NUR 306 Module 6 Disaster Preparedness Short Paper Example

When the Ferry Stops: Disaster Preparedness for a Nor'easter in a Harbor Town and Its Island

[Student Name]

Southern New Hampshire University

NUR 306: Nursing in the Community

Module Six Short Paper

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

When the Ferry Stops: Disaster Preparedness for a Nor'easter in a Harbor Town and Its Island

Coastal towns in Maine live with winter storms, and most of them pass with downed limbs and a day without power. A nor'easter that arrives with a high tide can be different: storm surge floods wharf roads, boats break their moorings, power fails for days and ferries stop running. This paper analyzes that kind of storm for Pell Harbor, a composite lobstering town, and for Tern Island, a composite island community of about 180 year-round residents reached by a 25-minute ferry. It argues that the greatest health risks in this disaster come not from the storm itself but from isolation and loss of power among older island residents, and that a community nurse's most valuable work happens in the days before the storm arrives. All places, people and figures in the scenario are composites.

The Scenario

Forecasters warn three days ahead of a nor'easter with hurricane-force gusts and a surge of two to three feet at the evening high tide. The storm is expected to last two days. Power lines on the island run on poles along the one shore road, and the island has no hospital, only a volunteer rescue squad with an ambulance boat that cannot run in high seas. The ferry company announces it will suspend service for at least 48 hours. On the mainland, the wharf road and the cooperative's buildings sit in the flood zone, and the regional hospital is 35 minutes away by road.

Who Is Most at Risk

About half of Tern Island's year-round residents are over 65, and several live alone. Aldrich and Benson (2008) note that about 80% of older adults have at least one chronic condition that makes them more vulnerable than healthy people during a disaster, and that physical, sensory and cognitive changes add to those needs. On the island, those needs include medications that could run out if the ferry stays down, oxygen concentrators and other equipment that stop working when power fails, and mobility limits that make evacuation or even walking to a neighbor's house difficult in a storm.

Through the emPOWER program, federal officials share de-identified counts with local and state health authorities on how many Medicare beneficiaries in an area depend on electricity-dependent medical equipment, so that planners can anticipate needs before power fails (Administration for Strategic Preparedness and Response, n.d.). For a place as small as Tern Island, the numbers are small, but knowing that several residents use home oxygen changes the plan. On the mainland, the highest risks fall on fishing families who try to save boats and gear during the surge, and on households that run generators in closed spaces during the outage, which is a common cause of carbon monoxide poisoning after storms.

Preparedness: The Days Before

Preparedness is where the nurse can do the most. Working with the town's emergency management director, the island's volunteer rescue squad and the health center, the nurse would first use emPOWER data and the health center's own lists to identify residents who use power-dependent equipment or who need regular care, and then call or visit each one. Those calls cover three questions: whether the person has at least a week of medications, whether they have backup power or a plan to go somewhere that does, and who will check on them during the storm. Pharmacies can be asked to allow early refills. Residents on home oxygen are reminded to call their supplier for extra tanks before the ferry stops. The nurse also helps the town set up a warming shelter at the island's community hall, which has a generator, and posts carbon monoxide warnings about generator use on the town's social media page and at the store.

Response: During the Storm

During the storm, the nurse's role shifts to shelter care and communication. At the community hall, the nurse screens arriving residents for medical needs, helps set up a quiet area for people with dementia or anxiety, keeps a simple log of medications brought in and identifies anyone whose condition requires evacuation once the seas allow. Communication with the mainland runs through the rescue squad's radio and cell service when it works. On the mainland, the nurse supports the emergency operations center by tracking which vulnerable residents have been reached and by relaying messages about power restoration and shelter locations. Veenema et al. (2016) argue that nurses are the largest part of the health workforce and must be prepared to lead in disaster response, not only to follow orders; a small town's nurse may be the only clinician present when roads and ferries close.

Recovery: The Weeks After

Recovery begins when the ferry returns. The nurse conducts wellness checks on residents who stayed home, arranges medication refills and follow-up for anyone whose chronic condition worsened, and watches for delayed problems such as injuries from cleanup, falls on icy debris and carbon monoxide exposure from generators left running. On the mainland, fishing families may have lost boats or traps worth a season's income, and the stress of that loss can surface weeks later as sleep problems, drinking or depression. The nurse can connect families with disaster assistance, the cooperative's relief fund and mental health services, and can ask the health center to screen for distress at routine visits during the following months.

Gaps to Close Before the Next Storm

The analysis points to three gaps. First, the island needs a standing list of residents who depend on power or regular care, updated each fall with their consent, instead of a list built in a hurry after the forecast. Second, the community hall's generator and supplies should be tested before winter, and a nurse or trained volunteer should be identified in advance to staff the shelter. Third, the town's emergency plan should name the community health nurse's role explicitly, including the authority to request evacuation for residents whose needs exceed what the island can provide. Aldrich and Benson (2008) recommend exactly this kind of coalition between public health, emergency management and services for older adults.

Conclusion

A nor'easter that stops the ferry turns a small island into a place without outside help for two days or more. The people most at risk are older residents who depend on medications, power and neighbors, and the most effective nursing work happens before the first gust: calls, lists, refills, backup plans and a shelter ready to open. The same preparation will serve the town in the next storm, whatever form it takes.

References

Administration for Strategic Preparedness and Response. (n.d.). HHS emPOWER program. U.S. Department of Health and Human Services. https://empowerprogram.hhs.gov/

Aldrich, N., & Benson, W. F. (2008). Disaster preparedness and the chronic disease needs of vulnerable older adults. Preventing Chronic Disease, 5(1), Article A27. http://www.cdc.gov/pcd/issues/2008/jan/07_0135.htm

Veenema, T. G., Griffin, A., Gable, A. R., MacIntyre, L., Simons, R. N., Couig, M. P., Walsh, J. J., Lavin, R. P., Dobalian, A., & Larson, E. (2016). Nurses as leaders in disaster preparedness and response: A call to action. Journal of Nursing Scholarship, 48(2), 187-200. https://doi.org/10.1111/jnu.12198