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“One of the immediate things that stood out in our regional plan is that everybody has to have similar training and similar processes to respond as a whole.” -Julia Henion, RN (far left), vice president and chief nurse officer of Driscoll Children’s Hospital in Corpus Christi

Nurses in a post-Sept. 11 world are filled with the same fears of bioterrorism attacks and mysterious illness outbreaks as the general population, but they are more prepared than ever to deal with the potential consequences.

Behind the scenes, nurses are being educated to deal with disasters that are not as hypothetical as once imagined. Nurses are considered part of the frontline of defense for hospitals and governments teaming up on strategies to combat these new, grave threats to communities.

“Preparedness” is the new keyword, and many states — including Texas and Louisiana — are taking the initiative to best support their nurses for the challenge. Although the defenses are far from fortified, the recognition of the danger is fully realized.

“Nurses are at the forefront of bioterrorism preparedness,” said Ronald Blanck, DO, president of the University of North Texas Health Science Center and chair of the Texas Medical Association’s Task Force on Bioterrorism. “They will play such a critical role in early recognition ... and will put themselves in harm’s way to do the right thing for the patient, no matter what. We need to help them be armed for that role.”

Disaster preparedness training now is in the curriculum of nursing schools, and federal grants are supporting continuing education programs. Hospitals also are conducting drills with local emergency responders to determine the impact a major event could have on health care staff and services.

M. Teresa Verklan, RN, CCNS, teaches bioterrorism classes at the University of Texas Health Science Center at Houston. She is concerned that health care workers “aren’t really prepared to handle anything of magnitude. I can’t even visualize how we would handle major casualties, get supplies out, and coordinate operations.”

If primary hospitals are hit in an attack on an urban area, the care will shift to tertiary centers in outlying areas.

“We are really looking at community hospitals delivering the majority of care in this event,” said Verklan, an associate professor at the UTHSC-Houston School of Nursing and director of clinical research and advanced practice at Memorial Hermann. “This is something that most people don’t know anything about.

“With the world getting smaller and smaller and the risk of something happening in this country getting greater, the prospect of people trying to handle mass casualties is a disturbing one.”

Should power be knocked out, for example, nurses may have difficulty manually calibrating dosages in specialized IV infusions and performing other functions traditionally reliant on computerization, Verklan said.

Time of need

In preparation for the worst, nurses throughout Texas, Louisiana, and the rest of the United States have been busy engaging in drills and continuing education, volunteering for “reserve” nurse units, and helping their own hospitals link with other institutions.

In the event of a disaster, a “nurse reserves” unit of at least 1,200 nurses has been formed to combat anticipated care shortfalls in Texas.

The Ready Texas Nurses Emergency Response System, initiated in early 2002 by the Texas Nurses Association, taps into a nurse population that may not be active in a hospital or clinic setting, but has the skills and active licenses to assist in time of need.

Nurses from a vast spectrum of practices have signed on (at www.texasnurses.org) for service, TNA Executive Director Clair Jordan said. Many are semiretired or not practicing. Volunteer applicants answer brief questions about their practice expertise and willingness to volunteer, she said.