How Can I Prepare for Any Emergency Situation?

Disasters can strike without warning. They can be large-scale or confined. When disaster strikes, responding to the emergency and recovering from any crisis situation becomes a priority for CNAs and HHAs, when caring for individuals in their home, a nursing care facility, a long- or short-term care facility, a hospital, or any other facility healthcare assistants work.

What sort of disasters might you encounter?

The kind of disaster sometimes depends on where you live.  However, not all emergency situations are caused by the forces of nature.  Some are manmade, industrial, transportation, or health disasters, and include:

• Floods
• Earthquakes
• Fires and wildfires
• Road or rail accidents
• Aircraft disasters
• Structural collapses
• Epidemics
• Terrorist incidents
• Riots

You, as a healthcare professional, perform an important function during pandemics and other emergencies. And, with so much at stake, CNAs and HHA must learn as much as possible about preparing for and managing disasters before they happen.  Prompt, reliable, and clear communication is vital to healthcare facilities at all times—but it’s absolutely critical during an emergency. Do you know if the facility where you work has a backup communication system in place in case of a blackout?  Will the telephone or computers work? Will a generator kick on, providing you and your patients with light and heat?  These are all things to know before an emergency happens, so you’re not panicking if and when you’re caught in a disaster situation.

What Can I Do To Protect Myself?

Understandably, you’re first thoughts are for your patients. But realistically, if you’re not safe, either are your patients.  Take for instance an infectious emergency, where you, as well as your patients are in risk of being infected by a pathogen or other contagious disease.  Would you know how to protect yourself?  Would you know how to protect yourself from radiation or chemical contamination?  Where do you dispose of contaminated linens?  Hopefully you learned much of what you need to know while in school, but often…a lot of that knowledge goes out the door when you have to put what you learned to the test in an emergency situation.

• Plan ahead. If you work in a facility that periodically has drills, which mimic a emergency, you’ll receive the training you need to effectively do your job in even the worst of times.
• Find out if you are at risk of infection from any of your patients. If you’re not sure, ask nursing staff. If they are also uncertain, wear gloves or other protective clothing until you know for sure.
• Collaborate with all staff about the facilities emergency response plan, including clarifying who is in charge and who is responsible.
• Cooperate with all other departments to ensure you are able to respond quickly and effectively to your patient’s needs.
• According to this plan, find out which patient’s you are directly responsible for.
• Find a flashlight (if the lights are out) so you’re not groping around in the dark and tripping on things.
• Make sure there are staff members you can talk to or lean on when afraid or
• Visit each patient’s room to ensure they are comfortable and safe.
• Get a pencil and paper if the computers or your tablet isn’t working. You’ll need to document patients’ location, status, medical needs, etc.
• See if the phones are working, or try your cellphone to call home in case you are required to stay though another shift.
• Follow any guidelines provided by your employer for proper patient care during any disaster.
• Relax and breathe. Your patients won’t be relaxed and calm if you’re panicking.

What Can I Do To Protect My Patients?

As a healthcare worker, you’re foremost responsibly is to provide safe, compassionate, competent, and specific care to each of your patients, as much as circumstances allow.  Your role also involves reducing the loss of life by lessening the impact a disaster has on your patients.  For instance, how would you evacuate patients if required? Do you have access to medical equipment if needed? How will you handle multiple patients if many are injured at one time?

Although you may never encounter a disaster or emergency situation as a CNA or HHA, being prepared is crucial.  After all, there were more than 30 natural disasters in the US in 2015 alone.  Disasters like tornadoes that wiped out whole towns, or floods that swept away buildings and roadways.  Any situation can be frightening to your patients, especially since they, in some way, are dependent on you to care for their needs.  Many patients can’t just run out the door during a fire, but must be transported by you.

If you’re not prepared or if you’re not sure what to do, your patients will suffer.  Work with nurses and other staff to develop (if it’s not already written) emergency response guidelines so that your patients are protected from harm, and so that you can provide the best care possible in the best interests of your patients and your employer.

Other ways to protect and care for your patients, include:

• Understand and practice CPR – one of the most important skills to have when it comes to dealing with an emergency situation.
• Know how to administer oxygen. If your patient(s) are anxious, they may need a boost of oxygen to help them calm down and get their breathing back to normal.
• Know when and how to use an automated external defibrillator. Stress and anxiety can cause a heart attack in people with high blood pressure or hypertension, or other diseases.  Knowing how to use a defibrillator is vital to keeping them alive.
• Know how to use the Heimlich maneuver. Knowing how to use the Heimlich maneuver might not seem an important part of emergency preparedness, but if your patient is eating and disaster strikes, they may need you to keep them from choking.
• Take your patients vital signs.
• Talk to your patients and help them relax as much as possible to eliminate any further health risks.
• Make sure your patients are dressed and have their shoes on, and a coat if necessary.
• Calmly and efficiently move your patients if necessary, and assess any complaints or noticeable problems.
• Organize personal items and medical equipment so you can transfer patients easily.
• If you must transfer your patients, do your best to make sure they are tracked in the system, so that family and friends know their location and status.

HHA’s in the home should also take steps to prepare your patient and their family in case of an emergency.

• If your patient’s family doesn’t have an emergency plan, make one, so that everyone is on the same page and understands what to do.
• Keep a stockpile of emergency supplies on hand
• Make sure you have a list of all important contacts
• If you must transfer your patient out of their home, make sure you have planned specific meeting points to reunite with family.

Patients Medications

During an emergency, patients and staff are thinking about a million things all at once.  This doesn’t always include taking your patients medications into consideration. However, your patient’s health may depend on taking their meds, so making sure you know which medications your patients are taking, where they are kept, and if not already put in order, doing so, is imperative.

Some patients will have their medications in their rooms. This can be particularly true in assistive living facilities or in a client’s home.  Having your patients medications in one place, and making sure your patient, or you, can gather their medications easily is essential so they are not forgotten if they need to evacuate quickly.

Emergency Preparedness Training

If, by chance, your CNA or HHA coursework didn’t include emergency preparedness training, there are online courses, courses through your local Red Cross, and sometimes you’ll find courses offered at a community or business college. One such online course is offered through the International CPR Institute (ICPRI.com).  The American Heart Association also has a list of courses available to CNAs and HHAs.

I Feel Torn Between Being With My Family or With My Patients

As part of the CNA Code of Ethics, you are to ‘make your patient’s welfare and safety the first concern’.  However, it’s not uncommon that during times of emergency you are torn between being with your family, and taking care of your patients as part of your job.  No one can fault you for having these feelings, as CNAs and HHAs can find themselves feeling terribly conflicted, depending on their work environment, the nature of the emergency, concerns for their own health, and their family responsibilities.

While no one can make a decision for you, you must think about when or if you are willing to stay at work or go into work in the case of an emergency, and then talk with your employer and come to a mutual understanding well in anticipation of a crisis. Talk to your family too, and come to a shared agreement so there are no surprises if and when a disaster strikes.

No one can know if and when you’ll find yourself in an emergency situation.  Having emergency preparedness training, and understanding what to do will go a long way in saving the lives of your patients, staff, and you; your patients CNA or HHA.

References:

• International CPR Institute; Online CPR Training and Certification.
• American Heart Association; Find a Course; CPR and First Aid, emergency cardiovascular care.

Disabled World; Certified Nursing Assistant Code of Ethics Outline; Author: Disabled World; July, 2009.