Position Statement: On the Role of the Registered Professional Nurse in Emergency Preparedness for all Hazards

INTENT

The intent of this position statement is to examine the role and responsibilities of the Registered Professional Nurse in planning and preparing for current and emerging threats to the public’s health.

POSITION

• The New York State Nurses Association (NYSNA) fully supports local, state and national efforts to achieve comprehensive emergency preparedness.
• The NYSNA encourages educational opportunities to prepare nurses for emergency response in all health care settings.

BACKGROUND

The inter-connectedness of today’s world as well as increasingly extreme weather events requires an “all hazards” approach to emergency preparedness. While some hazardous situations may be more likely to occur at one particular facility than others, an all-hazards approach must be developed to prepare a facility for all possible eventualities, whether the emergencies be internal to the facility, external, man-made or natural. Healthcare facilities must be prepared to provide care during a disaster even as the facilities themselves may be suffering from significant infrastructure damage.

Because of the devastating effects of massive storms, cyberattacks, active shooter events and virulent epidemics, healthcare institutions are at the forefront of safeguarding the public’s health while, at the same time, possibly suffering their own adverse effects. Some of these adverse effects include building damage and limited access to equipment, utilities, computer systems and supplies. The Centers for Medicare and Medicaid Services (CMS) and the Joint Commission (JC) have updated their emergency preparedness requirements to ensure that healthcare facilities can maintain vital services during emergency situations.

Preparedness must address potential loss of communication systems and other infrastructure damage, patient surges, patient evacuation, employee protection from epidemics, limited access to the facility and other possible complicating factors.

Emergency preparedness programs must include:

• Risk Assessment and Planning
• Policies and Procedures
• Communication Plan
• Training and Testing

Registered Professional Nurses’ input is vital to each of these key areas. The Registered Professional Nurse contributes a unique perspective on the patient, family, institution, community and nation and is an integral part of the planning, provision of services and evaluation process. As frontline providers of care during emergency situations, nurses’ voices must be included in all aspects of emergency preparedness plan to safeguard the therapeutic care environment and the safety of patients as well as fellow employees.

SUMMARY AND RECOMMENDATIONS

Nurses have a long and rich history of selflessly responding to disasters and emergencies. Nurses are an integral component of the nation’s health care system and continue to function at multiple levels, including as first responders and first receivers. Nurses are committed to help ensure that people affected by any hazard will receive the medical care they need. In order to successfully meet the public’s medical needs during an emergency, NYSNA recommends that the following steps be taken:

• Nurses need to be integral partners in the planning, provision of services, and evaluation of the effectiveness of the emergency response plan.
• Nurses must receive information and training on what will be expected of them in an emergency situation.
• Nurses need to develop their own personal preparedness plans to assure the safety of themselves and that of their families in the event of an emergency. The Joint Commission also requires healthcare facilities to plan for healthcare staff’s personal and family needs (Joint Commission EM.02.02.07 EP 5&6).
• Although covered by the Good Samaritan Law, NY Public Health Law § 3000-a (http://codes.lp.findlaw.com/nycode/PBO/2/17), nurses are strongly encouraged to maintain their own malpractice insurance.
• Nurses need to support their colleagues who have chosen to train and be available for emergency situations.
• Healthcare facilities must have policies and procedures in place that define the facilities’ role in responding to all hazards.
• Healthcare facilities must prepare staff for potential emergencies and continuously update and train staff for responses to all hazards.
• Healthcare facilities have the responsibility to ensure that adequate supplies and resources are available for health care providers to manage the impact of emergent situations.
• NYSNA members who wish to volunteer for NYSNA’s medical mission emergency response programs should be encouraged and facilitated by their employers. Nurses can find further information at www.nysna.org..

RESOURCES

Centers for Medicare and Medicaid Services (CMS) Emergency Preparedness for Every Emergency
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/index.html 

Joint Commission Emergency Management Portal
https://www.jointcommission.org/emergency_management.aspx 

Occupational Safety and Health Administration (OSHA)
https://www.osha.gov/SLTC/emergencypreparedness/

U.S. Centers for Disease Control (CDC) Emergency Planners and Responders resource page
https://www.emergency.cdc.gov/planners-responders.asp

U.S. Centers for Disease Control (CDC) Hospital All-Hazards Self-Assessment
https://www.cdc.gov/phpr/readiness/healthcare/documents/hah_508_compliant_final.pdf 

U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) Hospital Preparedness Program
https://www.phe.gov/Preparedness/planning/hpp/Pages/default.aspx 

Reviewed March 8, 2018

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