Working in bushfire affected areas: Nurses’ experiences

bushfireAustralia has been struck by numerous bushfires in the past few weeks and will be seeing many more as the peak of the bushfire season is yet to come. How do professionals experience working in bushfire situations? Samara Wilson* has summarized a recent study for you.

Ranse and Lenson (2012) have looked into the diverse role nurses played in the aftermath of the Australian Black Saturday and Victorian bushfires in 2009. Nursing staff are often among the first to be involved with response and recovery efforts following disasters such as bushfires. However, nurses often feel they lack the necessary training to provide adequate support for the people they encounter in these extreme situations. Education for disaster scenarios is not standardized across Australian settings, with nurses experiencing varied amounts of training, and there is little research in this domain.

This study used in-depth telephone interviews with 11 nurses volunteering with St John’s Ambulance Australia who were involved in the Black Saturday and Victorian bushfires in 2009. The researchers looked at the roles nurses played in psychosocial support, coordination, and problem solving, and examined how these were influenced by the nurses’ prior education, training, and availability of resources.

Two broad themes emerged from the interviews. The first theme was ‘being prepared’: having an appropriate level of training, having enough resources, and having adequate clinical experience. Nurses felt their training was sufficient to operate in an out-of-hospital setting. They also took efforts to ensure they had the appropriate resources to provide adequate clinical care. However most of their resources were not used, as their selection was non-strategic, and often further resources were recruited from local pharmacies or hospitals. Finally, the nurses felt they had adequate clinical experience, and worked both autonomously or in teams.

The second theme was ‘having an expansive role’, including the provision of minimal clinical care, being a psychosocial supporter, being a coordinator of care and resources, and being a problem solver. Most of the injuries the nurses dealt with were relatively minor, such as eye rinses, minor burns or scratches. Moreover, the interview participants provided psychosocial support to community members as required. They drew on their general nursing experience to help with this emotional side of the supporting role, mainly involving listening. Some nurses took on coordinator roles to help manage the logistics of the care and resources. Nurses were generally looked upon to be the problem solvers, particularly in terms of medical management.

What are the implications of this? Overall, participants’ training and education were adequate given the nurses in this study were deployed with an organization which is used to undertaking activities in an out-of-hospital setting. However, without an experienced organization, nurses may not have the necessary training as this is not a focus of many undergraduate nursing courses. In particular, psychological care could be included into a training framework.

Also, there is room for improvement in the systematic collection, transport, and distribution of resources. This is not specific to the Black Saturday and Victorian bushfires, but has been seen in other disasters, such as in the Haitian earthquake. Future research could aid by helping clarify what resources are most pertinent to different types of disaster situations.

In addition, nurses play quite diverse roles in emergency situations, rather than focusing on critical or acute clinical care. However, these roles can vary cross-culturally, and can differ between organizations and disaster situations. Therefore, additional primary, community, public and mental health nurses should be recruited alongside the emergency nurses to aid with the more diverse roles.

Still, it is important to keep in mind the results from this study were analyzed specific to the Black Saturday and Victorian bushfires, and care needs to be taken when generalizing from these findings to other situations and organizations.

In sum, the participating nurses felt educationally prepared, despite not having received specific disaster training. Resource collection distribution could be improved. Most importantly, this study highlighted the extensive role of the nurse, stretching beyond general clinical care, and can be used to educate nurses about the multiple roles they may play in disaster situations.

Reference:
Ranse, J., & Lenson, S. (2012). Beyond a clinical role: Nurses were psychosocial supporters, coordinators and problem solvers in the Black Saturday and Victorian bushfires in 2009 Australasian Emergency Nursing Journal, 15, 156-163 DOI: 10.1016/j.aenj.2012.05.001

*Samara Wilson is a research assistant with the Trauma Recovery Lab. She will soon start her DPsych degree at Monash University.

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