Thesis (MHSc--Health Science) -- Auckland University of Technology, 2004. / Also held in print (153 leaves, 30 cm.) in Akoranga Theses Collection. (T 610.7349 ZIN)

Thesis (Ph. D.)--University of Tennessee, Knoxville, 2007. / Title from title page screen (viewed on Sept. 18, 2008). Thesis advisor: Mary Gunther. Vita. Includes bibliographical references.

Thesis (M. S. N.) --Florida State University, 2005. / Advisor: Deborah Frank, Florida State University, School of Nursing. Title and description from dissertation home page (viewed Feb. 6, 2006). Document formatted into pages; contains viii, 44 pages. Includes bibliographical references.

Text in Afrikaans / In hierdie studie is die noodsaaklike bestuursrol van die rampverpleegster tydens rampoptrede en direk daarna verken, nagevors en beskryf. Haar bevoegdheid om die verskillende rampbestuurstake effektief te kan verrig voor, tydens en na rampe wat buite 'n hospitaal plaasvind, is oak nagegaan. Bestuurstake is geidentifiseer waarmee verpleegsters tydens rampsituasies buite hospitale vertroud behoort te wees. Die navorsingsprojek het deur middel van vraelyste biografiese data ingesamel met betrekking tot die persone wat as rampverpleegsters by Burgerlike Beskerming in Pretoria geregistreer is, met die doel om 'n kursus aan te beveel wat pertinent op hul behoeftes gerig is. Die rampverpleegster se behoefte aan toepaslike verdere opleiding, inoefening of leiding betreffende die ge1dentifiseerde bestuurstake, is bepaal. Dit het geblyk dat opleiding in die meeste take nodig is, en 'n kursus in rampbestuur vir verpleegkundiges is ontwerp / In this study the essential management role of the disaster nurse during disaster action was outlined, researched and described. Her competency to effectively execute disaster relief tasks before, during and after a disaster occurring outside a hospital, was studied. Management tasks were identified which nurses should have mastered regarding disaster situations occurring outside hospital boundaries. Research data were gathered by means of a questiorinaire on the biographic detail of disaster nurses registered with · Civil Defence in Pretoria, in order to recommend a course specifically aimed at fulfilling their requirements. The research project identified requirements of the disaster nurse for appropriate further training, practise and guidance regarding the identified-management tasks. It became evident that training is required in most of the tasks, and a training course for nurses in disaster management was designed / Health Studies / M.A. (Verpleegkunde)

Text in Afrikaans / In hierdie studie is die noodsaaklike bestuursrol van die rampverpleegster tydens rampoptrede en direk daarna verken, nagevors en beskryf. Haar bevoegdheid om die verskillende rampbestuurstake effektief te kan verrig voor, tydens en na rampe wat buite 'n hospitaal plaasvind, is oak nagegaan. Bestuurstake is geidentifiseer waarmee verpleegsters tydens rampsituasies buite hospitale vertroud behoort te wees. Die navorsingsprojek het deur middel van vraelyste biografiese data ingesamel met betrekking tot die persone wat as rampverpleegsters by Burgerlike Beskerming in Pretoria geregistreer is, met die doel om 'n kursus aan te beveel wat pertinent op hul behoeftes gerig is. Die rampverpleegster se behoefte aan toepaslike verdere opleiding, inoefening of leiding betreffende die ge1dentifiseerde bestuurstake, is bepaal. Dit het geblyk dat opleiding in die meeste take nodig is, en 'n kursus in rampbestuur vir verpleegkundiges is ontwerp / In this study the essential management role of the disaster nurse during disaster action was outlined, researched and described. Her competency to effectively execute disaster relief tasks before, during and after a disaster occurring outside a hospital, was studied. Management tasks were identified which nurses should have mastered regarding disaster situations occurring outside hospital boundaries. Research data were gathered by means of a questiorinaire on the biographic detail of disaster nurses registered with · Civil Defence in Pretoria, in order to recommend a course specifically aimed at fulfilling their requirements. The research project identified requirements of the disaster nurse for appropriate further training, practise and guidance regarding the identified-management tasks. It became evident that training is required in most of the tasks, and a training course for nurses in disaster management was designed / Health Studies / M.A. (Verpleegkunde)

This study is about the nature of nurses' decision making related to volunteering to provide humanitarian aid in a major national disaster. Additionally, it is about the lived experience of nurses who volunteered in that disaster. It is a transcendental phenomenological study using the approach of Clarke Moustakas and the purpose of the study was to describe the experiences of the nurses, their reasons for volunteering, and the impact of their experience on their lives several years later.

Bakgrund: Katastrofer orsakar stor skada på samhällen och människor samt är svåra att förebygga helt. Trycket på sjukvården ökar markant till följd av katastrofer. Sjuksköterskorna är den professionen som blivit synonym med katastrofvård. Syfte: Syftet med litteraturstudien var att belysa sjuksköterskors upplevelser av att vårda i ett katastrofdrabbat område. Metod: Studien genomfördes som en allmän litteraturstudie med induktiv ansats. Underlaget blev åtta kvalitativa resultatartiklar som bearbetades genom en innehållsanalys. Resultat: Studiens resultat påvisade att vårda i en katastrofvar mer komplext och hade fler dimensioner än vården i en icke katastrofmiljö. Sjuksköterskorna upplevde påfrestningar i form av yttre faktorer som farliga miljöer, bristande resurser, utmattande arbetsförhållanden och kulturella skillnader. Sjuksköterskorna mötte moraliska dilemman och tvingades till ställningstaganden med direkt påverkan på egen och patientens hälsa. En ökad emotionell och fysisk belastning på sjuksköterskorna förekom under katastrofen Konklusion: Sjuksköterskornas upplevelser grundade sig i de yttre faktorerna som i sin tur skapade moraliska dilemman. De upplevelserna la grunden till de emotionella och fysiska påfrestningarna som sjuksköterskorna upplevde. Det finns behov av vidare forskning kring omvårdnad i katastrofer för att möjliggöra bättre förberedelser vilket skulle stärka sjuksköterskornas resiliens och därav öka kvalitén på vården. / Background: Disasters cause great damage to communities as well as people and arehard to entirely prevent. The amount of workload on healthcare is heavily increased as aresult of a disaster. The nursing profession has become synonymous with disaster care. Aim: The aim of this study was to illustrate nurses' experiences of caring in a disasterstricken area. Method: The method used in this study was a general literature study with an inductive approach. Eight qualitative articles became the basis of this study and these were processed through a content analysis. Result: The result in this study showedthat caring in a disaster was more complex and featured additional dimensions compared to that of a non disaster-stricken environment. The nurses experienced strains from external factors such as dangerous environments, lack of resources, exhausting working conditions and cultural differences. The nurses were caught in ethical dilemmas and were forced to make the hard choices which had a direct impact on theirown and the patients health. An increase in emotional and physical load on the nurseswas apparent throughout the disaster. Conclusion: The nurses' experiences were based on external factors which in turn created ethical dilemmas. These experiences lay the foundation for the emotional and physical strains on the nurses. There is a need forfurther research of disaster nursing to improve the preparations which would in turn strengthen the nurses resilience and thereby increase the quality of care.

Bakgrund: Antalet katastrofer i världen och Sverige ökar och därmed ökar även behovet av katastrofmedicinsk beredskap. Akutmottagningen utgör ofta den första kontakten med sjukvården och därför har akutsjuksköterskorna en mycket central roll vid en allvarlig händelse. Sjuksköterskor är den största arbetsstyrkan vid en katastrof och sjukvården är helt beroende av deras kompetens. Forskning visar att bristfällig omvårdnad, triagering eller oförmåga till att finna den kritiskt dåliga patienten i ett tidigt skede, ökar mortaliteten. Dock visar forskningen även att sjuksköterskor inte känner sig tillräckligt förberedda. Sjuksköterskor som har arbetat i samband med allvarliga händelser beskriver starka och motstridiga känslor. Utbildning, övning och tidigare erfarenheter inom katastrofmedicin har uppgetts förbättra sjuksköterskornas beredskap. Trots vetskapen om sjuksköterskornas nyckelroll är forskningen angående sjuksköterskors uppfattningar om den katastrofmedicinska beredskapen begränsad. Fler studier inom området vore av värde med tanke på att behovet av katastrofmedicinsk beredskap ökar. Syfte: Syftet var att beskriva sjuksköterskors uppfattningar om den katastrofmedicinska beredskapen på akutmottagningar i Storstockholm. Metod: Studien utfördes med en kvalitativ metod och en induktiv ansats. Tio semistrukturerade intervjuer med sjuksköterskor från fyra akutmottagningar inom Storstockholm utfördes. Intervjuerna analyserades med hjälp av innehållsanalys. Resultat: Fyra teman kunde urskiljas: ”oro för organisationens begränsningar”, ”behov av struktur”, ”erfarenhet och övning skapar trygghet i nya situationer” samt ”motstridiga känslor och tankar om copingstrategier”. Inom det första temat beskrev deltagarna en stark oro för att akutsjukvården redan är högt belastad och att detta skulle äventyra patientsäkerheten ännu mer vid en allvarlig händelse. I ”behov av struktur” beskrev sjuksköterskorna att de uppfattade sin roll som central vid allvarliga händelser och att de hade behov av en tydlig struktur. Tema nummer tre, ”erfarenhet och övning”, förklarade sjuksköterskornas önskan om mer övning och att erfarenhet gynnar dem i deras arbete. Motstridiga känslor såsom skräck blandad med nyfikenhet inför arbete vid en allvarlig händelse belystes i tema fyra, liksom arbetsgruppens viktiga, stöttande funktion. Slutsats: Den katastrofmedicinska beredskapen behöver förankras bättre i akutsjukvårdens hektiska vardag. Sjuksköterskornas uppfattning var att en allvarlig händelse skulle kunna orsaka ett kaos som fordrar starka copingstrategier. Behov av ett nytt, strukturerat arbetssätt uppdagades. Realistiska övningar skulle kunna kompensera för bristen på erfarenhet från allvarliga händelser. Ett strukturerat arbetssätt och en stark arbetsgrupp är måsten för att kunna upprätthålla patientsäkerheten vid en allvarlig händelse. / Background: As the number of disasters increases in the world the need for an adequate disaster preparedness develops. Registered nurses in emergency departments have a significant role since they often constitute the first encounter with the healthcare after a disaster. Healthcare is dependent on the nurses' ability to effectively respond to an event of disaster. Studies have shown that a deficient triage, nursing and inability to identify a critically ill patient increase patient mortality. However, previous research reveal that nurses don’t feel properly prepared. Registered nurses with experience from disaster response describe strong and conflicting emotions. Experience, education and disaster-related training have been shown to improve registered nurses’ self-reported disaster preparedness. Despite the fact that there is knowledge about registered nurses’ key role in disaster response, research is limited regarding their perceptions of disaster preparedness. Since the need for disaster preparedness increases, more studies within the area would be worthwhile. Aim: The aim was to describe registered nurses’ perceptions of disaster preparedness in emergency departments. Methods: A qualitative interview study was carried out and ten interviews with registered nurses from four emergency departments were performed. During the interviews a semi structured method was used. The interviews were analyzed through content analysis. Results: Four themes emerged: “concern for organizational insufficiency”, “need for structure”, “experience and training create a feeling of security in new situations” and “conflicting emotions and thoughts about coping strategies”. Within the first theme the participants described a strong concern for the already existing high pressure in emergency care and that this could jeopardize patient safety in an event of a disaster. The second theme illustrates the registered nurse’s perception of having a central role and their need for a clear structure while working in an event of disaster. “Experience and training”, theme three, is about the registered nurses’ wish for more disaster-related training and the importance of experience in their work. The thought of disaster response generated conflicting emotions, such as fear mixed with curiosity, was highlighted in theme four, as well as the importance of a supportive work group. Conclusion: The disaster preparedness needs to be better anchored in reality’s crowded care situation within the emergency care. Registered nurses believed a disaster would result in a chaotic work environment with the need for coping strategies. A new and structured way of working was seen as necessary. Realistic disaster-related training might compensate for the lack of experience. To be able to withhold patient safety during a disaster structure and stability within the workforce is essential.