The document discusses challenges facing nurses in disaster management. It identifies 6 main challenges based on a literature review using a scoping methodology: 1) Disaster nursing is a new specialty with few trained experts and opportunities for training. 2) Inadequate preparedness of pre-hospital care systems, hospitals, and nurses themselves. 3) Poor formal disaster education for nurses at undergraduate and graduate levels. 4) Lack of research and evidence-based practices in disaster nursing. 5) Ethical and legal issues in disaster response. 6) Unclear roles and responsibilities for nurses in disasters. The findings indicate barriers that must be addressed to improve disaster nursing.

1. Presentation on
Concepts,principles
and types of Disaster:-
Bsc (H) Nursing

3. Introduction
 Disaster Management is a multi-disciplinary area in which a
wide range of issues that range from forecasting, warning,
search and rescue, relief, reconstruction and rehabilitation
are included. It is multi-sectoral as it involves
administrators, scientists, planners, volunteers and
communities. Their roles and activities span the pre-
disaster during disaster plans. All these activities are
complementary and supplementary to each other and here
is a critical need for these activities.

4. Definition and concept of
Disaster
According to WHO “A disaster can be defined as any
occurrence that causes damage ecological destruction loss
of human life, deterioration of health and human
services, on a scale sufficient to mordant an extraordinary
response from outside the effective community or era.”

5. Definition of Disaster
nursing:-
 It is defined as the adaptation of professional nursing skills in recognising and meeting the physical
and emotional needs resulting from a disaster. its main goal is to achieve the best possible level of
health for the people and the community involved in disaster.
 D – Destruction
 I – Incidents
 S – Sufferings
 A – Administrative, Financial Failure
 S – Sentiments
 T – Tragedies
 E – Eruption of Communicable disease
 R – Research program and it’s implementation.

6. Types of Disaster:-
 Man made Disaster
 Major man made disaster
 Minor man made Disaster
 Natural Disaster
 Major natural disaster
 Minor natural disaster

7. Major Man made Disaster:-
 Deforestation – Clearing of trees, forming a forest into cleared land.
 Chemical pollution – When chemicals are released into environment and they disturb
the balance of our ecosystem tracking for health for you the air we breathe.
 War – State of armed conflicts between different groups within a country.
 Fire – Substances combine chemically with oxygen from the air and typically give out
bright light heat and smoke, combusting or burning.
 Blast injuries – A last may result from terrorism but can cause by ROM circumstances,
example welding inside a time that formerly contained task but was not properly
cleaned can result in an explosion as well as she wear tar burns to the worker.
 Nuclear disaster – it is an accident taking place in nuclear facility or in a facility using
radioactive sources, leading to a large scale release of radioactivity in the
environment.
 Terrorism - it is the use of fear and acts of violence in order to intimidate societies or
government. It includes unlawful violence and war.

8. Minor man made Disaster:-
 Food poisoning – Caused by bacteria or other toxins in food typically
results vomiting and diarrhoea.
 Environmental pollution - introduction of contaminants into natural
environment that cause adverse change.
 Road accidents - refers to any accident involving at least one vehicle
appearing on road open to public circulation in which at least one
person is injured or killed.
 Industrial crisis - any situation that could harm the people or property
seriously interrupt business significantly damage reputation or
negativity impact the bottom line of business is called industrial crisis.

9. Major Natural Disaster:-
 Hurricanes/cyclones - cyclones are storms occur in coastal areas. Cause damage due to high velocity
of an followed by rainfall.
 Flood - most common. It occurs due to rivers and their tributaries overflowing their banks. It occurs
due to back flow of water and heavy rainfall.
 Earthquake - it sudden vibration or shaking of ground caused by movement in the rocks below the
earth’s surface.
 Volcanic eruptions - volcanoes can cause widespread destruction and its eruption itself may cause
harm following the explosion of the volcano on The fall of rock. The ash and the lava released is
harmful for humans plants and buildings.
 Droughts - weather related phenomena that causes severe economic impact. Example- crop damage,
water supply shortages.
 Tornadoes - violent rotating column of hair with wind speed up to 300 mph. They can destroy a large
buildings, uproot trees and hurt vehicle.
 Tsunami – series of water waves caused by the displacement of large volume of a body of water.
Ocean tsunami is most deadliest.

10. Minor Natural Disaster:-
 Cold wave – In winter season, when strong wind close and spreads cold
around, leading to low temperature of environment.
 Mudslide – Mass of mud and other material that is falling or has fallen
down a hill side or others slope.
 Thunderstorm – from with thunder and lightning and typically also
heavy rain/hail.
 Storms – Violent disturbance of atmosphere with strong winds and
usually rain, thunder, lightning or snow.
 Landslide – movement of a mass of rock or earth down a slope

11. Epidemiology of Disaster:-
Agent :-
 Primary agent – falling buildings, trees, wind, rising water, smoke.
 Secondary agent - bacteria and viruses.
Host :- characteristics of human that influence of disasters effect. It includes age, immunization
status, pre existing health status, degree of mobility, emotional stability.
Environment:-
 Physical factors – time when the disaster occur, weather conditions, availability of food and water
and telephone services.
 Chemical factors – include leakage of stored chemicals into air, river and groundwater and food
supply.
 Biological factors - this occur due to contaminated water, improper waste disposal, insect
proliferation and improper food storage.
 Social factors - which contributes individual social support, example - loss of family members and
changes in the roles.

12. Phases of Disaster:-
 Pre impact phase:- Initial phase prior to the actual occurrence warning is
given at first sign of danger to community. Many times there is no morning
but with the aid of weather networks and satellites many disasters can be
predicted. Emergency preparedness plan should be put.
 Impact phase :- it occurs when disaster happens. This is time when
individuals help the neighbour and family at the scene, a time of ' holding
on' until outside help arrives.
 Fast impact phase:- recovery begins during the emergency phaseand end
with the return of normal community order and functioning for persons in
the intact area, this phase may last lifetime.

13. Principles of Disaster management:-
There are 8 principles –
1. Prevent occurrence of disaster whenever possible.
2. Minimise number of casualties in the disaster cannot be prevented.
3. Prevent further casuality is updating after initial impact of disaster.
4. Rescue the victims.
5. Provide first aid to the injured.
6. Evaluate the individual to medical facilities.
7. Provide definitive medical care.
8. Promote reconstruction of live.

14. Disasters in India:-
 India is vulnerable to natural disasters due to unique jio climatic
conditions.Flood ,drought ,cyclones , earthquake s and landslide
would have been recurrent phenomena.
 About 59% of land mass is prone to earthquakes of various
intensities over 40 million hectares is prone to flood to cyclones
and 69% of the area is suspectible to draught.
 Super cyclone in October 1999 and Bhuj earthquake in gujrat For
example of natural disaster in India.

15. Phases of Disaster management:-
1. Mitigation :- It include activities that prevents the disaster, reduce the chances of
disaster happening or reduce damaging effects of disaster.Goal of mitigation is to
prevent or minimise death, disability, suffering and loss on part of disaster victims.
Mitigate is done by –
 Enforcement of good building.
 Observing proper safety precautions to prevent man made disaster.
 Public education in areas prone to certain type of disaster.
Nurses role in mitigation phases of disaster-
 Identify disaster risk and develop strategies through public education in disaster
prevention.
 Nurses should access information including knowledge of community, government,
officials and local industries.
 Nurses need to prepare to mobilize resources, provide care and minimise confusion.

16. 2. Preparedness:-
 Development of awareness among the people on how to behave in further disaster.
Personal preparedness:-Great stress is placed on the nurse with patient was
contributed who also becomes disaster victim. Community health nurse who assist in
disaster relief efforts must be healthy both mentally and physically.
Professional preparedness:- - nurse should be aware of disaster plans at
their work, place and community.Personal items recommended by nurse include –
 Copy of professional licence
 Cash
 Stethoscope
 Warm clothes and heavy jacket
 Flashlight and extra batteries
 Record keeping materials.

17. Community preparedness:-
community preparedness will be good as people and
organisation in the community make it. There must be
warning system as well as backup evacuation plan to remove
individual who hesitate to leave their homes because of
personal possessions lost from disaster.

18. Role of nurse in prepardness
phase of Disaster:-
 Nurse facilitate preparation
within community.
 Nurse should assist in recruiting
others who will help when
response is required.
 Should have decisiveness,
stamina, endurance.

19. 3.Response:-
it is determined by the level of disaster.
 Level 1 Disaster :- it requires activation by the local
emergency medical system in cooperation with local
community organisations such as police.
 Level 2 Disaster :- this requires more of a regional
response necessitating several protocols.
 Level 3 Disaster:- this level is one in which a federal
emergency has been declared because of widespread
destruction.

20. Response in adult :-
 Extreme sense of urgency
 Insomia
 Headaches
 Panic and fear
 Disorientation and numbing

21. Response in children :-
 Regression behaviour
 Fantasies that disaster never occurred
 Nightmares .
 School related problem
Role of nurse in response phase of Disaster management :-
 Nurses should have skill in tried and evacuation procedures
 Primary concern of nurses in disaster response is safety, safety of
themselves and rescue team victims.
 The nurses works to reduce fear, panic and hysteria by encourage victims
to express their feeling

22. 4. Rehabilitation:-
It starts from the very first moment of disaster. In the first weeks after
disaster, the pattern of health needs routine first healthcare.
5.Rreconstruction:-
Phase of disaster, recovery occurs as all involved agencies full together to
restore economic and civic life of community. Many organisations help in
rebuilding efforts voluntary agencies continue to access individual and
community needs and meet those needs as they are able.

23. NURSING responsibility in
rehabilitation and reconstruction:-
 Nurses should be vigilant Indian
make immunization up to date.
 Nurse should remain alert for
environment health hazards
during recovery phase.

24. Triage:-
Triage is a French word means
'sorting'. The goal is to
maximize by sorting free table
from untreatable victims.

26. Role of nurse in disaster:-
 Disaster nurses play key leadership and services provision role in planning and
implementing disaster relief efforts.
 Nurse collaborate with community agencies and officials to recognise and reduce
disaster risks and maximizes the health and safety of individuals involved in disaster
crises.
 Prepare selves, families, friends and communities for disasters in conjunction with local
disaster preparedness plan.
 Provide emergency services with consideration of victims, abilities deficits, culture,
language or special needs.
 Assist in mobilization of healthcare personals, food, water, shelter, medication, clothing
and other assistive devices.
 Consider needs of including shelter both temporary and permanent as well as
psychological, economic, legal and spiritual factors.

27. Community disaster
strategies:-
 Assess the community.
 Dinosaurs community disaster threats - determine actual and potential
disaster threats (toxic waste spills, explosions, floods, earthquake).
 Community disaster planning
1. Develop a disaster plan to prevent or deal with the identified disaster
threats.
2. Identify local community communication system.
3. Identify regional backup agencies and personnel.

28. Government initiatives for disaster
management:-
Disaster Management Act :-
 The Government have enacted and notified the Disaster Management
Act ,2005 on December 26,2005 to provide for institutional mechanisms
for drawing up and monitoring the implementation of the disaster
management plans, ensuring measures by various wings of government
for prevention and mitigation effects of disasters and for undertaking a
holistic , coordinated and prompt response to any disaster situation.
 The act provides for setting up of a National Disaster Management
Authority (NDMA) under the chairmanship of Prime Minister , State
Disaster Management Authority (SDMAs) under the chairmanship of the
Chief Minister and Disaster Management Authorities(DDMAs) under the
chairmanship of District magistrate.

29. Role of Central and State
Government:-
 Basic responsibility for rescue , relef and rehabilitation with the state
Governments.
 Central Government supplements the efforts of state governments .by providing
financial and logistic support in case of major disasters.
 The logistic support includes deployment of aircrafts and boats,specialist teams of
Armed forces , Central Para Military forces and personnel of National Disaster
Response Force (NDRF) , arrangements for relief materials and essential
commodities including medical stores , restoration of critical infrastructure
facilities including communication network and such other assistance as many as
required by the affected state to meet the situation effectively.

30. Funding mechanisms :-
 The existing scheme , based on the recommendations of the Eleventh Finance
Commission, is valid for the period 2000-05 . Under this , expenditure on
immediate relief to the victim of natural calamities can be met by the state
Governments through the following funds :
Calamity Relief Funds (CRF) constituted for each state with pre –determined annual
allocation for each of the 5 year period . The Cental Government contributes 75% and
the State Government 25%.
 When the calamity is of a severe nature and the CRF is not sufficient, the states
may approach Cental Government for additional assistance from the National
Calamity Contingency Fund (NCCF) which is financed by levy of a central (federal)
taxes for a limited period.

31. Research studies:-
Abstract :-
To reduce the impact of disasters, healthcare providers, especially nurses, need to be
prepared to respond immediately. However, nurses face several challenges in all phases
of disaster management. The findings of a literature review based on scoping
approaches, which utilized the Joanna Briggs Institute methodology, indicated that the
major barriers facing nurses include the following: (1) disaster nursing is a new
specialty; (2) inadequate level of preparedness; (3) poor formal education; (4) lack of
research; (5) ethical and legal issues; and (6) issues related to nurses’ roles in
disasters. Educators, researchers, and stakeholders need to make efforts to tackle
these issues and improve disaster nursing.

32. Method:-
In this review, we adapted the Joanna Briggs Institute’s scoping review
methodology,16 which consists of the following steps: (1) specify the research goals and
question, (2) determine the inclusion and exclusion criteria for the studies, (3) identify the
search strategies, (4) chart the results, (5) discuss the results, and (6) provide conclusions
and recommendations. Therefore, the first step in the present review was based on the
current gaps in the literature and the lack of a summary of the evidence related to
barriers. The following research question guided the scoping review: what challenges
obstruct nurses from achieving effective disaster management?the search strategy involved
finding articles on challenges facing nurses that obstructed them from achieving effective
disaster management. The search included the following keywords: disaster nursing,
barriers, challenges, and emergency nursing. Using the Saudi Digital Library, the Science
Direct, Scopus, and Cumulative Index to Nursing and Allied Health Literature databases
were searched for publications published between 2010 and February 2020.

33. Findings:-
six main challenges were identified: the newness of the disaster nursing specialty, lack of
preparedness, poor formal education, lack of research, ethical and legal issues, and unclear
roles. First, as disaster nursing is a new specialty, the lack of a paradigm, few evaluation
tools, limited disaster experience, limited availability of experts, and limited opportunities
for training are among the major challenges for nurses in disaster
management.17,19,22,24 Second, the level of preparedness in terms of prehospital care,
hospitals, and individuals (including nurses) poses a challenge for nurses. One study reported
the prehospital care system as a big challenge for nurses,17 while hospital preparedness was
reported in several studies, which noted that hospitals have limited capacities, resources,
and staffing, lack awareness about policies and procedures, and have poor planning and
leadership.17,22,24,25 The lack of preparedness of nurses was also reported as a vital
challenge in many studies.10,18,21–24 Third, poor formal education, including
undergraduate and postgraduate curriculum issues, is another serious issue affecting nurse.
Fourth , the lack of research and evidence-based practice was also reported as a challenge
for nurses.10,19,23 Finally, ethics and legal issues and uncertainty and ambiguity about
nurses role were considered barriers for nurses in disaster management.

34. Summary and conclusion:-
Today we have discussed about disaster,
definition, its types, epidemiology of disaster,
phases of disaster, its principle of
management, disaster in India, phases,
triaging in disaster management, role of nurse
in disaster management.I hope you all
understand the topic clearly and you will able
to use this knowledge to protect yourself and
community from disaster in future.