For an overview of the most important ethical issues, see Moreno JD, ed. In the Wake of Terror: Medicine and Morality in Times of Crisis. Cambridge, Mass.: MIT; 2003. To reduce the impact of disasters, health care providers, especially nurses, must be ready to respond immediately. However, nurses face several challenges at all stages of disaster management. Results from a literature review based on scoping approaches using the Joanna Briggs Institute methodology showed that the biggest barriers faced by nurses are: (1) disaster care is a new specialty; (2) insufficient preparation; (3) poor formal education; (4) lack of research; (5) ethical and legal issues; and (6) issues related to the role of caregivers in disasters. Educators, researchers and stakeholders must strive to address these issues and improve disaster response. The concept of disaster risk reduction is very broad and encompasses measures taken before a disaster occurs to ensure preparedness. This includes risk identification; Preparation of plans and guidelines; the development of education and training programmes, including exercises and preparation exercises; preparing the health system for disaster response; and improved disaster knowledge and awareness among health care providers, including nurses. This scoping review revealed that achieving a level of nursing readiness for effective work is one of the greatest challenges in disaster response.
One of the associated factors is a preclinical system that is not fully developed or coordinated with other healthcare facilities such as hospitals. This problem has been addressed several times in the literature. For example, Roy et al30 confirmed the lack of organization of the pre-hospital system in India, while Feizolahzadeh et al17 pointed out that the most common related problems in Iran were inadequate risk communication, weak preclinical interventions, and inappropriate referral of patients to hospitals. A pre-clinical system in which all first responders, such as police, firefighters and paramedics, work together is essential. Therefore, more needs to be done to improve this area and ensure that nurses and other health care providers coordinate and work effectively. In addition, it is recommended that nurses be involved in the development of disaster planning policies, procedures and measures at the regional level. However, it is important to note that this problem may not apply to all countries, as some of them have strong preclinical systems that function effectively in daily routines and disaster situations. Our threat assessment methodologies and the role of health professionals in protecting against bioterrorism need to be carefully examined. Some public health decision-makers believe that the current focus on medical control or containment of extreme events relies on highly controversial assumptions and reductive models to understand the nature of the threat. The current approach could represent a laborious step backwards from advances in social medicine and social epidemiology. To understand the nature of the threat, we could also focus on global economic structures that contribute to instability of production systems and labour markets, weak democracies, erosion of cultural identity and political freedoms, and the international arms trade.
Health professionals should strive to improve empowerment and equality and promote global health security, rather than being forced to focus their collective efforts on emergency preparedness on the domestic front. Health professionals can play a critical role in addressing these and other social determinants of health,59 but current policies limit their ability to effectively promote health and support social justice around the world. American Academy of Pediatrics. PAA Working Group on Terrorism to prepare paediatricians for disaster relief. AAP News. 2002;20:4. Centers for Disease Control and Prevention (CDC). Biological and chemical terrorism: strategic preparedness and response plan. Recommendations of the CDC Strategic Planning Working Group. MMWR Morbid Mortal Wkly Rep. 2000 Apr 21;49:1-14. Today, emergency preparedness captures the energy and expertise of not only first responders, emergency physicians and nurses, but virtually all clinicians and public health professionals – and increasingly defines the specific goals that organize their work.
Many health professionals are seeking funding from the “war chest” provided by the federal government for biopathogen research and medical intervention.7,8,9 Others are reshaping public health laws and establishing new links with law enforcement agencies.10,11 Emergency preparedness training – focusing on bioterrorism and weapons of mass destruction – is currently part of the curriculum. preferred for medical students and other health professionals in the European Union. Education.12,13,14,15,16,17,18 Public health authorities, academic health centres and medical specialists have organized working groups and defined emergency response competencies and protocols.19,20,21,22,23,24,25,26,27,28,29,30,31 Some health professionals have found themselves participating in (highly controversial) trials of smallpox vaccines.32 During a disaster, hospitals receive victims and their families in a certain period.