Disaster nursing or nursing in disaster: a case study approach to investigate the future requirements of disaster nursing in Norway.

Abstract

This PhD study has undertaken a critical evaluation of nurses’ role in disasters and mass casualty events with particular reference to remote community settings. Nurses in particular are important in order to reduce the effect of a disaster on the affected population and growing awareness of disaster facilitates and opens up discussion in relation to ‘disaster nursing’. Disaster Nursing (DN) can be briefly defined as providing holistic nursing to affected populations in all phases of a disaster. The main aim has been to critically evaluate the present and future requirements of Disaster Nursing using rural northern Norway as a case study. Rural northern Norway was chosen as a case study because the country as a whole represents an industrially advanced society with comparatively sophisticated health care provision and developed municipal nursing services. A Disaster Nursing (DN) and more generalist Nursing in Disaster (ND) Conceptual Framework (DN-ND) was introduced to understand the routes and processes for developing (more) effective disaster nursing arrangements and education. Interviews of municipal nurses and their leaders working in different districts of rural northern Norway revealed that nurses had little or no influence on or knowledge of local Disaster Management and Health Preparedness plans. The opinions of nurses and leaders also exposed that disaster training and exercises did not involve nurses. However, interviews uncovered the need for improvements in organisation, training and education of nurses to provide health care in disasters. Leaders and nurses express a need for Disaster topics at or in addition to BSc level, and a specialisation at MSc level, thus endorsing the DN-ND conceptual framework although with appropriate local adjustments. Finally, it is demonstrated that only through university academic research in nursing, giving the provision of a permanent comprehensive educational and training strategy can nurses realistically manage to handle health care in relation to disasters for all the differing aspects of, and within the disaster management cycle.