationship. Does she need to involve social services? Is a safe place to stay necessary for her and her infant? Although the nurse provided the necessary provisions, the social needs were not addressed in this home. While interviewing the community and assessing their needs, the Nurse gave options to the residents and made sure to include them in the decision making of what would be the best and or safest course of action for each family individually. In times of crisis, it is important that the residence are able to feel as if they have some control over the situation and giving them options is one way to help them feel this.(Olson, Larson, Scheller & Freiburg, 2006)
In cases of disaster emergencies with larger affected areas, a disaster plan is most helpful to keep the response and care organized. There are three aspects of Disaster Prevention. Primary Prevention: Primary prevention involves the preventing disasters and disaster related problems if disasters cannot be prevented. The Community health Nurse can play an important role in primary prevention. The Community Health Nurse can assess the community in regard to their attitudes to potential disasters and are they taking necessary steps to prepare for a disaster. Often the Community Health Nurse has a more specific knowledge of community resources and who in the community could be of assistance during a disaster. She can also assist in the education of the community on how to prevent problems that can occur after disasters. Secondary Prevention: Secondary prevention involves the action of the Community Health Nurse in the midst of the disaster crisis. This can involve immediate care of victims at the site of a disaster with rapid assessment of victims at the site of the disaster, triage or “sorting” victims based on their acuity and urgency of the care needed, and then treatment of those victims that can be treated and care of the dead. The Community Health Nurse can aide in caring for those who have been displaced due to the disaster. Shelters can be set up and the nurse can aid in supervision of those in the shelter while providing continued care in preventing further injuries or disease while being in large groups. Tertiary Prevention: Tertiary prevention focuses on what happens after the disaster has abated. Follow up care is needed both physically and mentally for those affected by disasters. Was the treatment effective? Do the victims require counseling? Is financial assistance required? These are all questions that the Community Health Nurse can answer while doing follow-up assessments of victims in her community. She can also advocate for future education and disaster readiness programs based on the current outcomes that where identified.(Clark, 2008)

Resources

Clark, M. J. (2008). Community health nursing. (5th ed.). Upper Saddle River, New Jersey:
Pearson Education Inc. Retrieved from http://media.pearsoncmg.com/pcp/2008935461/ebook/

Olson, D. (Writer), Larson, S. (Producer), Scheller, A. (Director), & Freiburg, J. (Editor) (2006).
Disaster in franklin county; a public health simulation [Web]. Retrieved from https://cpheo1.sph.umn.edu/fcs/index.asp