Disaster Bus Preps Nursing Students for Crisis

Teaching critical thinking skills is a priority in education. Perhaps nowhere is that more necessary than with the nursing students in Cindy Parsons’ Community Health Nursing class.

“Disaster preparedness is a key competency for nurses,” said Parsons, who invited a disaster simulation bus to campus for her nursing students.

In groups of five, they were led by Veterans Affairs (VA) medical staff through a series of nine simulation traumas involving chemical exposure. They had to work as a team to assess the victims (mannequins), identify what care they’d need at the scene and where the victims would be sent for further care.

“Disaster preparedness is like any other skill — practice, practice, practice,” Parsons said. “We give them education in a number of courses and all of our clinical partners have policies on the role of students in disaster response, so the students have the theoretical knowledge and now we will help them learn to apply it.”

For Megan O’Brien ’17, one of the most challenging things was the change of mindset of prioritizing patients in a disaster.

“As nurses, we are taught to care for the sickest or most critical patient first, whereas in disasters, you want to care for the people who are more likely to make it before those who are in critical condition,” said O’Brien, of Stratham, NH.

The nursing students were taught to use the START adult triage model to prioritize patient care. The way of thinking in a crisis is often counterintuitive for nursing students.

“I was surprised that some patients fell into the ‘expectant’ category, meaning that they were not expected to survive, and the focus of their care should be palliative,” said Alia Huizinga-Wright ’17, of Grand Cayman, Cayman Islands. “I am so used to working in a hospital where all possible measures are taken to preserve life. However, when working in a crisis, difficult decisions have to be made so that as many people can be treated as possible.”

The simulation bus is run by the James A. Haley Veterans’ Hospital and Clinics. Janet Sprehe, program director of simulations, said it is one of the few facilities to have a simulation bus, which it received in 2015. She coordinates disaster trainings within the VA as well as to schools like UT, the University of South Florida and Concorde Career College.

“We want to spread knowledge so these students will know how to triage and treat victims in a crisis,” Sprehe said. “It’s like a mini-hospital on this bus.”

Should a disaster strike, the mannequins and training equipment could be unloaded and within an hour or two, the bus could be on the road providing real support. The 36-foot bus can drive through 4-feet of flood water, host surgeries, isolate patients with contagious diseases like Ebola and even facilitate CAT scans.

“Knowing that the bus is an actual disaster bus — that same physical bus can be sent out to respond to emergency situations — it is nice to be oriented to actual crisis equipment,” said Holly Johnson ’17 of Los Angeles.

Next semester Parsons said her students will participate with Hillsborough County in the countywide disaster drill that includes schools, hospitals and health care facilities, first responders and Emergency Management.

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