The history of disaster nursing: from Nightingale to nursing in the 21st century

Abstract

Background Nurses have a rich history in performing their duty both domestically and internationally in response to a disaster. Comprising the largest proportion of the healthcare workforce, nurses possess a unique opportunity to inform disaster planning and management. With the ongoing threat from COVID-19 and continuing conflict, humanitarian aid needs, epidemics and natural disasters; the capacity of nurses to continue to respond in times of global need is unparalleled. Aims The aim of this paper is to explore the developments in the field of disaster nursing. Mapping key changes in policy, practice and outcomes. Methods A qualitative interpretive historical review was conducted to examine core developments in the history of disaster nursing, examining key organisations (e.g. World Health Organization, International Council of Nurses), national and international policies and historical accounts. Results 29 articles were analysed, and politics, strategic perspectives and nursing identity (‘sense of duty’ and roles) emerged from the literature. The influence of professionalisation and public health/health promotion emerged next. A total of 10 articles refer to disaster nursing specifically, of which 4 of these are reports/policy. Conclusions Nurses have spent centuries building the trust and legitimacy of the profession. Disaster nursing goes beyond the expectations of a registered nurse. The responsibilities of a disaster nurse encompass wider community health promotion, critical decision-making beyond the individual patient, resilience and ethical challenges. Whilst significant advancements have emerged in the last 30 years, further research, and representation of the profession at a strategic and political level could enhance the effectiveness of nurses’ roles in the 4 phases of disaster response: mitigation, preparation, response and recovery.

Care‐home Nurses' responses to the COVID‐19 pandemic: Managing ethical conundrums at personal cost: A qualitative study

“…By using the lens of Tronto's framework of ethical care we are able to distinctly examine and report on the micro (personal), meso (care‐home) and macro national polices and public discourses in relation to attentiveness and responsibility to provide good care and the consequences of when this was not possible; the demand and willingness to extend professional competencies; the responsiveness of relatives and care regulators to care provision and the way in which the care‐home workforce worked together. We now explore each component drawing on literature to situate our discussion in a registered nurses' professional sense of duty, obligation, and responsibility (Fletcher et al, 2022).…”

Disaster Preparedness in Home Care

“…Interventions to reduce barriers to disaster planning for patients are needed (Bell et al, 2021). Fletcher et al (2022) call for a need to better understand the influence and role of nurses in policy development, strategic and operation response, workforce preparation, and education development. Additionally, they suggest more research on role profiles within the four phases of disaster response.…”

“…Emergency management and disaster response have historically been more reactive than proactive, although a shift to prevention, planning, and risk reduction has emerged over the past 20 years. The literature focuses heavily on the preparedness and response phases and less on the clinician's role in the mitigation and recovery phases (Fletcher et al, 2022). The COVID-19 pandemic revealed a need for ongoing training, education, research, and planning to mitigate negative consequences on healthcare providers, patients, and communities (Anderson & Beach, 2022; Bell et al, 2022; Elliott et al, 2023).…”

Special Collection Editorial: Nursing through times of challenge and adversity

“…Calamassi et al (2021) explored the experiences of healthcare professionals during the conflict in Iraq. This study identified themes that in some regards are somewhat unique to the setting, but others that may also be recognisable in other healthcare settings; a second paper by Fletcher et al (2022) utilises a historical interpretative approach and explores the history of disaster nursing from the time of Florence Nightingale to the present day, highlighting the dynamic nature of nursing in these circumstances and how nurses must have strategic and policy-level input to plan for future events.…”