October 12, 2001

Urbano leads Nursing School bioterrorism fight

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Terri Urbano

Urbano leads Nursing School bioterrorism fight

For at least two years, the Vanderbilt University School of Nursing has been touting nurses as one of the primary weapons in disaster response efforts.

As recently as March, the School held a national meeting of nursing leaders to develop a collaborative nursing group to discuss the need to include bioterrorism training and education in nursing curricula.

Those attending the meeting agreed that although nurses have not traditionally been on the front lines of disaster response, it is time to move forward. Efforts to secure funding for the program are paramount.

The International Nursing Coalition for Mass Casualty Education was formed. Its goal—to provide leadership for systematic development of policy related to nurse practice, education, regulation and research for mass casualty incidents.

Membership and interest in the coalition has been steady.

“The coalition was the vision of Colleen Conway-Welch, the dean of VUSN,” said Terri Urbano, Ph.D., RN, associate dean and director of the Coalition. “The federal government (Office of Emergency Preparedness) shared in identifying the need to provide nurses with education related to mass casualty, particularly that resulting from bioterrorism.

“The dean gathered leaders to discuss what steps need to be taken to create a curriculum and disseminate the information to all levels of nursing. We were in the process of developing grant proposals for funding various aspects of the program when the events of Sept. 11 occurred.

“That put us on the fast track and it appears that a lot of other agencies and organizations also became more interested in what we were doing,” she said. “Things are definitely moving along.”

There are about 2.7 million nurses in the country, with more than 40 percent outside of the hospital setting. Nurses are a pivotal part of the health care equation when dealing with unusual health care events.

“Nurses are working in all areas of the community,” said Urbano. “They need to be educated about the early diagnosis of symptoms that might result from bioterrorist agents. We are targeting nurses on the forefront. We want them to work closely with public health officials for community-wide disease surveillance.”

The coalition’s highest priorities are: increasing awareness of all nurses about mass casualty incidents (MCI); providing leadership to the nursing profession for the development of knowledge and expertise of MCI; establishing a clearinghouse of information and Web links for professional development of nurses about MCI; developing a strategic plan for the nursing coalition to address MCI; and influencing policy related to nursing practice, education and research about MCI at the government and institutional levels.

“We are the only nursing coalition focusing on mass casualty education,” Urbano said. “We are assuming a leadership role in the national nursing response to bioterrorism.”

Aiding the School is Dr. Robin Hemphill, assistant professor of Emergency Medicine at Vanderbilt.

“The School of Medicine has been proactive in its development of plans for mass casualty incidents,” Hemphill said. “Nurses are very critical to the plan. In the event of a bioterrorism event, the first place people go is typically to their own physicians.

“Nurse practitioners and nurses see these folks. There is a huge need for education so that they are able to recognize patterns of symptom development. They are the first line of health care professionals often able to make these assessments. Nurses will be the first to sound the alarm.”

Hemphill said interest in VUSN’s plans is mounting since the September attacks.

“VUSN has been on board long before there was any terrorist activity, long before there was actually something to do. It has taken a lot of dedication and effort, especially when no one at the time wanted to listen.

“Colleen has been motivated to make this happen. She has worked tirelessly and kept at it,” Hemphill said.

Conway-Welch will join Sen. Bill Frist next week in a roundtable discussion on Tennessee’s preparedness.

Urbano agreed that the terrorist activity in September alarmed many in the health care field about the need to be prepared and have heightened the coalition’s profile.

“We all realized that we are vulnerable to terrorist attacks,” Urbano said. “The uncertainty and lack of information have increased the level of anxiety felt by many. The important thing is to remember that the U.S. has public health surveillance and response plans in place. That training has already taken place for first responders, emergency response teams and governmental groups.

“What we are advocating is that the training be expanded by strengthening the public health infrastructure and educating all health care professionals.”