Ulster teaches nurses to keep cool in a disaster

The sinking of the Estonia passenger ship, the Kobe earthquake, the Manchester bombing, refugees in the former Yugoslavia, flooding in Bangladesh: the list of recent natural and man-made disasters makes grim reading.

But Ulster University is now heading a European project to develop high-level training for nurses to work in disaster areas worldwide.

Ulster is leading a core group, including universities and colleges in Sweden, Finland, Spain and the Republic of Ireland, which has won Pounds 55,000 under the Socrates masters programme to set up an MSc in disaster relief nursing. The core group will be backed in the two-year project by advice from other higher education institutions and relief agencies such as the British Red Cross, Medecins sans Frontieres and Concern Worldwide.

The project is the first response of its kind to the World Health Organisation's recent call for countries to improve preparations for emergencies, and improve their ability to respond to disasters. Pat Deeny, lecturer in nursing care in Ulster's school of health sciences, said current evidence showed nurses working for relief agencies largely learned on the job, and the course aimed to give them a better understanding of the issues involved.

"It will look at issues such as what kind of skills are needed in, say, an aircraft crash, such as resuscitation and pain relief. It will look at nursing in situations like war zones where staff have to assess the risks to their safety."

The two-year course, expected to be launched in session 1998/99, will also cover possible public health disasters such as the effects of toxic spillages, and issues such as infection control.

A pioneering element will be fieldwork in a disaster area for around four months, marking the partnership between the academic institutions and relief agencies.

"There will be a major practice focus, but they will be collecting data and doing research for their dissertation," said Mr Deeny.

"In a lot of publications on disasters, the nursing input isn't emphasised as much as it could be, and nurses' evaluation of their contribution has never been looked at seriously."

The course is aimed at nurses with at least four years' experience. Those who had worked in accident and emergency departments, in intensive care, or in hospital theatres would already be skilled in looking after patients who were critically ill, and in prioritising care, but were unlikely to have similar expertise in psycho-social care, Mr Deeny said.

"They may already be able to deal with a wide range of injuries, such as burns, broken bones and gunshot wounds, but most wouldn't be that well versed in how to deal with post-trauma stress, which was most of the work in the Estonia disaster, and is also a problem among refugees."

While the nurses might themselves be involved in counselling individuals, the main aim of the course was to train them to help develop local counselling systems, said Mr Deeny.

The students will also be trained to work in a team whose members are themselves coming under stress, and to cope with difficult decisions such as food rationing.