SON: Connections - Spring 2003

Headlines | Briefly | From the Deans Desk

New Curriculum Prepares Nurses to Respond
to Mass Casualty Incidents

Nurses are among the first to respond to mass casualties. New training helps with special technical skills, assessing safety and crisis communication.

Before the Al Qaeda attacks on the World Trade Center and before the anthrax scare, there was a wake-up call that should have rallied the health care community to prepare for terrorist attacks. But it didn't. In the fall of 1984, health care workers in The Dalles, Ore., found themselves dealing with 751 individual poisonings-all victims of a terrorist attack on their quiet, rural city. Using squirt guns filled with salmonella bacteria, members of a local religious cult deliberately contaminated salad bars on two different occasions, sending hundreds of residents to physicians' offices and hospitals.

"Few people remember this attack," explains Randy Beaton, an Emergency Medical Technician and Research Professor of Psychosocial and Community Health at the University of Washington's School of Nursing. "Despite the strong evidence for bioterrorism, officials believed it was a naturally occurring food-borne outbreak until a cult member confessed to the crime sometime later," Beaton says. "It took the events of Sept. 11 to jolt us out of the myth that terrorism would never happen here."

A researcher on emergency preparedness and bioterrorism, Beaton assists in the process of integrating disaster preparedness training into the school's nursing curricula and conducts much-needed research on this subject.

Educational Deficit

While disaster response has been a part of most nursing school curricula, it has traditionally received only the most superficial treatment. Sept. 11 revealed the field's serious educational deficit. Since then, training has been delivered to practicing nurses, but there is a critical need and mandate from the state of Washington to provide undergraduate nurses with the skills to work effectively in all types of catastrophic events.

Mobilized to meet the educational need, an international coalition of nursing schools, nursing specialty organizations and governmental agencies drafted a set of core competencies which are now in the final stages of review.

The competencies should ensure that a nurse workforce has the skills to respond to mass casualty incidents. They focus on the areas of critical thinking, assessment (such as assessing safety issues for the responder team and victims), technical skills (such as decontamination procedures) and communication skills (such as knowing where to find key resources). The UW curriculum is already changing to help nurses care for patients in a disaster. Students are now learning how to practice safely, implement and evaluate institutional and community resources, report and communicate during disasters and access current information.

Risk Factors

Washington state residents are vulnerable to an alarmingly long list of potential disasters. The region's nuclear plant, active volcanoes, busy ports (which serve as entry points for communicable diseases) and potential for floods and earthquakes are a few of the risk factors posing challenges to health care workers. Whether the next crisis is the outbreak of a naturally occurring infectious agent such as E. coli, a terrorist attack or a nuclear accident, two things are certain: the state is still poorly organized to respond, and nurses will be on the front lines.

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