Kerry Griffiths, a pediatric nurse and British tourist riding on the Staten Island ferry that crashed on Oct. 15, helped save the life of fellow passenger Paul Esposito by improvising a tourniquet from his belt to stanch the bleeding from his crushed legs.
Ms. Griffiths' fast response in an emergency is just one well-publicized example of how nurses, who are taught first-aid during their training, can offer invaluable assistance during emergencies. Awareness is growing in the nursing profession that nurses' training must be expanded so that they can provide assistance in situations that result in mass casualties.
To address this need, the nursing schools at Columbia University and Vanderbilt University co-hosted a symposium in October at Low Memorial Library to announce new guidelines on what every nurse should be prepared to do for patients and communities during emergencies. Columbia and Vanderbilt are founding members of the International Nursing Coalition for Mass Casualty Education (INCMCE), a group of more than 70 organizations representing nursing schools, licensing boards, specialty associations, and government agencies that developed the list of competencies.
The growing interest in emergency preparedness has impelled nurses and nursing institutions to examine their own readiness, says Dr. Mary O. Mundinger, dean of the Columbia University School of Nursing. What is needed in an emergency varies, but it may include identifying the right response in a situation with multiple casualties, responding to a call to go to the scene of an incident, working at a local hospital or emergency field hospital where victims are being treated, or relieving nurses initially involved in these activities.
"Columbia nurses have always been at the forefront of the response to casualties, including all of the major American wars. I am delighted that we are leaders in establishing this international standard so the public knows what to expect from competent nurses," Dr. Mundinger says.
At the symposium, Dr. Colleen Conway-Welch, dean of the Vanderbilt School of Nursing, discussed how INCMCE developed the guidelines the Educational Competencies for Nurses in Mass Casualty Events to serve as a common guide for professional nursing education programs. The competencies are consistent with and build on the public health competencies work done at Columbia's School of Nursing by Dr. Kristine Gebbie, Elizabeth Standish Gill Associate Professor of Nursing, and colleagues.
Schools following this guide can assure the public that their graduates are prepared to offer effective care under emergency conditions, whether they practice in hospitals, clinics, schools, homes, or other community settings. The educational competencies cover topics such as recognition of emergencies, triage and immediate care of the injured, mental health care including the worried well, and coordination of care within an emergency incident management system. Nurses also must have sufficient knowledge to understand when their own health and welfare may be in jeopardy and they have a duty to protect themselves and others.
All types of emergencies, including bioterrorism, are addressed, and the guidelines can be applied to practice in different ways depending on the specific roles and responsibilities the nurse performs within the agency, community and national response plans. The format is consistent with the standards set in the United States for baccalaureate nursing education; the American Association of Colleges of Nursing provided significant support in the development of the competencies.
"The coalition will continue to reach out to nursing schools to assure they are aware of the competencies and use them in developing new courses or improving existing ones," Dr. Mundinger says.