Equipping Nurses with Disaster Skills is Critical to Prepare for the Unpredictable

Equipping Nurses with Disaster Skills is Critical to Prepare for the Unpredictable

Disasters—both natural and man-made—can bring great loss and destruction, but are inevitable and unpredictable. Each year, we witness deadly earthquakes, hurricanes, floods, wildfires, accidents, and mass shootings.

Dating back to the Galveston Hurricane in 1900, Johnson & Johnson has demonstrated its unwavering commitment to disaster relief. Support continued during the San Francisco earthquake of 1906 through to recent disasters, like Hurricane Harvey and Hurricane Maria. Today, guided by  Our Credo, which states that the company must be “responsible to the communities in which we live and work and to the world community as well,” the company alongside our partner organizations continue to focus on responding and rebuilding in the wake of disasters across six continents. Our strong, longstanding partnerships give proof that banding together with others, uniting under a common purpose, sharing knowledge, and combining reach can bring results, as detailed every year in our Health for Humanity report. This report also highlights our Campaign for Nursing’s Future initiative.

At Johnson & Johnson, we recognize that nurses have a unique and critical responsibility when disaster strikes. They provide vital medical aid, comfort, and leadership during times of confusion, fear, loss, and suffering. Often, they face uncomfortable and dangerous conditions, with risk to themselves, limited resources, and very little sleep.

Although disasters usually follow a similar sequence of prevention, preparedness, response, and recovery, no two disasters are exactly the same. Nurses need different knowledge, a new set of skills, and diverse experience to respond to a hurricane, disease outbreak, or a transportation accident. As the backbone of disaster response, nurses must learn how to solve problems quickly, rapidly direct groups of people, prioritize needs, and allocate inadequate supplies.

Johnson & Johnson is helping to equip nurses with the skills to respond by partnering with organizations that train and mobilize disaster nurses. For example, Johnson & Johnson supports the TOMODACHI Disaster Nursing Training Program, which aims to deepen the professional knowledge of nursing students specializing in disaster medicine and nursing in Tohoku, Japan.

Born out of support for Japan’s recovery from the Great East Japan Earthquake and Tsunami in 2011, Johnson & Johnson is partnering with the U.S.-Japan Council to develop a seven-month Disaster Nursing Training Program. As part of the initiative’s cultural exchange, participants from Japan visit the U.S. to visit facilities specializing in disaster response and meet with U.S.-based experts who helped during and after 9/11 and Hurricane Sandy.

Many participants were personally impacted by the Great East Japan Earthquake—and became nurses as a result. Yumi Gima, a participant in 2018, said: “I experienced the Great East Japan Earthquake during my first year of middle school. At the time, there was no water in the area where I lived, and when I saw seniors volunteering to collect water, I became inspired to volunteer and help others. However, I could not take any real action at the time.

“I became interested in disaster nursing due to my experience during the earthquake—it is why I applied to this program. In recent years, a variety of disasters have taken place in Japan due to extreme weather. During the study tour in the U.S., I’ve learned about disaster response measures not only for earthquakes, but also for hurricanes and other disasters that cannot be easily studied in Japan. In the future, I would like to become a member of a disaster medical assistance team (DMAT) and be able to take positive action in times of disasters.”

In addition to developing disaster nursing skills, participants like Yumi share their memories of the Great East Japan Earthquake and Tsunami, while demonstrating their compassion for strangers. They interact with a multilingual and multiracial society, uncommon in Japan, and learn the importance of understanding and respecting other cultures, backgrounds, and ways of thinking to foster a global perspective not only as health providers, but also as human beings.

September is National Preparedness Month and programs like the TOMODACHI Disaster Nursing Training Program are critical for preparing frontline responders for the unpredictable. Johnson & Johnson appreciates that the need to care for, comfort, and advocate for patients comes naturally to nurses—even when their own health could be at risk. This compassion makes them vital during this time of unprecedented disasters and supporting their knowledge, skills, and abilities through training is imperative to help them mobilize and respond faster and, ultimately, save lives.

Personal Needs vs. Professional Responsibility: A Nurse’s Perspective During Hurricane Harvey

Personal Needs vs. Professional Responsibility: A Nurse’s Perspective During Hurricane Harvey

With hurricane season fast approaching, individuals in vulnerable areas are preparing for the possibility of an active hurricane season. Last year was a particularly active season that affected the Caribbean and most of the Gulf Coast areas. As health care providers, nurses are particularly affected due to our responsibilities to both our patients and families as well as ourselves. This can be not only physically stressful, but also emotionally taxing on the individual.

In August 2017, Hurricane Harvey hit the Texas/Louisiana coastal areas and caused massive flooding, damage, and fatalities. The Texas Medical Center in Houston sustained flooding that stranded many hospital staff and patients for several days while the hurricane lingered in the area.

Heidi Aghajani is a nurse employed in the Houston area who spent six days working at the hospital during Hurricane Harvey while also being responsible for her family at home. She shares her story and expresses how she was affected during our interview.

Heidi Aghajani

What do you think went well with the hurricane preparation efforts of the hospital?

The hospital constantly informed staff of the hurricane via text messages, emails, and even huddles with managers about what’s happening, what to expect, and the time frame of when to expect it.

When did that start?

It started probably about 4-5 days before we knew the hurricane would hit.

When did your hospital notify you that you would need to come in as the ride-out team?

They notified us that Saturday before the storm hit Houston.

For the preparation, how many days’ worth of clothes, food, etc. did they tell you all to bring?

We were told to bring 4 days’ worth of clothes and food.

How long were you assigned to the hospital following Hurricane Harvey’s landfall?

We ended up staying for six days.

Were there any specific preparations your unit used that were particularly helpful?

They stockpiled patient supplies such as syringes and medications days in advance to last through the hurricane because they knew we would not get supplies.

Have you experienced any other natural disasters since becoming a nurse? If so, how would you compare that experience to your experience with Hurricane Harvey?

I was a nurse during Tropical Storm Allison where everything flooded badly so I would say that this time around the Medical Center itself was much more prepared with the underground doors and shutting streets down.

 Explain your feelings regarding the uncertainty of the condition of your family, home, while you were at the hospital?

There were a lot of emotional breakdowns; a lot of people cried. The first couple of days were good, but about the third or fourth day it got very emotional. If you called your family and they didn’t answer or if you heard something on the news about an area that your family was in it just became very stressful and a lot of nurses really had some long periods of just crying; just wanting to get out and wanting to be with their families.

Do you feel that these emotions could have interfered with a nurse’s ability to care for their patients?

I don’t think we would admit that, but we did offer each other breaks during our shifts to get some alone time. I ended up on night shift so we kind of traded off letting people nap and just get away and just take moments because during the daytime a lot of people could not sleep because of the helicopters and the tornado threats.

Did you view news coverage of the damage of Hurricane Harvey during the storm? If so, how did that affect you or your colleagues?

Yes, we watched it nonstop. We were obsessed with watching it actually. It was on every TV on our unit and if you saw an area that was close to your family it really affected people. You would hear nurses say, “Oh my God, my son is in that area” or “That’s were my family is staying.” It was sad.

Did you personally have a conflict with your responsibilities as a nurse and your responsibility to your family?

Yes. You’re going to make me get emotional [with tears in eyes]. Yes, the conflict was: do I stay home and take care of my family, or do I perform my duty as a nurse and take care of my patients? I knew that my son would be with my family who would take care of him just as I would, so I found comfort in that and I was able to just be a nurse.

Were there other nurses on your unit whose family had to evacuate, and were they aware of the evacuation? 

Yes. We had a nurse that learned that her husband and mother were evacuated off their roof while she was working and had to be taken to a shelter. She was very emotional.

 Do you feel better prepared for any future natural disasters having experienced Hurricane Harvey? Why or why not?

Yes. I know now what needs to be in my disaster bag for real [laughing].

Will you volunteer as part of the predesignated ride-out team again? Why or why not?

I think I would because my son is older, and I would hate for someone who has a younger child to have to do that, but yes, I would.

Is there anything you would have done differently if you could?

Yes, I would have planned my bag better. I ran out of personal supplies, clothes, and food. I would have probably stockpiled my locker days before.

Any additional tips for other fellow RNs regarding how to personally prepare as a ride-out team member during a hurricane?

No one can prepare you or train you on how to handle the fear you will feel in your heart and the long days of relentless worry. But the same patients I was there to take care of, ironically, in a way took care of me. It’s amazing how grateful they were that we were there for them. That helped me focus on my duties and remind myself that this is what nursing is all about. We don’t run from it. We run to it. This is who we are.

Hearing nurse Heidi’s story only reminds us how amazing our nursing profession is. Nurses will continue to perform during natural disasters, but we must also remember that they too are going through this experience. They have family and friends out in the community that they cannot help. They are experiencing emotions that they will never allow their patients to see. They are having thoughts in their minds on whether they made the right decision on being a nurse or a loved one. But this is what nursing is all about. This is who we are, and this is what we do.