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.

1 BACKGROUND

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

condition.

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

others.

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.

298

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

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.

2 METHODS

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.

3 RESULTS

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

practiced.

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

backgrounds.

4 DISCUSSION

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

situations.

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.

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299

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

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5 CONCLUSIONS

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

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