Call to Action: The Case for Advancing Disaster Nursing Education in the United States

The Role of the School Nurse in Addressing Climate-Associated Illnesses: Mental Well-being

Human health is being impacted by anthropogenic (human-made) climate change. This article describes four ways that climate change may affect mental well-being in school-age children. First, natural disasters-such as more frequent and intense tornadoes and flash floods-may have a direct influence on mental well-being by contributing to acute anxiety and distress. Second, indirect effects of severe weather-including changes in social support systems-may affect mental well-being by increasing isolation. Third, children may suffer feelings of anxiety or depression if they perceive a sense of powerlessness to solve the challenges of a changing climate. Finally, school nurses need to be aware of the emergence of correlations-such as data that suggest increases in temperature may influence the use of inpatient mental health services and suicidal ideations-that require further scientific exploration. This article aims to increase school nurses' understanding of how climate changes may impact the mental well-being of school-age children and to provide strategies for creating a safe, healthy learning environment. This article is the fourth in a series aimed at raising awareness among school nurses about climate-associated illnesses and equipping them with the resources they need to protect school-age children's health.

Teaching Disaster Nursing Competencies: Strategies to Succeed

BACKGROUND

Disaster education for nurses at all levels is imperative to improve the ability for communities to be prepared to respond and recover from disasters and public health emergencies. A variety of educational strategies are available to deliver this vital content.

METHOD

A variety of strategies to deliver necessary disaster nursing education are discussed. The development of online disaster response modules for nurses at all levels from nursing student through advanced practice, delivered via a learning management system is described along with standard approaches to disaster content delivery.

RESULTS

All methods of teaching disaster nursing competencies are valued.

CONCLUSION

Through the effective online approach, nurses can receive disaster management training at the time and location that is most comfortable and convenient for them, thus increasing the potential to train more nurses in this important content area. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Cognitive maturity of Portuguese nursing students to intervene in disasters: initial training contribution

OBJECTIVE

To understand whether, from the perspective of coordinators/directors of nursing courses and nurses with skills in the field of disasters, nursing students have the necessary cognitive maturity to articulate the various dimensions inherent to the area of disasters, allowing efficient performance.

METHOD

A study with a qualitative methodological approach, based on inductive reasoning and rigorous phenomenon description, based on exploratory research.

RESULTS

Given the specificity and complexity of these phenomena, the inclusion of the disaster domain in the teaching-learning process, supporting valid knowledge construction and allowing the development and maturity of nursing students' cognitive processes, is crucial.

CONCLUSION

Currently, reduced technical-scientific training in the field of disasters in Portugal constitutes a barrier in the development of nursing students' cognitive maturity, impeding their ability to respond when faced with phenomena of this complexity.

A Call to Action: Why Anesthesiologists Must Train, Prepare, and Be at the Forefront of Disaster Response for Mass Casualty Incidents

Disasters, both natural and man-made, continue to increase. In Spring 2023, a 3-hour workshop on mass casualty incidents was conducted at the Society for Pediatric Anesthesia-American Academy of Pediatrics Annual conference. The workshop used multiple instructional strategies to maximize knowledge transfer and learner engagement including minididactic sessions, problem-based learning discussions in 3 tabletop exercises, and 2 30-minute disaster scenarios with actors in a simulated hospital environment. Three themes became evident: (1) disasters will continue to impact hospitals and preparation is imperative, (2) anesthesiologists are extensively and comprehensively trained and their value is often underestimated as mass casualty incident responders, and (3) a need exists for longitudinal disaster preparedness education and training over the course of a career. In this special article, we have sought to further define the problem and evidence, the capacity of anesthesiologists as leaders in disaster preparedness, and the rationale for preparation with current best practices to guide how best to move forward.

Environmental Sustainability and Climate Change Content in Canadian Baccalaureate Nursing Programs

BACKGROUND

This study analyzed publicly available resources related to environmental and climate change material available within the Canadian Bachelor of Nursing Program curricula.

METHOD

This thematic review project contained two stages of data collection: (1) a comprehensive team-based review of Internet materials and (2) a digital survey of program faculties.

RESULTS

Most content reviewed included references to climate change. According to survey responses from program directors (n = 12), barriers to integrating climate change content included lack of institutional support, the perception that content was not important in undergraduate curriculum, a conviction that the material would be more appropriate for public health, and an overall lack of understanding of the topic by course authors.

CONCLUSION

With increasing emphasis on the importance of geopolitical health and climate change to many facets of nursing practice, nurse educators require support from colleagues and postsecondary institutions to incorporate this material into undergraduate nursing curricula. [J Nurs Educ. 2024;63(4):212-217.].

Culture of Safety and Preparedness: Benefits of Applying a Daily Mitigation Mindset in the Hospital Setting

AIM

Utilizing the subjective experience of nurse executives who have supervised nurses during a major disaster in a hospital setting, this study aims to describe the subjective experience of nurse executives (NE) who have supervised nurses' responses to major disasters. This paper will focus on strategies to support nursing response to disasters, specifically to strengthen resiliency and the ability to maintain function despite the shock of a disaster, including those caused by climate change.

METHODS

Semi-structured interviews were conducted with 11 hospital-based nurse executives who supervised nurses during some of the worst natural and human-made disasters in different regions of the United States. A phenomenological approach was used to analyze and describe emerging themes from the qualitative data.

RESULTS

Three nurse executives demonstrated theme saturation for mitigation steps to augment traditional disaster readiness activities: (1) Assessment of human infrastructure: daily skills needed during disaster response; (2) Identification and study of failure points and metrics; (3) Strengthening human infrastructure: rectifying deficiencies; and (4) Monitoring metrics and making corrections during conventional periods.

CONCLUSION

Mitigation steps may improve outcomes in hospital function during conventional times; therefore, these steps may improve resiliency and the ability to maintain functions during major disasters, including climate change.

Ethics: Crisis Standards of Care Simulation

Ethical dilemmas exist with decision-making regarding resource allocations, such as critical care, ventilators and other critical equipment, and pharmaceuticals during pandemics. Triage artificial intelligence (AI) algorithms based on prognostication tools exist to guide these decisions; however, implicit bias may affect the decision-making process leading to deviation from the algorithm recommendations. Conflict within the ethical domain may be affected as well. A knowledge gap was identified within the Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) curriculum regarding ethics in crisis standards of care (CSC) medical decision-making. Incorporating a CSC simulation looked to address this knowledge gap. A simulation-based learning (SBL) experience was designed as a critical access setting where CSC are in place and three diverse, medically complex patients in need of critical care present to the hospital where one critical care bed remains open. Given the complexity of the simulation scenario, a table-top pilot test was selected. Three AG-ACNP fourth-quarter students in their critical care rotation volunteered for the pilot test. Students were provided with the topic, "ethics crisis standards of care" and the article, "A catalogue of tools and variables from crisis and routine care to support decision-making during pandemics" by M. Cardona et al. (2021), to read in advance. Students were provided with the triage AI algorithm (M. Cardona et al., 2021) utilizing prognostication tools to prioritize which patient requires the critical care bed. The expectation was that implicit bias would enter the decision-making process, causing deviation from the triage AI algorithm and moral distress. The debriefing session revealed that students deviated from the triage AI algorithm, experienced implicit bias, moral distress, and utilized clinical judgment and experience to care for all three patients. The pilot test results support that a CSC SBL experience addresses a critical knowledge gap in AG-ACNP education and an SBL experience incorporating ethical decision-making curriculum with standardized patients should be developed and trialed as the next step.

Teaching disaster preparedness to pre-licensure students: A collaborative project during the pandemic

Readiness of nurses to respond to disasters has become paramount with the advent and sequelae of the COVID-19 pandemic. The Future of Nursing 2020-2030 report calls for nurses to be knowledgeable in preparing and responding to disaster management. In New Mexico, five associate degree nursing programs and three university nursing programs collaborated to develop a novel project in teaching disaster preparedness using COVID-19 as the disaster. Tabletop methodology via Zoom was used to simulate incident command centers in Zoom breakout rooms. Students were assigned roles to carry out during the four-hour event using resources from FEMA's Emergency Management Institute. Student and faculty post-surveys were completed with themes identified. Students appreciated collaborating with students from different schools, but also identified challenges with the event posed by remote learning. Students reported their "biggest takeaways" and identified action steps for improving future events; particularly, requesting more information to better understand their roles.

The 2023-2026 Hospice and Palliative Nurses Association Research Agenda

The Hospice and Palliative Nursing Association established the triannual research agenda to ( a ) provide focus for researchers to conduct meaningful scientific and quality improvement initiatives and inform evidence-based practice, ( b ) guide organizational funding, and ( c ) illustrate to other stakeholders the importance of nursing research foci. HPNA Research Agendas are developed to give direction for future research to continue advancing expert care in serious illness and ensure equitable delivery of hospice and palliative care.

Partnering to prepare: An academic/workforce collaboration to develop disaster shelter training for nurses

In California, more frequent, intense, and destructive wildfires have prompted public health departments to enhance disaster response plans as evacuations and shelter needs increase. In addition, individuals utilizing shelters have increasingly complex medical and behavioral health needs and are accessing shelters for longer periods of time. Public health nurses (PHNs) are often called to staff disaster shelters but may have less recent experience in, or comfort with, direct patient care. Many health departments are experiencing challenges developing sustainable training infrastructure that prepares PHNs to deliver direct patient care in disaster shelters. Partnering with academic institutions can address this challenge. This article describes a partnership between a regional collaborative of health jurisdictions and a public university to train public health nurses to work in disaster shelters. The training demonstrates a sustainable way to instruct public health nurses while also highlighting the potential of partnerships between academic institutions and local health departments to address disaster preparedness and response needs in a community. Public health nurses are essential to public health preparedness and providing additional training can augment their ability to respond to disasters.

An Unfolding Tabletop Simulation Training Exercise on Disaster Planning for Nursing Students

BACKGROUND

Disaster planning is an essential component for nursing students to learn.

PROBLEM

Clinical experiences of disasters are typically unavailable for nursing students. Increasing frequency of disaster events around the globe has made disaster planning knowledge and skills a critical component in nursing education and professional practice.

APPROACH

An unfolding tabletop disaster planning exercise was created as a simulation training strategy meant to strengthen essential disaster response skills. The exercise involves 5 realistic scenarios related to a mass casualty event, taking students from the disaster site to the hospital-based disaster response.

OUTCOMES

Implementation of a tabletop disaster planning simulation in one nursing program replaced the traditional lecture-based disaster content.

CONCLUSION

An unfolding tabletop disaster planning simulation is a comprehensive, interactive, sustainable, and low-cost teaching strategy that draws on nursing students' fundamental knowledge. Students had the opportunity to practice clinical skills required during a disaster, such as communication, prioritization, teamwork, and delegation.

Nursing During a Disaster Starts With Education

Future nurses, both entry level and advanced practice, are pivotal to the nation's disaster response. They are critical frontline, acute, primary, and public health workers in the United States and internationally. To respond well, they must be taught how to prepare and intervene appropriately. This preparation is multidimensional and includes not only concrete knowledge but mental, emotional, and ethical preparation for the realities of working and providing care while affected by chaos. Training should be experiential and reflective and expose students to the interprofessional nature of disaster planning and response. New nurses, as they enter practice, as the COVID-19 pandemic has demonstrated, may also take on the role of a frontline disaster responder. The ability to effectively respond and access available resources to care for patients is required. Schools of nursing and nursing faculty increasingly will be required to include disaster preparedness as an integral part of the nursing curriculum.

Nursing perspectives about the critical gaps in public health emergency response during the COVID-19 pandemic

INTRODUCTION

The purpose of this qualitative study was to synthesize frontline U.S. nursing perspectives about the current state of U.S. public health emergency preparedness and response. The study findings may inform public health policy change and improve future national pandemic planning and responses.

DESIGN

We conducted a secondary thematic qualitative analysis using grounded theory methodology.

METHODS

Data collection occurred through semi-structured, in-depth focus groups between July and December 2020, from 43 frontline nurses working in hospitals in four states (Ohio, California, Pennsylvania, and New York). Data were analyzed deductively, aligned with Khan et al.'s Public Health Emergency Preparedness Framework and inductively for emergent themes.

RESULTS

Three themes emerged: (1) Validation of the presence of health disparities and inequities across populations; (2) Perceived lack of consistency and coordination of messaging about pandemic policies and plans across all levels; and (3) challenges securing and allocating nursing workforce resources to areas of need.

CONCLUSION

From a frontline nursing perspective, this study demonstrates the critical need to address health inequities and inequalities across populations, a consistent national vehicle for communication, and national plan for securing and allocating nursing workforce resources.

An Online COVID-19 Simulation to Explore Interprofessional Collaboration and Foster Systems Leadership Competencies in Doctor of Nursing Practice Students

Organizational and systems leadership, a competency for doctor of nursing practice students, encompasses the evaluation of care delivery systems, accountable care of populations, and resolution of ethical dilemmas. Faculty created an online simulation in which students developed a management proposal for an impending pandemic. All students agreed or strongly agreed that the simulation increased their skills in systems-based thinking, increased their knowledge of others' roles and responsibilities in addressing health care crises, and enabled them to balance ethical considerations and societal interests. Online simulations are a feasible, cost-effective method to foster systems leadership competency and ethical decision-making in doctoral students.

Impact of the COVID-19 Pandemic on the Hawai'i Nursing Workforce: A Cross-sectional Survey

The coronavirus disease (COVID-19) pandemic has placed extraordinary strain on health care systems. This has led to increased stress among health care workers, and nurses in particular, which has had a negative impact on their physical and psychosocial wellbeing. This is likely to negatively impact the nursing workforce at the state and national levels as the pandemic continues. The purpose of this study was to assess whether nurses licensed in Hawai'i have considered leaving the workforce. A cross-sectional online survey was conducted among Hawai'i nurses at all levels of licensure, with 421 responding. Of these nurses, 97 (23.0%) reported considering leaving the workforce, with safety (39.2%) and family/caregiver strain (32.0%) being the most common reasons. Reconsidering whether they should stay employed in their current roles (Odds ratio [OR] 2.05; 95% CI 1.56 - 2.69) and fear to continue providing direct patient care (OR 1.97; 95% CI 1.54 - 2.54) were associated with increased odds of having considered leaving the workforce. Based on these results, the State of Hawai'i and local health care organizations need to adjust their nursing workforce estimates and address how to alleviate nurses' stressors and safety concerns to mitigate a potential workforce shortage. Research is needed to develop interventions to support and empower nurses in their current roles but also address future emergency preparedness.

Developing pre-registration nurses' resilience to mass casualty situations through the pedagogy of simulation

Simulation has become a core component of nursing curricular worldwide. Within a three-year, pre-registration degree typically students would not be exposed to disaster type situations and it was believed that a well-coordinated simulation exercise could replicate this. It was hoped that the simulation would require students to think quickly on their feet and transfer acquired skills. Worldwide disasters including the current novel coronavirus have, heightened the need for well-prepared resilient health professionals capable of responding to many different types of emergencies including mass casualty situations. The simulated event involved 80 adult field student nurses, 19 probationer police officers, 6 photojournalism students, 2 Welsh Ambulance paramedics, 5 staff from 203 Field Hospital, 2 St John Cymru Wales Officers, 1 community first responder and 6 Fire and Rescue personnel. All these individuals came together to undertake a simulated emergency response to a mass casualty incident. Behaviours and clinical skills were observed throughout the event along with interprofessional interactions.

A Qualitative Study Focused on Maternity Care Professionals' Perspectives on the Challenges of Providing Care During the COVID-19 Pandemic

Maternity care services were significantly altered with the start of the global pandemic in 2020, challenging the ways care was provided for families during childbirth. This qualitative analysis focuses on maternity care professionals' perceptions of the impact of COVID-19 on maternity care in Michigan early in the pandemic. The question "How has COVID-19 impacted your work?" was embedded into a survey focused on maternity unit culture in process across Michigan. Directed content analysis was applied to the open text responses to identify themes. From April-June 2020, 1071 surveys were completed by nurses, physicians, and midwives; 647 (60%) included responses to the COVID-19 question. Five themes emerged: (1) provider health; (2) patient care impact; (3) burdens of personal protective equipment; (4) decreased support during labor due to visitor restrictions; and (5) ethical challenges and moral distress between concerns for self and carrying out professional roles. Maternity care providers in Michigan experienced a range of complex challenges due to the pandemic, with many experiencing conflicts and questioning their role as a provider amid concerns of the effects of COVID-19 on themselves and their families. Resources are necessary to support providers who experience distress to promote well-being and retention of this essential workforce.

Interprofessional Disaster Simulation During the COVID-19 Pandemic: Adapting to Fully Online Learning

Background

This paper describes the rapid conversion of a face-to-face interprofessional (IP) disaster simulation to an online format in response to COVID-19 campus closures.

Methods

The online disaster simulation utilized internet-based tools allowing real-time collaboration between IP students. Team exercises involved disaster triage, disease outbreak investigation, and disaster response. Surveys measuring self-assessment of various IP skills and simulation learning outcomes (SLOs) were compared with responses from previous face-to-face simulations.

Results

Results indicated mean scores for IP skills were higher for online students when compared with in-person simulations, and all SLOs were met.

Conclusions

The online disaster simulation provided an effective, innovative IP educational opportunity.

Mapping a postgraduate curriculum in disaster nursing with the International Council of Nursing's Core Competencies in Disaster Nursing V2.0: The extent of the program in addressing the core competencies

BACKGROUND

The increasing frequency and magnitude of disasters call for enhancing the preparation of nurses with advanced knowledge and skills in disaster management.

OBJECTIVES

With the release in December 2019 of the updated version 2.0 of the ICN's Core Competencies in Disaster Nursing (ICN CCDN V2.0), the aims of this study were to examine the extent to which the selected disaster nursing postgraduate program curriculum and the dissertation projects address the updated core competencies and to determine whether the syllabus requires revision.

METHODS

A data mapping analysis approach was used to review the syllabus of the studied program for coverage of the ICN V2.0 core competencies for general professional (Level I) and advanced/specialized nurses (Level II). The dissertation projects of the students were also included in the mapping analysis.

RESULTS

It found that 83% of the core competencies were addressed at Level I for general professional nurses and 69% at Level II for advanced/specialized nurses in the curriculum. Out of the 35 core competencies at Level I under the eight domains, six items (17.1%) were not covered under the domains of Intervention and Recovery. Out of the 32 core competencies at Level II, ten items (31.3%) were not covered under the domains of Communication, Incident Management, Safety and Security, Assessment, Intervention, and Law and Ethics. Students' dissertations could complement some of the competencies not covered in the syllabus.

CONCLUSIONS

The studied curriculum covered the majority of the core competencies proposed by ICN CCDN V2.0, but subjects were required to be revised to address the competencies missing from the syllabus. Moreover, it is critically important for educators to review their curriculum to prepare nurses for disasters, to ensure that they are equipped with the competencies required to meet the demands arising from the increasingly frequent occurrences of global disaster.

From Florence to fossil fuels: Nursing has always been about environmental health

BACKGROUND

Since its founding, professional nursing has applied an environmental lens to healing.

METHODS

This CANS 2020 Keynote article describes the history of nursing environmental science and nurses important contributions to the US Environmental Justice Movement. Starting with Florence Nightingale's Notes on Nursing, which established Environmental Theory, the paper introduces key figures throughout nursing history who have studied and advocated for environmental health and justice.

FINDINGS

The paper emphasizes that nursing has always been about environmental health and that, regardless of specialty or practice setting, all nurses are called to incorporate environmental science and translation into their research and practice.

CONCLUSION

This call to action is especially critical today in the context of urgent issues like climate change, environmental racism and racial health disparities, emerging infectious diseases like COVID-19, and chemical exposures in the home and workplace (among others).

The Healers Are Broken: A Call for Trauma-Informed Professional Development in Nursing

The COVID-19 pandemic has highlighted the fact that nurses are at risk for poor mental health, but there is evidence that this risk existed long before the pandemic started. Nurses in professional development have a unique opportunity to support nurses through trauma-informed professional development. Evidence-based interventions, such as peer support, attention to cultural differences, and empowerment, can enhance protective factors and also promote recovery from trauma-related poor mental health outcomes.

Identify the Disaster Nursing Training and Education Needs for Nurses in Taif City, Saudi Arabia

Introduction

Nursing is considered the healthcare profession with the most members. Emergency nurses constitute the first line of treatment in healthcare facilities when catastrophic events bring disaster victims in need of medical attention. Therefore, these nurses must be well educated and trained efficiently to be able to deal with disastrous situations properly. This study aimed to distinguish the most important elements of education and training for preparing emergency nurses to face disasters in the Kingdom of Saudi Arabia (KSA), specifically, the city of Taif.

Methods

This study employed a tool to measure nurses’ most important training and education needs that was created by the authors based on a literature review and was approved by an expert panel in disaster nursing. Questionnaires were distributed to emergency nurses in four hospitals run by the Ministry of Health in Taif city. Survey responses were received from 210 participants, and the data were analyzed using a principal component analysis (PCA). A one-way ANOVA was used to determine the differences between groups according to their experiences.

Results

The following three factors were extracted from the data after redundant items were loaded and excluded: incident management systems (IMSs), disaster triage, and disaster drills. Nurses with less than three years of experience have a significant need to learn about these elements in order to be able to cope with disasters.

Conclusion

Understanding different types of disasters and how to deal with these catastrophic events is crucial. Significant differences existed between ED nurses in their understanding of the basic elements of disaster management based on their level of experience in an ED. Therefore, disaster education must be included in nursing curricula, and more training courses, mock drills, and simulations must be conducted in hospitals for nurses, especially nurses with less experience, so they can learn to manage their responsibilities during disasters.

Cohort research analysis of disaster experience, preparedness, and competency-based training among nurses

Introduction

It is expected that in unforeseen situations, nurses will provide appropriate medical interventions, using their expertise and skills to reduce the risks associated with the consequences of disasters. Consequently, it is crucial that they are properly prepared to respond to such difficult circumstances. This study aimed to identify the factors influencing the basic competences of nurses in disasters.

Materials and methods

The survey was directed to 468 nurses from all medical centres in Lublin. IBM SPSS Statistics version 23 was used for statistical analyses, frequency analysis, basic descriptive statistics and logistic regression analysis. The classical statistical significance level was adopted as α = 0.05.

Results

Based on the logistic regression analysis, it was found that work experience, workplace preparedness, as well as training and experience in disaster response are important predictors of preparedness.

Conclusions

These findings indicate that the nurses' core competencies for these incidents can be improved through education and training programmes which increase their preparedness for disasters. Nurses are among the most important groups of healthcare professionals facing a disaster and should be involved in all phases of disaster management, such as risk assessment and pre-disaster planning, response during crisis situations and risks’ mitigation throughout the reconstruction period.

Educational needs and disaster response readiness: A cross-sectional study of clinical nurses

AIM

To analyse clinical nurses' educational needs and disaster response readiness and the factors influencing their disaster response readiness.

DESIGN

This was a cross-sectional study.

METHODS

A convenience sample comprising 260 nurses with more than a year of working experience at a hospital in Korea was selected from 1-31 August 2019. Data on nurses' educational needs and disaster response readiness were collected from participants. A multiple regression model was used to examine the factors influencing disaster response readiness among nurses.

RESULTS

Factors influencing personal readiness were number of years of clinical experience, being female, working in a medical ward, and educational needs for disaster response. Factors influencing self-protection were working in a medical ward and working in the emergency room. Factors influencing the emergency response were working in a medical ward and working in the emergency room. Factors influencing clinical management were a graduate-level education or higher, working in a medical ward, working in the emergency room, working in the paediatric ward, experience receiving disaster-related education, and educational needs for disaster response.

CONCLUSION

It is essential to be aware of the educational needs and disaster readiness of hospital clinical nurses, to develop their capacity to respond such situations. In addition, to improve the disaster competency of nurses, it is necessary to develop an education programme that considers the factors influencing disaster response readiness in this study.

IMPACT

Nurses must have the knowledge and skills to respond to a disaster. Nurse educators should help nurses strengthen their disaster-related knowledge, skills, and judgment. Hospital administrators should encourage nurse educators to provide disaster-related training and simulation-based education to increase nurses' disaster competency to act during disasters.

Association of Community Health Nursing Educators 2020 Research Priorities and Research in Action Model

OBJECTIVE

The Association of Community/Public Health Nurse Educators (ACHNE) Research Priorities Subcommittee presents a report on the state of the science of public health nursing education.

DESIGN

Whittemore and Knafl's (Journal of Advanced Nursing, 2005, 52, 546) five-step integrative review was used.

SAMPLE

Fifty-two articles were reviewed.

MEASUREMENTS

Braun et al's. (Handbook of research methods in health social sciences, 2019, 843) thematic analysis methods were used.

RESULTS

Four themes emerged: (a) Community/Public Health Nursing Education and teaching strategies/modalities; (b) Clinical teaching and learning partnerships; (c) Environmental health and emergency response; and, (d) Cultural competence and awareness.

CONCLUSIONS

Themes informed the following research priorities: (a) a need for rigorous scientific studies highlighting the impact and effectiveness of Community/Public Health Nursing Education; (b) a need for evidence on faculty development, support and training related to community/public health activities; (c) a need for evidence on impact of Community/Public Health Nursing teaching on communities and students, and (d) a need for evidence on impact of C/PHNE strategies on long-term student knowledge, attitudes or behavior (competencies). Finally, a Research in Action Model is proposed as a means for continued forward movement of the discipline, connecting the three fundamental driving mechanisms.

Emergency Preparedness Competencies Among Nurses: Implications for Nurse Administrators

OBJECTIVE

The aim of this study was to examine current levels of self-reported professional emergency preparedness competence among nurses. In addition, relationships between nurse professional emergency preparedness competence, personal preparation for a disaster, and perceived likelihood of reporting to work after a disaster are examined.

BACKGROUND

Evidence suggests wide gaps in nurses' familiarity with the dimensions of professional emergency preparedness competence and their likelihood to report, potentially impacting human life after a disaster.

METHODS

An exploratory, cross-sectional survey design was used with a sample of 186 RNs and licensed practical nurses.

RESULTS

Results indicate significant weaknesses in nurses' professional emergency preparedness competence. There are positive correlations between likelihood to report, personal preparedness, and professional emergency preparedness competence.

CONCLUSIONS

Nurses across the United States lack sufficient competence in professional emergency preparedness. Results demonstrate the need to improve the education of nurses to meet the demands of populations in urgent situations. Action items nurse administrators can take are provided.

I Want to Become a Registered Nurse as a Non-Traditional, Returning, Evening, and Adult Student in a Community College: A Study of Career-Changing Nursing Students

The current significant human resource and workforce shortages of registered nurses (RNs) are impacting urban, suburban, and rural hospitals and healthcare facilities all over the globe, regardless of the entities' economic and financial backgrounds. The purpose of this research study is to understand why non-traditional, returning, evening, and adult (NTREA) students decided to enrol at the Associate Degree in Nursing programme during their mid-adulthood? 40 s-career nursing students who are pursuing their nursing programme were invited to individual interview sessions and focus group activities on sharing and expressing the motivations in the New England region in the United States. Based on the theoretical framework of Social Cognitive Career Theory, the researcher concluded that family consideration and higher social status were two of the major themes. The study provided a blueprint for human resource professionals, health and social caring leaders, government agencies, policymakers, and researchers to reform their current nursing curriculum and health workforce policy to attract potential second-career nursing joining the nursing profession.

Climate Change and Mental Health: Implications for Nurses

Climate change has received public health attention over the past 3 decades. It is well established that climate change is associated with myriad health issues, but less has been mentioned in public health discourse about the impacts of climate change on population mental health. The purpose of the current article is to provide an overview of the impacts of climate change on mental health, and to discuss opportunities for mental health nurses to reduce health problems related to climate change. Acute events and chronic consequences of climate change can impact mental health outcomes and contribute to depressive disorders, anxiety, and trauma-related disorders. The nursing profession must be prepared to address climate change to promote best health outcomes for individuals around the globe. It is critical that mental health nurses act as leaders in understanding and addressing climate change to improve the mental health of populations. [Journal of Psychosocial Nursing and Mental Health Services, 58(9), 25-30.].

Effects of a simulation-based education program for nursing students responding to mass casualty incidents: A pre-post intervention study

BACKGROUND

The necessity of disaster preparedness among nursing students has been continuously emphasized.

OBJECTIVES

This study aimed to verify the effectiveness of a simulation-based education program for nursing students responding to mass casualty incidents (MCI) from the perspectives of triage accuracy, response attitude, teamwork, and program satisfaction.

DESIGN

This study employed a pre-post intervention design.

SETTINGS

Disaster Simulation Lab and a debriefing room in the University Nursing Simulation Center in South Korea.

PARTICIPANTS

The participants were 34 graduating nursing students attending a university in Seoul.

METHODS

The program consisted of lectures on disaster nursing, group discussions, practice, debriefings, and a pre- and post-test, conducted over 180 min. Simulation-based training was conducted using the Emergo Train System®. The simulation environment comprised pre-hospital and hospital sections, with videos displayed on a large screen and sound effects played on loudspeakers.

RESULTS

Participants were likely to undertriage. There was a significant increase in positive attitudes after the intervention (p < .001). Self-reported teamwork was high, and among its subfactors, "leadership and team coordination" scored the highest. Participants' satisfaction with the program was high (4.5/5.0).

CONCLUSIONS

The simulation-based MCI program was effective in boosting positive attitudes among nursing students. In future, comparative studies including control groups and different instructional methods should be conducted. A patient bank should also be developed considering participants' knowledge levels and the circumstances of each country.

Evolution of Experiential Learning Opportunities for Nursing Students After Natural Disaster

BACKGROUND

Natural disasters, such as Hurricane Harvey, can provide unique hands-on learning experiences for nursing students.

METHOD

The University of Texas Health Science Center at San Antonio School of Nursing deployed teams of faculty and students to Rockport, Texas, two to three times per week to provide post-disaster relief following Hurricane Harvey. Each team included a minimum of 10 students and two faculty to provide primary care, prevention, and door-to-door canvassing. Nursing students provided physical examinations, urgent care, vaccines, first aid training, and education.

RESULTS

Across 6 months and more than 60 trips, over 200 students (supervised by 12 faculty) successfully delivered care to Rockport residents. This learning experience was invaluable for the nursing students, who expressed that "I felt like a real nurse" and "This is the best experience I have had since I decided to become a nurse."

CONCLUSION

This intervention highlights the potential of disaster relief as a unique hands-on educational experience for nursing students. [J Nurs Educ. 2020;59(1):30-33.].

Characterization of nurses’ duty to care and willingness to report

Background:

Nurses must balance their perceived duty to care against their perceived risk of harm to determine their willingness to report during disaster events, potentially creating an ethical dilemma and impacting patient care.

Research aim:

The purpose of this study was to investigate nurses’ perceived duty to care and whether there were differences in willingness to respond during disaster events based on perceived levels of duty to care.

Research design:

A cross-sectional survey research design was used in this study.

Participants and research context:

Using a convenience sample with a snowball technique, data were collected from 289 nurses throughout the United States in 2017. Participants were recruited through host university websites, Facebook, and an American Nurses Association discussion board.

Ethical considerations:

Institutional review board approval was obtained from the University of Texas at Tyler and the University of Arkansas.

Findings:

Analysis of willingness to report to work based on levels of perceived duty to care resulted in the emergence of two groups: “lower level of perceived duty to care group” and “higher level of perceived duty to care group.” The most discriminating characteristics differentiating the groups included fear of abandonment by co-workers, reporting because it is morally the right thing to, and because of imperatives within the Nursing Code of Ethics.

Discussion:

The number of nurses in the lower level of perceived duty to care group causes concern. It is important for nursing management to develop strategies to advance nurses’ safety, minimize nurses’ risk, and promote nurses’ knowledge to confidently work during disaster situations.

Conclusion:

Level of perceived duty to care affects nurses’ willingness to report to work during disasters. Primary indicators of low perceived duty to care are amenable to actionable strategies, potentially increasing nurses’ perceived duty to provide care and willingness to report to work during disasters.

From Brainstorming to Strategic Plan: The Framework for the Society for the Advancement of Disaster Nursing: A Work in Progress

Professional health care societies play a critical role in promoting excellence in patient care, educating and certifying their members on evidence-based practices, and pursuing relevant research agendas to advance the science in the field. Disaster nursing is a subspecialty of professional nursing characterized by a unique knowledge base and set of skills and abilities not used in normal daily health care activities. A disaster or large-scale public health emergency creates a sudden, unanticipated surge of patients with health care needs that far exceeds the capacity of the health care system. This creates a significant burden and risk for the nurses participating in the response. Recognizing the critical need to define scope of practice and core standards for disaster nursing and to promote greater nursing leadership in disaster preparedness and response, a group of subject matter experts established a professional society to provide leadership and guidance. The strategic planning process as described by M. Kwestel et al was used as the overarching framework for describing the design, development, and implementation of the new society. Establishment of the Society for the Advancement of Disaster Nursing is a definitive step toward improving national nurse readiness in the United States.

Ethical Reasoning Debriefing in Disaster Simulations

BACKGROUND

With disasters occurring often, nurses must understand and ethically implement disaster management and patient care coordination. Yet these topics are often not discussed in nursing education curricula. Simulations are a potential solution to this ethical educational deficit, allowing students to act as professional nurses in a realistic scenario with minimal threat of harm to themselves or others.

AIM

This study investigates the effect of a high fidelity, multiple-casualty disaster simulation followed by a structured faculty-led debriefing session on perceived ethical reasoning confidence on senior Bachelor of Science in Nursing (BSN) students. Additionally, the effect of the intervention on students' perceived importance of ethical reasoning and perceptions of such skills was explored.

METHODS

Students were provided with preparatory materials on the START (Simple Triage and Rapid Treatment) System and The Madison Collaborative's Ethical Reasoning in Action Eight Key Questions (8KQ) frameworks one week before the simulation exercise. In total, 90 students worked in pairs during the 15-minute disaster simulation. Participants' ethical reasoning attitudes were measured before and after the exercise, employing the Survey of Ethical Reasoning (SER) to indicate the importance of each of the 8KQ in students' ethical reasoning process using a five-point Likert scale. The SER was administered electronically using Qualtrics and statistical analysis was completed using SPSS. The 8KQ was also used in the debriefing led by faculty.

RESULTS

Comparative assessment of pre and post-results demonstrate significant growth in students' ethical reasoning confidence scores (t(89) = -6.609, p < 0.001).

CONCLUSIONS

Simulations are shown to be effective educational approaches in developing ethical reasoning confidence and promoting the development of students' ethical preparedness.

Climate Change Impacts on Disaster and Emergency Medicine Focusing on Mitigation Disruptive Effects: an International Perspective

In recent decades, climate change has been responsible for an increase in the average temperature of the troposphere and of the oceans, with consequences on the frequency and intensity of many extreme weather phenomena. Climate change’s effects on natural disasters can be expected to induce a rise in humanitarian crises. In addition, it will surely impact the population’s long-term general health, especially among the most fragile. There are foreseeable health risks that both ambulatory care organizations and hospitals will face as global temperatures rise. These risks include the geographic redistribution of infectious (particularly zoonotic) diseases, an increase in cardiac and respiratory illnesses, as well as a host of other health hazards. Some of these risks have been detailed for most developed countries as well as for some developing countries. Using these existing risk assessments as a template, organizational innovations as well as implementation strategies should be proposed to mitigate the disruptive effects of these health risks on emergency departments and by extension, reduce the negative impact of climate change on the populations they serve.