Natural Disaster in a Small Community - HESI RN Case Studies

A small community hospital that serves a population of 1100 is roughly 20 years old, has 4 critical care beds and 2 operating room suites, 20 medical surgical beds and 8 labor and delivery rooms. The staff members in the emergency department are exchanging report during change of shift at 0645 when they are interrupted by a loud sound resembling a thunderclap. Within seconds the ground shakes slightly then the overhead lights get very bright just before the power goes out. The charge nurse passes out flash lights while one of the nurses announces that the phone lines are down. The nurse manager tells everyone to remain calm; the generator will turn on any minute. Everyone rushes to check on their clients. The manager receives a call that due to an explosion at the nearby chemical plant, the power grid for the area is damaged and the hospital's generator burned as a result of the power surge. The communication system is down, there is no running water, and there is no functioning sewage system. The hospital's oxygen tank is malfunctioning. The manager is notified that the people injured at the plant will be arriving shortly. The hospital is placed on internal and external disaster mode. The manager quickly asks who is leading the hospital's command center, the approximate number of injured people, and the identification of staff reassignments available to assist. The manager is told that 18 clients will arrive within a 45 minute window and that the explosion involved the following blistering agents: sulfur mustard, distilled mustard, and nitrogen mustard. - Answer- Due to the proximity to the chemical plant, the hospital has historically prepared for a potential disaster such as this. The disaster team is paged, anticipating multiple casualties resulting from this disaster. The proximity of the chemical plant leaves little time for the emergency department to prepare for what is arriving. The charge nurse is aware that the hospital has a disaster preparedness plan for such incidents. Which key components should the nurse expect to be included in the plan? (Select all that apply. One, some, or all responses may be correct.) a. Effective triage strategy for clients. b. Reminding staff that they are not going home. c. Client care, communication, and safety. d. Security, documentation, and resource allocation. e. Placing an order for additional supplies. - Answer- a. Effective triage strategy for clients. c. Client care, communication, and safety. d. Security, documentation, and resource allocation. The emergency department disaster preparedness plan must include detailed guidelines that explain how the hospital's plan collaborates with the community plans. The key components of the disaster plan include client care, communication, resources, safety or security, coordination, and documentation. - Answer- The new graduate nurse that just started orientation 6 weeks ago in the Emergency room. After receiving disaster training, which statement indicates that the new nurse needs additional disaster orientation? a. An internal disaster is anything that may cause an influx of clients disrupting the normal shift without notice. b. An external disaster is anything that endangers clients, staff, or requires evacuation or relocation with or without notice. c. An internal disaster is anything that doesn't impair the operations of the hospital but disrupts normal client care.