Major Article
Nurses and emergency disasters: What is known

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Following the events of September 11, 2001, the threat of bioterrorism events has become a realistic concern for health care workers in the United States. Bioterrorism events caused by infectious agents will be challenging because nurses will need to recognize unfamiliar infections and work long hours with limited resources in stressful conditions. During a bioterrorism event caused by biologic agents, nurses will be expected to provide care to infected patients and may fear that they, or their families, could also become infected. A review of literature suggests that nurses' response to working during a bioterrorism event is not well described. The limited number of studies regarding nurses' concerns, fears, and anxieties is focused on nurses' experiences in natural disaster or war situations. Additional studies are needed to validate the appropriateness of applying findings from disaster response studies to bioterrorism events. During bioterrorism events, nurses will be expected to provide physical care and emotional and psychologic support for victims and victims' families. Realistic bioterrorism plans should incorporate strategies to support nurses and address their physical, psychologic, and emotional issues. Strategies to optimize safe working conditions and minimize psychologic trauma such as technical training regarding bioterrorism agents and debriefing opportunities should be included.

Section snippets

Methods

Literature searches were conducted in 2 primary databases for English-language articles published in the last 20 years that related to the psychologic implications of disaster work, bioterrorism, and nurses and disaster work. The databases used were Ovid-Medline and PubMed. The World Wide Web was used to find on-line nursing journals, such as Nursing World. Additional literature was collected from experts in the field of bioterrorism preparedness and planning. The search and retrieval of

Psychologic implications

Experts working in the filed of disaster, such as by Ursano et al,1 describe the traumatic nature of public health emergencies and identify factors that may influence the experience of nurses working during such events. Their work suggests that there are predictable responses to trauma by both individuals and communities. The way in which those involved experience a traumatic event depends on the nature of the stressors and the mediators associated with the event. The nature of potential

Discussion

There are limitations in the research about variables that may influence nurses who are expected to work during a bioterrorism event. The studies that are used to approximate working conditions in a bioterrorism event describe the experiences of nurses working during natural disasters, multicasualty terror, or the events of September 11, 2001.16, 17, 19, 20, 21 Additionally, of the bioterrorism planning articles selected for this review, none include opinions of nurses.

Published reports

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