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

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.

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

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