NURSING DISASTER

According to the Ministry of Health Republic of Indonesia disaster definition is the

event/incident in an area that resulted in ecological damage, loss of human life as well as
worsening health and meaningful health care so that it requires extraordinary assistance
from outside parties.
In law No 24 year 2007 on disaster relief, known understanding and some terms related to
disasters.
Disaster is an event or community event that threatens and disrupts life and livelihoods
caused, both by natural factors and/or factors of non-natural or human factors, resulting in
the emergence of human soul victims, environmental damage, property loss, and
psychological impacts.
Natural disasters are disasters caused by events or series of events due to natural
earthquakes, tsunamis, eruptions, floods, drought, hurricanes, and landslides.

1. Types of disasters
Usep Solehudin (2005) classify disasters into 2 types:
Natural disasters are natural events such as natural events such as floods, puddles,
earthquakes, volcanic eruptions, storms, droughts, outbreaks, insects and others.
Man made disaster is the events because of human deeds such as aircraft or vehicle
collisions, fire, riots, sabotage, explosion, electrical disturbances, communication
disturbances, transport interference and others.
While based on regional coverage, disasters consist of:
a. Local disasters
This disaster usually impacts the adjacent surrounding area. Disasters occur in a
building or buildings around it. Usually it is due to human factors such as fire, explosion,
terrorism, chemical leakage and other.
b. Regional disasters
This type of disaster has an impact or influence on a wide geographic area, and is
usually caused by natural factors, such as storms, floods, volcanic eruptions, tornadoes
and others.
2. Disaster Phases
According to Barbara Santamaria (1995), there are 3 phases in the occurrence of a disaster,
namely :

a. The preimpact phase is a warning phase, the initial stage of disaster. Information is
obtained from the satellite bodies and weather meteorologists. It should be in this
phase that all preparations are made both by Governments, institutions, and citizens
 b. Impact phase is the phase of the climax of disasters. This is the time when people are
as hard as trying to survive (survive). The impact phase continues until damage and
emergency assistance is performed.

c. The post impact phase is when the start of the emergency repair and recovery phase,
as well as the stage where society begins to return to normal community function. In
general, in this postimpact phase the victims will experience a level of psychological
response from rejection, anger, haggling, depression to acceptance

3. Evolution of views on disaster

a. Conventional View
Disasters are natural. Disaster occurrence: Accident (accident); unpredictable,
uncertain, inevitable and out of control. Communities are seen as 'victims' and
'beneficiaries' from outside parties.

b. Views of Natural Sciences

Disasters are elements of the physical environment that endanger human life.
Because of the extraordinary power of nature. Geophysical, geological and
hydrometeorological processes. It does not take humanity into account as a
cause of disaster.

c. View of Applied Science

The magnitude of the disaster depends on the amount of resilience or damage
caused by the disaster. Disaster assessment is aimed at increasing the
physical strength of building structures to minimize damage.
d. Progressive View
Regard disasters as part of 'normal' community development. Disasters are
problems that never stop. The central role of the community is to recognize the
disaster itself.
e. Social Science View
Focus on how the response and preparedness of the community faces danger.
Threats are natural, but disasters are not natural. The magnitude of the disaster
depends on differences in the level of community vulnerability.
f. Holistic View
Emphasizing the threats (threats) and vulnerabilities (vulnerability), as well as
the ability of people to deal with risk. Natural phenomena become a threat if
they threaten life and property. Threats will turn into disasters if they meet with
vulnerability.
4. Disaster Management paradigms
Disaster Management cycle: Viewing disaster as a series of events with a focus
on when, before and after a disaster.
Kue-marmer Model: Disaster management efforts can be carried out at any time,
each expanding or narrowing, depending on the risks faced.

THE ROLE OF COMMUNITY NURSING IN DISASTER MANAGEMENT

MANAGEMENT

Community nurses in community nursing care have a responsible role in helping to

cope with disaster threats both during the preimpact, impact / emergency, and post
impact stages.
The role of the nurse here can be said to be multiple; as part of the drafting of the
plan, educators, nursing providers part of the disaster incident assessment team.
The main objective: The purpose of community nursing care actions in this disaster
is to achieve the best possible level of health of the affected community.

1. The Role of Nurses

a. Role in Primary Prevention
There are several things nurses can do in this pre-disaster period, including :

1) Recognizing hazard threat instructions,

2) Identifying needs during the emergency phase (food, water, medicine,
clothing and blankets, and tents),
3) Practice first handling disaster victims, and
4) Coordinate various government agencies, environmental organizations, the
national red cross and social institutions in providing counseling and
simulation preparations for facing the threat of disaster to the community.
Health education is directed at :
a) Self-help business (in the community).
b) Family first aid training such as helping family members with
suspected bone fractures, bleeding, and first aid burns.
c) Provide several addresses and emergency telephone numbers such
as fire service, RS and ambulance.
d) Provide information about equipment that can be carried (eg clothing
as needed, portable radio, flashlight, battery).
e) Provide information on alternative places for shelter or disaster posts.

b. The Role of Nurses in Emergencies (Impact Phase)

Usually first aid for disaster victims is done right after the situation is stable.
After the disaster stabilized, each field of the survey team began to conduct a
rapid assessment of the damage, as well as nurses as part of the health team.
The nurse must conduct a quick assessment to decide on first aid measures.
There are times when a patient's "selection" for immediate treatment will be
more effective (Triage).

TRIASE:
1) Red - most important, top priority. life-threatening conditions most patients
experience hypoxia, shock, chest trauma, internal bleeding, head trauma
with loss of consciousness, burns degree I-II.
2) Yellow - important, second priority. The second priority includes injuries
with a systemic effect but has not fallen into a state of shock because in
this situation the patient actually still can last for 30-60 minutes. These
injuries include multiple bone fractures, open fractures, spinal cord injury,
laceration, second-degree burns.
3) Green - third priority. Included in this category are closed fractures, minor
burns, minor lacerations, contusions, abrasives, and dislocations.
4) Black - died. This is a disaster victim who could not survive the disaster,
was found dead.

c. The role of nurses in evacuation posts and disaster posts

1) Facilitating the schedule of medical consultations and daily health checks.
 2) Keep preparing the priority plans for daily nursing care.
3) Plan and facilitate the transfer of patients who need health care in the
hospital.
4) Evaluate daily health needs.
5) Check and regulate the supply of drugs, food, special baby food, health
equipment.
6) Assist in the handling and placement of patients with infectious diseases
and unstable psychiatric conditions that endanger themselves and their
environment in coordination with a psychiatric nurse.
7) Identifying psychological reactions that occur in the victim (anxiety,
depression that is indicated by frequent crying and isolating themselves)
and psychosomatic reactions (loss of appetite, insomnia, fatigue, nausea,
vomiting, and muscle weakness).
8) Helping psychiatric therapy victims, especially children, can be done by
modifying the environment for example with play therapy.
9) Facilitating counseling and other psychiatric therapy by psychologists and
psychiatrists.
10) Consult with local supervision regarding health checks and the needs of
people who are not displaced.

d. The role of the nurse in the postimpact phase

Disasters certainly give special marks to the physical, social and
psychological conditions of the victims. During the repair period nurses help
the community to return to normal life. Some diseases and physical
conditions may require a long period of time to return to normal even there
are circumstances where disability occurs.