Disaster Nursing Preparedness in Local Wisdom
A Systematic Review
Setyo Kurniawan
, Tintin Sukartini
and Joko Suwito
Faculty of Nursing Universitas Airlangga, Kampus C Mulyorejo, Surabaya, Indonesia
Health Polytechnic State of Surabaya, Jl. Pucang Jajar Tengah 56 Surabaya, Indonesia
Keywords: Disaster Nursing Preparedness, Disaster Nursing response, Local wisdom.
Abstract: Disaster is a serious dysfunction that occurs in a community with widespread losses. In the field are still
often encountered in the situation the victim was referred to definitive care in unstable condition. The key
word, namely: “disaster nursing preparedness, disaster nursing response and local wisdom in disaster”.
Search Journal articles done electronically using by ProQuest, Sage, Google Scholar, EBSCO, and Science
Direct. Limitation has been use for 10 years (2007-2017). From a numbers of article have been reviewed
that nurses are not confident with their abilities and not ready when dealing with disaster victims, a number
of nurses feels they need to receive training related to disaster management. Every nurses requires a disaster
management training because it can be happened anytime. The training should be standardized across
countries, so every nurses who working in disaster areas can work with nurses from other countries. In
addition to focusing on disaster, nurses need to pay attention with local wisdom in order to work with
communities to rebuild a better life.
Disaster is a serious dysfunction that occurs in a
community with widespread losses. It caused by
natural or non-natural factors and human factors
resulting in the occurrence of human casualties,
environmental damage, property loss and
psychological impact. A disaster occurs when there
are hazard (natural or manmade) strikes with a
vulnerable society. Increasing number frequency of
disasters globally has make WHO (World Health
Organization) make plan to increasing for disaster
preparedness and management in the world. China,
Japan, Indonesia are examples of the countries with
experience disaster every years.
In China at the beginning of 2016, it was
reported 1074 people died from the disaster and 270
people were missing. In Indonesia Based on the
National Disaster Management Agency (BNPB)
note that during 2016 there were 2,342 disasters in
Indonesia, up to 35% than 2015. Recorded 766
floods, 612 landslides, 669 tornadoes, 74 flood and
landslide combinations, 178 forest and land fires, 13
earthquakes, 7 volcanoes and 23 tidal waves and
abrasion. The impact of the disaster has caused 522
people to die and disappear, 3.05 million people
displaced. Various efforts continues to be done to
develop human resources in the face of disaster, but
the number of high disaster victims can’t be avoided.
In the disaster field is still often encountered that the
victim was referred to definitive care in unstable
Nurses as part of first responder in disaster must
have some knowledge and skills on disaster
management. Nursing health care in disaster area
will be effective and efficient to deliver if the nurse
have the fundamental disaster competencies like the
International Council of Nurses suggest in 2009.
Such as emergency response, triage, critical
assessment, critical thinking for problem solving and
It’s important for nurse and health care volunteer
to help maintain the stability of communities during
disaster relief. Disaster nursing roles include respond
if there are an emergency, detecting threats, giving
nursing care, managing health care and the facilities,
reducing or minimalized injuries and morbidity.
Even in situation to developing disaster healthcare
policies and collaboration with other organizations
(Baack and Alfred, 2013), or even working together
with local communities.
Kurniawan, S., Sukartini, T. and Suwito, J.
Disaster Nursing Preparedness in Local Wisdom.
DOI: 10.5220/0008324202980301
In Proceedings of the 9th International Nursing Conference (INC 2018), pages 298-301
ISBN: 978-989-758-336-0
2018 by SCITEPRESS Science and Technology Publications, Lda. All rights reserved
According Hammad et al (2012) In nurse
response disaster situations dealing with various life
dynamics, the characteristics of each individual,
positive or negative experiences that nurses have in
the face of disasters, emotional feelings including
pride or fear, affect how nursing actions are given to
disaster victims. And disaster nurses must also be
able to adapt when faced on the life of different
cultural characters in the face of disaster victims.
The method used in this study begins with the
selection of topics using the PICO framework, and
then determined keywords to search Journal articles
electronically using by ProQuest, Sage, Google
Scholar, EBSCO, and Science Direct. Limitation has
been use for 10 years (2007-2017). The key word
used to search the journals “disaster nursing
preparedness, disaster nursing response and local
wisdom in disaster”
Journals were selected for review based on
studies appropriate to the inclusion criteria. Search
using the above keywords found 20 journals. Of all
the journals obtained that fit the theme is 8 articles.
From several journals that had been reviewed
generally found that the nurses in the phase of
disaster preparedness feel unconfident with their
ability possessed (Baack and Alfred, 2013) it cause
the they has never helped deal with the disaster
victims, some are feeling that they are carried away
with the emotional atmosphere of sadness
experienced in the event of disaster.
There are nurses who feel they are not ready to
help in the event of a disaster because they are not
familiar with the existing protocols in the disaster
management (Loke and Fung, 2014). There are 58%
of Jordanian nurses were not familiar with the
disaster protocol in their workplace. The most of
them who were aware in disaster planning reported
that they having no confidence applying the disaster
management plan (Al Khalaileh, Bond and Alasad,
2012). In this study, more than half of the participant
were not aware with disaster management protocols
in their workplace, although they agreed that disaster
management protocols and disaster management
courses should be implemented, developed and
Some nurses feel that they are not ready to
handle disasters because they have never received
special training on disaster nursing (Yan et al., 2015)
they feel that they need special or more specific
training in disaster management.
From several nursing journals that have been
reviewed there’s none get the discussion on the role
of nurses in dealing with local cultural or local
wisdom. While the occurrence of disasters that occur
in various countries must have different cultural
Nurse as part of the first responder in a disaster
response situation is inseparable that they are part of
a community group. So that nurses are also expected
to be able to play its role in social life. According to
Martinsen in Alligood, (2014), a nurse has the
responsibility to use his knowledge and ability to
help others as fellow human beings in a variety of
conditions whether in professional or
nonprofessional duties, including in disaster
As part of the first responder, disaster nurses are
required to continue to develop and provide their
skills in disaster management to provide assistance
to every need in any circumstances, including in
disaster response situations (Baack and Alfred,
2013). So when in the handling of disaster, nurses
need to be better prepared in treating mass casualties
(Wenji et al., 2014) start when finding the victim,
stabilize the victims to do refers to definitive care.
Nurses can be place in the all phases of disaster
management. They can play an important role in all
phase from disaster, but they needed to be
competent. Nurse must be equipped with the all
about disaster skills to provide comprehensive and
holistic care to the victim who affected by or at risk
of disasters (Al, Plummer and Williams, 2016).
Therefore, emergency education and training for
nurses is needed to improve nurses' ability in
disaster management.
Based on studies wrote by Ahayalimudin and
Osman (2016) says that the association between
disaster education or training is significant and
beneficial to improve the knowledge, attitude and
practice of emergency medical personnel,
specifically for the nurses. Especially for education,
they suggest that the authorities should include the
syllabus of disaster management into the existing
curriculum, specifically for the advanced disaster
management programme.
Disaster Nursing Preparedness in Local Wisdom
This is suitable with the study who submitted by
Al, Plummer and Williams (2016) they wrote that
knowledge was the core of competencies, such as
understanding the content and location of the
disaster plan, communication during disaster and
ethical issues was happened in disaster is
fundamental knowledge for disaster nurses.
Including for these domains in the planning and
provision of training for disaster nurses, such as
disaster drills, will developing their preparedness to
respond competently to disaster cases.
What has been mentioned above has actually
been addressed by the WHO (World Health
Organization) in 2009 in ICN (The International
Counselling of Nursing) contained in the Framework
Of Disaster Nursing Competencies. According to
WHO the role of a disaster nurse must be able to
work internationally, in various forms of situations
with nurses and healthcare providers from all over
the world. These situations can be emergency
services (pre hospital, evacuation and intra-hospital)
to disaster recovery situations. This framework
helped the disaster nurse to explain the importance
of disaster management and identified the
knowledge, skills and abilities which must have in
disaster nurses in all phase of a disaster.
But until now, there’s no unified standards for
competencies have been validated to global disaster
management. Willing to explore disaster nursing
core competencies in various health care systems
and cultures will contribute to the body of
knowledge of nursing. The exploration indicate that
many domains in the area can be found by the
provider especially nurses, because nurses not only
life with their job but also exist with social and
cultural life of society.
The absence of global competency standards for
disaster nursing is responded differently by
Yamamoto (2004). She argues that the absence of
uniform standardization of disaster response nurse
competence is based on the nature of the disaster
that cannot be predicted, and how the impact will be
caused by the disaster itself in a region. So in
developing education and disaster training need an
outline that can be made as a reference in creating
the curriculum of education and emergency training
in addition to the introduction of a particular culture.
In the development of nursing science there is a
transcultural theory developed by Leininger (2002).
This theory is based on the understanding of the
difference of cultural values in the life of society.
Leininger assumes that it is important that a nurse
pays attention to cultural diversity and values in
applying nursing care to clients including in disaster
management. The side effect of a disaster on a
society is closely associated to disaster preparedness,
how people to prepare, response, and capability to
recover from a disaster in the context of their own
culture. (Varghese, 2010). In fact this cultural
groups cannot recover from disaster impact, because
the less of technology and communication,
minimally heed warnings about impending disasters.
Finally, these groups are not survive to prepare on
disaster situations.
Based on transcultural nursing theory, the action
and decision have been made by nurses should be
influence from the value and belief component on
cultural of society. Because every cultural society
has unique support system and different from the
other to make a deal with crisis situations.
When disaster happened, the social system in
society will be down may cause chaos even it would
be effect to decision maker in community no longer
exist anymore while at the same time there are many
requires some command or mechanisms associated
with the disaster response until recovery
When local resources are not enough, outside
assistance has been needed to support local resource.
There are some organizations and volunteers from
the outside local culture and society try to helped to
rebuild the mental and physic from the disaster
victim. But their presence may a problem if they
don’t know about local habit or a community’s
cultural beliefs. So they need to know how the local
habit for adaptation and work together with them.
Therefore it is necessary for a disaster nurse and
disaster volunteers to recognize a little about the
local cultural character and local wisdom in the
disaster area in both the disaster preparation phase
and the resilience
This is like a result of research from Kusumasari
and Alam, (2012). They wrote that Bantul (small
district in the province of Yogyakarta, Indonesia)
has known as a very urban area, poor and
underfunded, they have limited ability to manage a
disaster. But, just need two years after earthquake to
recovery and has resulted in a friendly atmosphere
and "Re-imaging" to be district as a planned area
with a targeted development strategy.
The recovery result are quite enough to
satisfactory because the high of quality of local
culture, local wisdom and inter-community
cooperation and the volunteers. The local
government only give assistance an earthquake
resistent house for victims and basic housing needs
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
From some of the results of research journals that
have been reviewed can be concluded if disaster
education or disaster training is very important and
useful to improve knowledge, attitude and practice
of emergency medical personnel, especially for
disaster nurse or emergency nurse. This training is
expected to improve nurse preparedness in disaster
response at early stage of preparedness. With the
improvement of skill nurse ability in expecting at the
time of disaster management nurse able to think
more critical, recognize emergency that happened to
patient through triage, able to do critical assessment
in effort to stabilize victim condition. Until able to
refer victims to definitive care in stable condition.
With the optimal ability possessed by the disaster
nurses, they are expected to be able to cooperate
with other health workers and even health workers
from abroad in an effort to help deal with disaster
victims. If the skill possessed by the nurse is in
accordance with the guidelines set by the WHO
(World Health Organization), it is expected that the
nurse will recognize and learn how the cultural
aspects and local wisdom that exist in a region. It
aims to enable a nurse to adapt to local communities
and cultures so that nurses and other health workers
can work together to rebuild post disaster lives for
the better.
In relation to disaster education and disaster
education materials, some journals recommend that
authorities may incorporate the syllabus of disaster
management into the existing curriculum, especially
for further educational programs and add an
introduction to local cultural wisdom
Ahayalimudin, N. A. and Osman, N. N. S. (2016)
‘Disaster management: Emergency nursing and
medical personnel’s knowledge, attitude and
practices of the East Coast region hospitals of
Malaysia’, Australasian Emergency Nursing
Journal. College of Emergency Nursing
Australasia, 19(4), pp. 203209. doi:
Al, A., Plummer, V. and Williams, B. (2016) ‘What
are the most common domains of the core
competencies of disaster nursing ? A scoping
review’, International Emergency Nursing.
Elsevier Ltd. doi: 10.1016/j.ienj.2016.10.003.
Baack, S. and Alfred, D. (2013) ‘Nurses’
preparedness and perceived competence in
managing disasters’, Journal of Nursing
Scholarship, 45(3), pp. 281287. doi:
Al Khalaileh, M. A., Bond, E. and Alasad, J. A.
(2012) ‘Jordanian nurses’ perceptions of their
preparedness for disaster management’,
International Emergency Nursing. Elsevier Ltd,
20(1), pp. 1423. doi:
Kusumasari, B. and Alam, Q. (2012) ‘Local
wisdom-based disaster recovery model in
Indonesia’, Disaster Prevention and
Management: An International Journal, 21(3),
pp. 351369. doi: 10.1108/09653561211234525.
Loke, A. Y. and Fung, O. W. M. (2014) ‘Nurses’
competencies in disaster nursing: Implications
for curriculum development and public health’,
International Journal of Environmental Research
and Public Health, 11(3), pp. 32893303. doi:
Varghese, S. B. (2010) ‘Cultural, ethical, and
spiritual implications of natural disasters from
the survivors’ perspective’, Critical Care
Nursing Clinics of North America. Elsevier Ltd,
22(4), pp. 515522. doi:
Wenji, Z. et al. (2014) ‘Nurse Education in Practice
Chinese nurses â€
relief experiences following
two earthquakes : Implications for disaster
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Yan, Y. E. et al. (2015) ‘Disaster nursing skills,
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Disaster Nursing Preparedness in Local Wisdom