The literature provides unequivocal evidence that nurses globally are unprepared, or not confident, to respond to a disaster and nursing curricula are often deficient of evidence-based disaster content. The compilation of these two entities hinder nurses from effectively responding to disasters. While evidence exists of disaster education being implemented in nursing programs, no disaster content is all encompassing and required as evident at Shenandoah University. To ensure future nurses possess the knowledge to provide skilled and humanitarian care to individuals, families, and communities affected by a disaster, comprehensive disaster education must begin in nursing programs.
In 2005, the faculty in the school of nursing recognized the increasing number of disasters that included the 911 terrorist attacks, anthrax cases, Oklahoma City bombing, hurricane Katrina in addition to tsunamis, earthquakes, and many natural disasters. They recognized the limited education nurses receive related to disaster preparedness and response. As a result, the school of nursing established, and continues to offer, disaster courses throughout the nursing curriculum. A three-credit emergency and disaster preparedness and response course was developed and implemented and sustained in the undergraduate curriculum. For the last 13 years the course has been consistently offered twice a year as a required class for all senior nursing students. About 150 students graduate annually with comprehensive foundational knowledge of emergency preparedness and disaster nursing. The goals of the program are to enable students to transition into nursing practice with basic disaster knowledge and skills to effectively and safely respond to an incident; understand the importance of collaborating with other agencies throughout the disaster cycle; and ensure graduating nurses are personally prepared for a disaster so they can report to work when called upon. Since its inception, over 2,000 nursing students have taken the course, acquiring foundational disaster knowledge that better prepares them to respond to an incident.
The success of the undergraduate program, and the need for advance disaster knowledge, contributed to the development and implementation of two graduate level disaster courses. At the master’s level, students have the option to take an online disaster course as an elective. The course focuses on assessment, diagnosis, and treatment of patients affected by different types of disasters, i.e., chemical or biological warfare, crush injuries related to earthquakes, etc. At the post graduate level, Doctor of Nursing Practice (DNP), students may take an online emergency preparedness course that centers around incident management and leadership roles of healthcare administrators throughout the disaster cycle.
A multitude of innovative pedagogical approaches to teaching the disaster courses are used. Strategies include, but are not limited to, theoretical analyses, tabletop exercises, interactive activity, video-based discussions, disaster drills, simulations, and virtual reality (VR). The use of virtual reality integration provides the students with near reality experiences that provide the participant with stress inoculation of a what a real disaster experience might be like. Most recently, in collaboration with community partners, specialty trainings were added to the undergraduate disaster curriculum. Specialty trainings include Stop the Bleed, a training to control severe bleeding, and Revive! for the administration of naloxone for recognizing and treating opioid overdose in the community.
The disaster content presented in these courses fulfill expected program outcomes set forth by the nursing accrediting organizations. The undergraduate courses prepare students for NCLEX licensure and the graduate courses prepared students to take the Advanced Practice Board Certification Exam in disaster related topic areas (American Nurses Credentialing Center, 2016; National Council of State Boards of Nursing [NCSBN], 2016). Disaster knowledge is imperative for every nurse and disaster education begins in every nursing program.
Nurses who are not prepared for disasters are less willing to respond to an incident when called upon. The lack of available nurses has the potential to create a cascading effect that negatively impacts the health and well-being of populations and communities.