Doctoral thesis

Australian civilian hospital nurses’ lived experience of an out-of-hospital environment following a disaster

Mass Gathering Health / Mass Gathering Medicine

Various publications and presentations relating to Mass Gathering and Major Event health

Disaster Health

Various publications and presentations relating to disaster health

15 October, 2012

Disaster health: An Australian nursing perspective


This presentation was delivered to delegates visiting the University of Canberra from the Naresuan University, Thailand. This presentation focused on what is known about the Australian disaster environment. In particular, this presentation highlighted the various disasters Australian nurses have participated in nationally and internationally. Additionally, various other factors that impact on a health professional to perform in a disaster was discussed, such as: education, willingess to assist in a disaster and role. Finally, future collaborative opportunities between the University of Canberra and Naresuan University were discussed.

Ranse J. (2012). Disaster health: An Australian nursing perspective; paper presented to delegates of the Mahidol University Thailand, University of Canberra, ACT, 15th October

11 October, 2012

Beyond a clinical role: nursing is disasters


This presentation highlighted the key findings of research that explored the role of nurses who participated in the Black Saturday and Victorian bushfires in February 2009. It was highlighted that the nurses’ role in providing health care during and/or following a disaster is more than a clinical care role. Nurses undertook roles including being a psychosocial supporter, a coordinator of care and resources, and problem solvers.

It was argued that this understanding regarding the role of nurses in disasters should be applied to the development of education programs, competencies and policies, with a particular focus on contextualising the education to the realities of possible disastrous scenarios that incorporates elements of coordination, problem solving and psychosocial care within a national framework. Additionally, this awareness education should be used to inform nurses about the realities of working in disaster environments.


Ranse J, Lenson S. (2012). Beyond a clinical role; paper presented at the 2nd Australian Capital Region Nursing and Midwifery Research Conference, Canberra, Australia, 11th October.

19 September, 2012

Minimum data set for mass gathering health research and evaluation: A discussion paper


This paper aims to commence international discussions regarding the need to have a standardised approach to the reporting of biomedical information from mass gatherings. In particular it focuses on the need to have consistency in the reporting of patient presentation rates, medical usage rates, referral to hospital rates and transport to hospital rates. Additionally, it highlights the need for the consistent use of a research and evaluation tool, such as a minimum data set. This paper provides an example of a minimum data set, as an opportunity to commence these international discussions.


ABSTRACT
This paper discusses the need for consistency in mass gathering data collection and biomedical reporting. Mass gatherings occur frequently throughout the world and having an understanding of the complexities of mass gatherings is important to inform health services about the possible required health resources. Factors within the environmental, psychosocial and biomedical domains influence the usage of health services at mass gatherings. The biomedical domain includes the categorisation of presenting injury or illness and rates such as patient presentation rate, transferred to hospital rate and referred to hospital rate. These rates provide insight into the usage of onsite health services, prehospital ambulance services and hospital emergency department services.

Within the literature these rates are reported in a manner that is varied, haphazard and author dependent. This paper proposes moving from an author dependent practice of collection and reporting of data. An expert consensus approach is proposed as a means of further developing mass gathering theory and moving beyond the current situation of reporting on individual case studies. To achieve this minimum data set with a data dictionary is proposed in an effort to generate conversation about a possible agreed minimum amount and type of information that should be consistently collected for research and evaluation at mass gatherings. Finally, this paper outlines future opportunities that will emerge from the consistent collection and reporting of mass gathering data, including the possibility for meta-analysis, comparison of events across societies and modelling of various rates to inform various health services.


Ranse J, Hutton A. (2012). Minimum data set for mass gathering health research and evaluation: A discussion paper. Prehospital and Disaster Medicine. 27(6):1-8. doi:10.1017/S1049023X12001288

17 September, 2012

Role of mental health nurses in disasters



This presentation provided an overview of the role of Australian nurses in disasters, both locally, nationally and internationally. In particular the focus of this presentation was on the mental health aspects of disasters - particularly from a population health perspective. Following the presentation, the group discussion focused on the role of mental health nurses in disasters.

Ranse J. (2012). Role of mental health nurses in disasters; presented to students of the University of Canberra – Postgraduate Mental Health Nursing, Canberra, ACT, 17th September.

11 September, 2012

Role of critical care nurses in disasters



I presented to a group of students undertaking postgraduate studies in Critical Care Nursing at the University of Canberra. My presentation focused on both the in-hospital and out-of-hospital role of critical care nurses, in disasters. The presentation was a superficial overview of a number of issues associated with the health effects of a disaster, and the role of nurses in these circumstances

This presentation covered topics such as: the nurse role, willingness to assist during a disaster, disaster triage concepts, education for nurses in disaster health and other topics of consideration for emergency and intensive care nurses.


Ranse J. (2012). Role of critical care nurses in disasters; presented to students of the University of Canberra – Postgraduate Critical Care Nursing, Canberra, ACT, 11th September.

04 September, 2012

In the wake of disaster: treating physical and mental injuries


This article was published in NursingReview. It highlights that nurses during the Black Saturday and Victorian Bushfire in 2009 undertook a variety of roles:
  • Minimal clinical care
  • Coordinator of care
  • Problem solver
  • Psychosocial support
In particular, this paper argues the need to think about which 'group' of nurses is most appropriate to assist in the response / recovery to a disaster. This article highlights that we commonly send emergency, intensive care  and/or peri-operative nurses to disasters; whereas, community, mental health, general practice and public health nurses should also be considered.


Ranse J. (2012). In the wake of disaster: treat physical and mental injuries. Nursing Review [Australian College of Nursing – newsletter publication]. September:

02 September, 2012

Beyond a clinical role: Nurses were psychosocial supporters, coordinators and problem solvers in the Black Saturday and Victorian bushfires in 2009


Aim: This research explores the roles of nurses that participated in the Black Saturday and Victorian bushfires in February 2009, including aspects that influence nurses’ roles, such as prior education, training and availability of resources.

Background: It is acknowledged that nurses play an important role in disaster response and recovery. However, our understanding of nurses’ roles is superficial and commonly based on descriptions of events in which specifics relating to the nurses’ roles are embedded within other topics or issues. Similarly, aspects that support nurses in the disaster environment, including previous experience, education and the provision of resources, are not well understood.


Method: Single, semi-structured telephone interviews were conducted with 11 volunteer nursing members of St John Ambulance Australia. These interviews were electronically recorded, transcribed verbatim and thematically analysed using a well-recognised human science approach.

Findings: The thematic analysis identified two broad themes: being prepared and having an expansive role. Participants indicated that they were educationally prepared and had adequate clinical experience. They outlined that they took many resources with them; however, they were used very little, as their role consisted of minimal clinical care. Additionally, nurses performed roles including a psychosocial supporter, a coordinator of care and resources, and problem solvers.

Conclusions: The nurses’ role in providing health care during and/or following a disaster is more than a clinical care role. This understanding should be applied to the development of education programs, competencies and policies, with a particular focus on contextualising the education to the realities of possible disastrous scenarios that incorporates elements of coordination, problem solving and psychosocial care within a national framework. Additionally, this awareness education should be used to inform nurses about the realities of working in disaster environments.


Ranse J, Lenson S. 2012. Beyond a clinical role: Nurses were psychosocial supporters, coordinators and problem solvers in the Black Saturday and Victorian bushfires in 2009. Australasian Emergency Nursing Journal. 15(3):156-163. doi:10.1016/j.aenj.2012.05.001

27 August, 2012

How to survive a mass gathering


I was interviewed for an article in Science Illustrated on 'how to survive a mass gathering'. Overall, the final article summarised our telephone conversation. In particular, it highlighted some key points to survive a mass gathering, such as the:
  • Early identification of 'safe' places within the event, such as first aid, police, and event officials,
  • Organisation of a meeting place with family and friends, if you become lost,
  • Ensure you have a list of your medications, previous medical and surgical history
  • Remain well hydrated in hot weather, and
  • Ensure you have adequate sun protection,
The article makes reference to surviving the effects of tear gas during a mass gathering - I did not make any comments related to tear gas as it has not been an element of Australian mass gatherings. 

03 July, 2012

Hermeneutic phenomenology: Australian civilian nurses' lived experience of assisting in disasters

This presentation was delivered as part of my PhD progress at the Flinders University, School of Nursing and Midwifery, Higher Degrees Research Week.




ABSTRACT
Australian civilian nurses actively participate in disasters, both nationally and internationally. This participation is understood primarily from anecdotal descriptions of single events. Additionally, our understanding stems from small volumes of Australian research pertaining to the nurses’ role, educational preparedness and willingness to assist in disasters. To date, an in-depth understanding of the experiences of Australian nurses’ who have participated in disasters remains superficial, relying on anecdotal descriptions.

This research aims to explore and interpret the lived experience of Australian civilian nurses (division 1) working in the out-of-hospital disaster environment. To achieve this, this research will use a hermeneutic phenomenological approach, employing a traditional snowballing purposive sampling technique and individual in-depth interviews as a means of data collection.

This presentation will provide an overview of phenomenology, focusing on hermeneutic phenomenology. This overview will include a historical account of the development of the phenomenological movement. Key philosophers and their contribution to the philosophical thinking that underpins phenomenology will be discussed, such as Husserl, Heidegger, Satre, Merleau-Ponty, Dilthey and Gadamer. Primarily, this presentation will highlight the suitability of hermeneutic phenomenology as an approach to address the research aim.

Ranse J. (2012). Hermeneutic phenomenology: exploring Australian nurses' lived experience of assisting in disasters; paper presented at the Flinders University, School of Nursing and Midwifery, Higher Degrees Research Week, Adelaide, South Australia, 3rd July.

30 June, 2012

Examining the roles nurses play in disasters


I was interviewed by Sue Goss from The Age regarding my nursing career and current nursing activities. This was published in the My Career section in a lift-out for the Royal College of Nursing, Australia – Melbourne Nursing and Health Expo.


Examining the roles nurses play in disasters. The Age. June 30 2012. p.6 of the My Career lift-out.

26 June, 2012

Invitation to share your experience of disasters for a PhD research project


Below is the 'invitation and information' that I used in the participant recruitment phase of my PhD. I used a purposive snowballing technique to recruit participants, and this ivitation was initially e-mailed to members and associates of the Flinders University, Disaster Research Centre.

Dear ............

I obtained your contact details through your affiliation with the Flinders University, Disaster Research Centre. I wonder if you could assist me in the recruitment of participants for my PhD research? To assist could you circulate this e-mail and the attached ‘invitation and information’ sheet to your colleagues and associates that may be interested in participating?

I wish to recruit nurses who:
• Primarily work as a clinician in a hospital,
• Have participated in the health response and/or recovery to a disaster, in the last five years,
• Responded with a civilian (non-military) organisation, association, group or health service, and
• Worked in the out-of-hospital environment during the disaster.

The attached document outlines additional information about the project such as an overview of the project, the project aim, what participation will involve, information about the researcher and research ethics relating to this project.

Please feel free to contact me if you have any questions or wish to participate.

Kind Regards,

Jamie

The document below was attached to the initial e-mail. It outlines information about the project such as an overview of the project, the project aim, what participation will involve, information about the researcher and research ethics relating to the project.

19 May, 2012

Understanding and identifying potential risks for participants at music festivals


This presentation provided an overview of the preliminary findings of a project that aimed to enhance our understanding of the nature of patient presentations of young people (aged between 18 and 25 years) at music festivals in Australia. This presentation focused on data from outdoor music festivals in four Australian States.


Hutton A*, Ranse J, Arbon P. (2012). Understanding and identifying potential risks for participants at music festivals; paper presented at the St John Ambulance Australia Member Convention, Sydney, New South Wales, Australia, 19th May.

13 February, 2012

Be prepared – thinking of your health during natural disasters



I published an article in The Conversation regarding the role of first responders during disasters. In particular, this article focused on the need for governemnt to support first responders, and the need for communities to prepare for thier health needs prior, during and following a disaster.


Ranse J. (2012) Be prepared - thinking of yoru health during natural disasters. The Conversation. https://theconversation.edu.au/be-prepared-thinking-of-your-health-during-natural-disasters-5160

22 January, 2012

"UC expert urges Australians to be ‘health prepared’ for disasters"

Photo from University of Canberra - Monitor Online by Michelle McAulay

In late January / early February I participated in a number of media interviews that focused on the need for members of the community to be 'health prepared' for disasters.

Print media appearances: 
Article above from the City News, 21st June 2012

Radio media appearances:
  • What you can do to be health prepared for a disaster; radio interview on 2CC Canberra weekend lifestyle program, 21st January
  • News headlines on the following stations (January / February): Radio National; ABC 891 Adelaide; ABC North and West SA (Port Pirie); ABC Riverland SA (Renmark); ABC South East SA (Mt Gambier); ABC West Coast SA (Port Lincoln); ABC 612 Brisbane; ABC Capricornia (Rockhampton); ABC Far North (Cairns); ABC Gold and Tweed Coasts (Gold Coast); ABC North Queensland (Townsville); ABC North West Qld (Mt Isa); ABC Southern Queensland (Toowoomba); ABC Sunshine and Cooloola Coasts (Sunshine Coast); ABC Tropical North (Mackay); ABC Western Queensland (Longreach); ABC Wide Bay (Bundaberg); 2CA (Canberra); 2CC (Canberra).
Media release:
We are used to preparing our homes and belongings for the threat of bushfires, storms and floods in the summer disaster season, but Australians need to be prepared to look after their own health in emergency, according to a University of Canberra disaster response expert.

Jamie Ranse, a health academic specialising in disasters, said in the wake of a major incident emergency services are stretched and medicines in short supply so residents should be ready to look after themselves.

“People often think about sentimental items they would collect if they were evacuated from their homes, such as photo albums and computers, but they often forget to think about items that support their health needs,” he said.

Mr Ranse said during the Queensland floods, Victorian and Canberra bushfires, people were relocated to evacuation centres where they remained for days or weeks.

“Whilst in these centres, a number of people required medications of some kind. However, during a disaster, medications become increasingly hard to access, and this is made even harder if people don't know what medications they take.”

Mr Ranse said there are a few simple steps people can take to be health prepared, including preparing a list of previous medical and surgical history, as well as a list and a supply of current medication.

“This list should be placed with other items you might take in an evacuation such as blankets and warm clothes. People should also have a basic understanding of first aid and have a small first aid kit in an accessible location.

“It’s also a good idea to get to know your neighbours as you may be able to help them prepare for a disaster, or provide assistance during a disaster.

“It is important that people are as self-sufficient as possible as emergency services are stretched beyond capacity, and they will not be able to respond in a timely matter to minor injuries or ailments.”

Key points to being health prepared:
  • Have a current list of medications, aliments and previous medical / surgical history. Keep this list with other items you might take in an evacuation, such as photo albums or computers
  • Keep a stocked first aid kit in your car
  • Learn first aid and know basic first aid principles such as how to control bleeding, how to open an airway and how to do CPR
  • Get to know your neighbours

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