Lessons from disaster zones

Collapsed building in ChinaNursing expert Lisa Conlon is sharing her extensive knowledge of emergency and disaster health care with nurses across the Asia-Pacific.

She has resuscitated people with a rifle slung over her shoulder in East Timor, and she’s been deployed on the US hospital ship USNS Mercy. She’s also served as a nurse in Antarctica – twice.

Now, Lisa Conlon is changing the role of nursing in emergency and disaster situations across the Asia-Pacific.

When the UTS lecturer was called to China just weeks after the devastating Sichuan earthquake in 2008 to train nurses in emergency and disaster response, she found they were in need of additional first-aid training, such as patient assessment, triage (prioritising patients) and managing wounds.

“The training programs were non-existent,” says Conlon, who rapidly developed a ‘train the trainers’ program for disaster and emergency nursing. Fifty senior registered nurses involved in delivering care to victims of the earthquake learned the basics of emergency nursing and were able to then pass on the knowledge.

“These were things they hadn’t done before,” says Conlon. “A lot of what we consider to be basic emergency and disaster nursing procedures aren’t routinely practised in China. This is now changing. Chinese nurses have taken really big steps – and all in just 18 months.”

Conlon’s training, delivered for the World Health Organisation (WHO) in partnership with Sichuan University and the Hong Kong Department of Health, was the first of its kind in China. The program has since been enhanced to incorporate many elements of trauma care, including psychosocial and mental health care, and is now being implemented at universities around China.

In another first, nurses across the Asia-Pacific are undergoing similar WHO training, which Conlon says will equip them with the skills to prepare for a crisis, and to cope during its peak and the recovery phases.

Conlon is one of two program leaders tasked with developing the training programs, which will then be adapted to meet the specific needs of a country, as well as the cultural and religious beliefs of a community.

“We need to make the courses relevant to the individual countries and to the nurses and health care workers,” says Conlon. “Some topics such as trauma care, triage and wound care are applied across-the-board but psychosocial and disability issues need to be very much tailored to an individual country.”

At the third annual meeting of the Asia-Pacific Emergency and Disaster Nursing Network in Cairns in September 2009, senior nurses from countries around the Asia-Pacific took part in programs such as trauma care; psychosocial and mental health care in an emergency and disaster situation; and disability care and the vulnerable population.

“In 2008 in Jinan, China, we ran a modified psychosocial and mental health program for emergency and disaster situations, so last year we went a step further with the additional sessions,” says Conlon, who is also working to ensure nurses are recognised for their work.

“Nurses are usually at the frontline during an emergency and disaster situation,” she says. “They should be the ones assisting to prepare their country for an emergency or disaster situation. We want to empower nurses to say: ‘this is your role, and you need to be there at the tables with senior government officials telling them what needs to be addressed to be ready for a disaster or emergency’.”

She says both patients and those caring for them are affected on a psychosocial and mental health level during emergency or disaster, and this is covered in the training.

“We are preparing nurses to work in difficult situations with limited equipment; but also to prepare nurses for the fact that people will die and there will be things they won’t be able to do to save some people – and that’s a very hard thing for any health care professional to deal with. We try to teach them coping strategies.”

The nurses also learn the importance of taking a break during the acute phase of an emergency or disaster, and to keep an eye out for each other.

“We teach them mechanisms to identify concerns with their colleagues – when to tell someone to stop, that they need to eat and sleep. You become a protective mechanism for your colleagues and your staff.”

Conlon also manages to find time to teach undergraduate and postgraduate courses in the UTS Nursing, Midwifery and Health faculty, as well as completing the final year of her Doctor of Nursing. Her thesis topic is Preparing military trauma teams for conflict and humanitarian crisis situations.

“I hope to be able to advise the military about the training that is currently delivered to trauma team members, about the scope of practice that our team members work under, and the composition of the teams. I think all of this will be relevant to the civilian sector as well, as they work hand-in-hand with the military to develop its trauma care capabilities.” And, of course, she says, “all of this work is done with the great support of the faculty”.

Conlon knew she wasn’t leaving a life of adventure behind when she left the Royal Australian Navy for academia after 13 years as a nursing officer.

“The beauty of it is that I still have my close ties with the military,” says the reservist. “Every time there’s something on – when the Samoan tsunami and Indonesian earthquake happened – I am on call.”