Readiness Of NursesIn Emergency Situations

Everyone reaches a certain point in their lives wherein they would need a helping hand to hold on to. There would be times that even strongest people would need a friend, a companion, or someone they could seek for help. These times would have to be the lowest points in their lives, and these are called disasters.

Disaster comes at any time. It chooses no time, no place, and people involved. It may sometimes be caused by variable reasons. Be it due to the natural phenomenon, the weather, but most of the time, our actions and negligence are accounted for the disastrous situations that we encounter in our lives. These situations usually come unannounced resulting to more grief and sorrow whenever something devastating had occurred that killed the lives of many. Whenever these situations come, emergency nurses are always the one responsible in responding and giving help to those affected. They are the ones who are called upon during these kinds of situations. They come without hesitation because it is a part of their full pledged duty- – to help those in need, and help save lives.

Emergency nursing is the field these nurses chose to pursue. This field of nursing is one of the most unpopular but is considered very integral part of nursing. Saving lives starts here. Rescuing people from the disaster they have undergone requires immediate response from the rescuers since emergency situations are life-threatening and may require immediate interventions to help minimize the aggravation of the problems caused.

Emergency nursing may be classified into several types. First is the medical emergency where pathological conditions are included. These are the kinds of emergency where medical attention, usually hospital care, is required to be given immediately. Second is the natural disaster including tornado, flashfloods, hurricane, and mud slides. These are those that require rescue from government agencies for supportive interventions. Third, and the final emergency situation is the property- emergency (e.g fire).

Property emergency such as fire are considered by most of the agencies to be the least priority since it has the lowest risk in dealing with it. But needless to say, every single emergency is still an emergency and needs to be attended immediately in order to save lives.

In this study, emergency nursing during disastrous situations should be presented and elaborated step by step, to prove that all emergency cases must be attended accordingly, regardless of the severity or complexity of each situation.

BACKGROUND OF THE STUDY

According to Debbie et.al (2006), Decades ago, nursing practice was unlike today – systematic and very professional. But in observation, nurses have long existed even before Florence Nightingale came into the spotlight. In fact, nurses have existed since the time humans cared for others. The knowledge and experience may not be as broad as today but people have been nursing others in need knowingly or otherwise in times of disaster. Simple things like sharing food and giving shelter to the homeless are ways to show that people “care.”

During wars, nurses have been battling alongside soldiers with injured comrades attending to each and every one of them. At that time, Florence Nightingale emerged like a superhero assembling 38 volunteer nurses to care for wounded soldiers during the Crimean War. With their help, death rate has decreased, so did instances of infection. And many of those implemented protocols became prominent health care models later on. Reed (2010)

Many of the improvements in Accidents and Emergency services were first pioneered in England and Germany. The United States (US) also started to promote the importance of A&E services, especially after the Second World War. As far back as the 1960s, it was realized that the role of A&E nurses was noticeably different from that of other nurses. The necessity of providing these nurses with more specialized training was being realized. As nurse training improved noticeably during the 1970s, the development of branch nursing was formed. In the US, EDNA – the Emergency Department Nurses Association – was established by a group of nurses to help the medical world recognize their specialist needs. In 1985, the group changed its name to ENA – Emergency Nurses Association. In 1972, the English Royal College of Nursing separated accident nursing and emergency nursing groups. . In 1990, these two separate groups combined under the name “Accident & Emergency Nursing Association”, enabling the group to establish a professional authority to standardize training opportunities in emergency nursing care. Later, developments within the nursing profession resulted in the roles and responsibilities of emergency nursing being regarded as a specialized branch of nursing, which is based on an extensive and specific set of skills and knowledge. Selimen et. al(2009)

One of the key success stories of emergency nursing and another major celebration milestone has to be the emergence of emergency nursing groups. Since the early seventies many countries have developed national organizations, spreading the word and professionalism of emergency nurses. Responding to emergencies is far more than knowing how to identify the signs and symptoms of traumatic injury or exposure to hazardous chemicals. Effective response requires a disciplined team in which each participating individual follows clear lines of communication and performs according to clearly assigned role directions.

III. CONCEPTUAL FRAMEWORK

Self-Care Deficit Theory (Dorothea Orem)

Sources: Nursing Theorist and Their Work 5th edition

Research Paradigm

Efficiency to render care

Competency

Age

Gender

– Length of emergency nursing experience

-Level of training

-Level of confidence

-Level of Anxiety

-Knowledge

Emergency Nurse

Self-Care Demands

-Insufficient airway, water and food -illness, injury, pathological conditon

Emergency/Life Threatening Conditions

Self-Care Agency

Self-Care

STATEMENT OF THE PROBLEM

This study aims to determine the readiness of nurses to respond in emergency situations.

Specifically, the study sought for the answers for the following questions:

What are the factors affecting readiness of nurses in responding to emergency situations?

What are the different hindrances that cause delay in responding to emergency situations?

Do the nurses comply with the standard nursing procedures and principles when responding during emergency situations?

Up to what extent is the nurses’ readiness when responding to emergency situations?

What is the level of nurses’ training level in regards to responding in emergency situations?

How does it affect their responses during emergency situations?

HYPOTHESIS

Based from the problem of the study , the research hypothesis is formulated and will be tested at the level of significance of 0.05.

Nurses are not ready enough to respond in emergency situations.

SIGNIFICANCE OF THE STUDY

The study aims to benefit the people who are involved in the nursing field and those who will be able to read this study.

For the hospitals, they can provide proper evaluation to the level of preparedness of the equipment, staff and management in response to emergency situation. Assurance of quality care given to patients is guaranteed safe. This level of preparedness will give the community the information on how reliable our Filipino nurses are when danger emerges

For the academe, they can present guidelines and information in education for possible activities that can improve the performance and competitiveness of student nurses in clinical settings. Programs and seminars can be provided to enhance knowledge and capabilities of the nursing students in terms of emergency situation and will give their students an idea on what these emergency nurses experience during those times.

For emergency nurses, they may learn how effective their training programs are in real danger and through this study nurses can improve their own strategies in saving lives and making priorities especially in their clinical practice. This will give them more information that would increase level of their competence that can be assured and can be reflected through their own performance during emergency.

For the patients, they can assure their safety in the hands of their emergency nurse. Competence and competitiveness of an emergency nurse can establish trust and cooperation of the patient.

For most of the student nurses who are interested on the emergency field, they can have a clear understanding on what emergency practice in real situation is. Performances of emergency nurses can be reflected in this study that may help the students visualize and let them learn in advance the real settings that they can apply in future situations.

For the future researches,they can be provided baseline data. It can also be use for comparison of results in the future and to find out if there is any improvement about the readiness of emergency nurses in responding emergency situation.

SCOPE AND DELIMITATION

The study focuses on the readiness of nurses when responding to emergency situation. The scope of the study will only be on the field of emergency nursing. The study will concentrate on the following factors: the hindrances that causes delay in responding to emergency situations, the compliance of nurses to the standard nursing procedures during emergency situations, the level of training and competence of the nurses when responding and lastly the extent of readiness of the nurses. The study will cover emergency nursing situations such as disasters, vehicular accidents, fire accidents and such. The study will be conducted only within the vicinity of Metro Manila area. The study will not cover emergency nursing in hospital based settings. The respondents will be limited to graduate nurses specializing in the field of emergency nursing, volunteer nurses, members of the Fire Emergency Paramedic Assistance Group or FEPAG, and also members of the MDC Health Emergency Medical Services Association or HEMSA.

DEFINITION OF TERMS

Academe – a place in which instruction is given to students and where learning happens.

American Red Cross – an international organization that cares for the wounded, sick, and homeless in wartime, according to the terms of the Geneva Convention of 1864, and now also during and following natural disasters.

Competence – the state or quality of being adequately or well qualified.

Disaster – an occurrence causing widespread destruction and distress; a catastrophe.

Disaster response – a phase of the disaster management cycle. Its preceding cycles aim to reduce the need for a disaster response, or to avoid it altogether.

Duty – a piece of work that has been assigned: assignment, chore, job, task.

Emergency nurses – nurses who specialize in rapid assessment and treatment when every second counts, particularly during the initial phase of acute illness and trauma.

Emergency nursing – a field of nursing which deals with human responses to any trauma or sudden illness that requires immediate intervention to prevent imminent severe damage or death

FEPAG – Fire Emergency Paramedic Assistance Group is a non-stock, non-profit civic organization which aims to provide rescue and emergency pre-hospital care during fire emergencies, vehicular accidents, medical emergencies, disasters and other calamities. It also aims to promote public safety thru activities and projects geared towards emergency preparedness, mitigation and safety practices, and other related public service programs.

HEMSA – Health Emergency Medical Services Association is an organization in Manila Doctors College which aims to promote wellness and safety for the community by providing pertinent programs of education and training, awareness, prevention, preparedness and response to any situation pertaining to Emergency Medical Services (EMS) and pre-hospital emergencies.

Hindrance – something that interferes with or delays action or progress. These are barriers to proper intervention

Military nursing – a field of nursing which focuses on caring the nation’s service members and families either state side or abroad.

Nursing – a health-care profession providing physical and emotional care to the sick and disabled and promoting health in all individuals through activities including research, health education, and patient consultation.

Rescue – an act which refers to operations that usually involve the saving of life, or prevention of injury.

Triage – a process for sorting injured people into groups based on their need for or likely benefit from immediate medical treatment. Triage is used in hospital emergency rooms, on battlefields, and at disaster sites when limited medical resources must be allocated.