Community Preparedness and Response
NUR/408

Community Preparedness and Response
This paper discusses The Neighborhood - Pearson Health Science season two, episode five at the University of Phoenix student website. The examination of the actions of health care workers in response to the health concerns of key characters will be highlighted including the community hospital, senior center, school, and the Bley household. The role of the preparedness of the public health agencies, who initially responded to the community emergency, and who should monitor the effects on the community health will be assessed. Identification of how public health care teams can enhance the citizens’ preparedness for emergencies will be explored as well as suggestions to improve personal preparedness in a similar community emergent event.
The Neighborhood
The Neighborhood has a population of 64,200 including all ages from zero to over 90 years-old. An uncontrolled forest fire has been burning for over five days. As firefighters battle the fire, city officials state the community is not in any danger. However, the thick smoke is covering the town. The healthcare workers are working hard to treat people of the community with chronic lung problems (Pearson Health Science, 2009).
Hospital
The local hospital is a 362 inpatient bed facility (Pearson Health Science, 2009). The raging fire has the emergency room and local offices seeing an increase of patients suffering breathing problems from the fog of smoke over the community with many residents being admitted to the hospital. The hospital’s medical-surgical beds are full and the shortage of nurses just made the stress levels rise as the influx of patients needing beds is critical. The medical-surgical manager, Pat Richmond, has learned from an administrative meeting that mandatory overtime will be instituted. The stress of the flood of patients being admitted from the fire with respiratory issues has the nursing unit already stressed with morale low. The mandatory overtime could break an already short staffed unit. The emergency room admission demands are creating a stressful environment for the nursing staff trying to keep up with the discharges and admissions. The hospital apparently did not have an emergency plan and is presently struggling to rectify an already out of control community emergency. The hospital failed to have an emergency preparedness plan in place, which places undue stress on the staff and community. The nurses that were off could be called with a “disaster call plan” into the hospital to assist with the overwhelming situation and ease the burden of discharges and admissions throughout the hospital.
Senior Center
Karen Williams is a geriatric Registered Nurse for 30 years. At the Outpatient Senior Center, Karen is seeing the effects of the fire on the seniors who attend the center. She advises individuals to stay indoors to avoid the aggravating factors to the respiratory system because she is seeing an increase of coughs and use of oxygen. Karen’s influence with the Senior Center’s visitants can be advantageous and desirable to encourage them to stay indoors and only come out in case of an emergency. The Senior Center employees could have a disaster plan in place, which could include phone calls to the patients to encourage them to stay at home until the smoke blows over. The Senior Center could also be involved with mutual aid in the community to take needed supplies to the seniors.
School
A six-year practiced school nurse Violet Brinkworth is very busy between two schools. A teacher sends student Kelsey Young, a second grader to the nurses’ office because she has been coughing. Violet notices Kelsey has an increased rate in breathing, frequent coughing, and wheezing in her lungs. Violet calls Kelsey’s mom to come get her and suggests she get checked by her physician and that she should send an inhaler to the nurses’ office in school. Mrs. Young seemed reluctant to comply with this request. Although Violets’ action with Kelsey was appropriate, an educational opportunity to Mrs. Young was missed in regard to the importance of the inhaler in the school’s nursing office and how it could prevent a serious asthmatic incident.
Bley Household
Native Americans, Jimmy and Cecilia Bley, both over 70, have large family consisting of eight children who live in the area. Jimmy Bley has emphysema and with the smoke hovering outside he understands he should not be outside but a strong statement from his wife about the dryer being broke again tempts him to go out and get the part needed to fix the dryer. However, their daughter visits and takes Cecilia to the Laundromat to complete that task. A family emergency preparedness consisting of the large family could assist the parents with their tasks or taken them to stay with one of their children until the emergency has passed. In addition, community care teams could assist with tasks without the seniors going outdoors.
Preparedness and Improvements
The frontline of this community crisis was the local hospital emergency room. Emergency room nurses role is prioritizing and properly triaging patients. The hospital failed preparedness for this crisis. Recognizing the urgency or emergent community admissions and calling a “disaster code” would have provided more assistance in the hospital as well as the community resources. The chief improvement for this community is an emergency preparedness plan.
Responding to a disaster can be the easy part for a disaster relief worker but in “times of crisis or great uncertainty call for great skills in communication. The community needs accurate information transmitted in a timely manner. Health care personnel are the best sources for essential health information that is technical in nature” (Stanhope & Lancaster, 2012, p. 525). Organization is paramount. Stanhope and Lancaster (2012) state, “mutual aid agreements establish relationships between partners prior to the incident at the local, regional, state, and national levels and ensure seamless service” (p. 516).
The World Health Organization (WHO) states “Emergency preparedness is a programme of long-term activities whose goals are to strengthen the overall capacity and capability of a country or a community to manage efficiently all types of emergencies and bring about an orderly transition from relief through recovery, and back to sustained development. It requires that emergency plans be developed, personnel at all levels and in all sectors be trained, and communities at risk be educated, and that these measures be monitored and evaluated regularly (n.p.). It is essential to communities not only to have a strategic disaster plan in place but have simulation drills for a disaster before a disaster strikes.
Developing an emergency preparedness plan for the community and allowing state and federal assistance to step in would have alleviated the stress on the only local community hospital. For example, the U.S. Department of Health and Human Services (HHS) (2011) states, “after a tornado demolished a hospital in Joplin, Mo., the state’s disaster medical assistance team and hospital staff set up a mobile medical unit at the hospital site” (para. 3). Mobilizing a triage and emergency mobile command center at the hospital would have been ideal if mutual aid agreements were in the community’s emergency preparedness plan.
The public health agencies that would join in community emergency response include the local health department, hospitals, emergency medical services, fire departments, police departments, and the local American Red Cross chapter. State agencies that would assist in a crisis would include State Police agencies, State Health Officer, Public Health Officer, and State Offices for Emergency Management. On a federal level of emergency management and preparedness, the Federal Emergency Management Agency (FEMA) (2011) states “protection and National Preparedness (PNP) is responsible for the coordination of preparedness and protection related activities throughout FEMA, including grants, planning, training, exercises, individual and community preparedness, assessments, lessons learned, continuity of government and national capital region coordination (para.). FEMA is a national organization that supports the citizens and first responders to create, maintain, and improve the capability to protect against, prepare, respond, recover, and mitigate all disasters. FEMA has more than 7382 employees working all over the United States (FEMA, 2011). Many agencies have the ability to allocate and supply manpower, volunteers, equipment, supplies, and financial support. Another core support in a disaster is the American Red Cross. “Red Cross disaster relief focuses on meeting people's immediate emergency needs caused by disaster. When disaster threatens or strikes, the Red Cross provides shelter, food, health, and emotional health service to address basic human needs and assist individuals and families in resuming their normal daily activities independently” (American Red Cross, 2011).
Care Teams
Public health team coordination in this community with mutual aid efforts could have checked on the community’s most at risk population, like the Bley household in “The Neighborhood” scenario. Many communities are taking the initiative for emergency preparedness by forming citizen councils and corps to assist in an emergency. They are identifying local partners like the police, firefighters, and hospitals, building a preparedness team, setting goals, and participating in mock drills. According to FEMA at ready.gov (2012) “the Citizen Corps effort is coordinated at the local level by Citizen Corps Councils or similar coordinating bodies, which bring together community leaders to plan for emergencies before they happen. The local leaders who serve on the Citizen Corps Councils should reflect all sectors of the whole community to ensure every stakeholder has a seat at the table. Citizen Corps Council members participate in developing community emergency plans, conduct localized outreach and education to the public, offer training and participation in exercises, encourage volunteerism, and in the event of a disaster, form an integral part of the response” (para. 2).
Personal Emergency Preparedness
Education of the area and the potential of natural disasters such as mud slides, wildfires, hurricanes, tornadoes, tsunamis that could occur would be a first step. Creating a family emergency preparedness plan would be a practical and sensible step. Being prepared and understanding what to do during an emergency can reduce fear, anxiety and losses that disasters create. There are state, federal, and international websites on family preparedness that one could investigate. The New Jersey Office of Emergency Management (n.d.) outlines the following steps for family preparedness: [Create a disaster plan by meeting with your family and discuss why you need to prepare for disaster. Explain the dangers of fire, severe weather, and earthquakes to children. Plan to share responsibilities and work together as a team. Pick two places to meet and everyone must know the address and phone numbers. Discuss what to do in an evacuation. Plan how to take care of your pets. Practice and maintain your plan. Have emergency kits ready with a three-day supply of water (one gallon per person per day) and food that won't spoil, one change of clothing and footwear per person, and one blanket or sleeping bag per person, first aid kit that includes your family's prescription medications, emergency tools including a battery-powered radio, flashlight and plenty of extra batteries, an extra set of car keys and a credit card, cash or traveler's checks, sanitation supplies and keep important documents in an easy to reach container with you. Make sure you have two escape routes mapped out. Listen for emergency communication about the disaster] (para.). One should also have fire extinguishers at hand in case use is required.
Conclusion
Natural and man-made disasters can occur at anytime and anywhere. Being prepared for a disaster is essential for every citizen. In The Neighborhood community, the raging forest fire creating smoke which filled the air was producing respiratory issues in the community overloaded the only resource in the community, the hospital. If this community had a preparedness plan then safe and rapid assistance to the citizens in need of attention would have been taken care of directly. Educating communities and having citizens involved in emergency preparedness, forming citizen corps, and jointly working with other public health agencies will improve and alleviate confusion and anxiety when a disaster strikes.

Reference
American Red Cross. 2011. What We Do. Retrieved from http://www.redcross.org/what-we-do/disaster-relief Federal Emergency Management Agency. 2011. Emergency Preparedness. Retrieved from http://www.fema.gov/
Pearson Health Science. 2009. The Neighborhood. Retrieved from http://pearsonneighborhood.ecollege.com/re/A_PSH.real?47=6100510
Ready.gov. 2012. Citizen Corp. Retrieved from http://www.ready.gov/build-team
Stanhope, M. & Lancaster, J. (2012). Public health nursing: Population-centered health care in the community (8th ed). St. Louis, MO: Mosby Elsevier
The New Jersey Office of Emergency Management. N.D. Emergency Family Plan. Retrieved from http://www.state.nj.us/njoem/preparedness_fampln.html
World Health Organization. 2012. Emergency Preparedness. Retrieved from http://www.who.int/hac/techguidance/preparedness/en/index.html U.S. Department of Health & Human Services. 2011. Mobile Hospital. Retrieved from http://www.hhs.gov/news/press/2011pres/07/20110701a.html