Pandemic in Your Jurisdiction
It is not a stretch to think of our country in a pandemic as we have been living in a pandemic with COVID-19. COVID-19 shut the country down and many people succumbed to its detrimental effects of it. In this case, this writer’s jurisdiction has been hit with cases of the flu. This occurred in my jurisdiction in Richmond, VA with the H1N1 in 2010. This H1N1 was a strain of the flu virus and did reach pandemic levels. By April 2010, over a quarter of Virginia’s population had been vaccinated against the H1N1. (VDH, n.d.)
This leads us to our current discussion on the availability of various agency resources, the effectiveness of resources, gaps in care, and the strengths and weaknesses of a community.
Availability of Resources
In a community disaster, one can expect the Centers for Disease Control, Department of Health, Salvation Army, American Red Cross, local fire, and EMS, local hospitals will be interdisciplinary resources that will come together. The CDC provides guidance on all emergencies. The Health Departments take their direction from the CDC and epidemiological findings. If the local health department could gather a medical reserve Corp of nurses that will vaccinate the public at various locations throughout the city. Vaccination clinics can be held in local nursing homes, at school gyms, and/or at the health department. The health department will be the source for the latest on flu vaccination status as they perform epidemiological research on the greatest concentrations of illness, and most vulnerable populations and put together clinics that are accessible for those who are homeless, students away from home, and medically impaired. Mobile vaccination units can be run by a group of medical reserve nurses with the local health department. A mobile unit is much more accessible to members who are street homeless and for the public that doesn’t have access to an automobile or any other sort of transportation.
Gaps in Care
Gaps in care for this population in Richmond, VA include a lack of transportation for members. Many people will state, “But there is Uber” to which we must be culturally sensitive to those populations that cannot afford an “Uber”, taxis, buses, etc. We have a high number of refugees who resettle around Richmond and its immediate localities. A question that has to be looked at is, do we have professional personnel that can provide language support, or is there a dedicated line that can be used on a mobile device? These underserved populations will have to be reached out to.
Strengths and Weaknesses of a Community
Communities from different places have different resources. Strengths of the community of Richmond, VA as discussed in this writing includes, public transportation, the Virginia Department of Health utilizing resources such as banners, flyers in the multiple languages of the community, emails, and television spots to get the information out to the public.
Primary prevention with the signage everywhere, and mass media, to name a few. (Stanhope and Lancaster, 2016.) Mass media outlets can roll information and vaccination updates via this means. Educating the public is essential and remains essential throughout.
Especially in times of a pandemic such as this instance, information should be streamlined and backed by at least one, if not a more reliable source, such as the local HD and the CDC.
A weakness may include mass shortages of hospital staff in every area of work, hospitals, schools, retail store owners, etc. The cost of a pandemic on the local economy can be devastating; stores will have to close from lack of staff. In pulling together a large medical reserve Corp of nurses, and companies, the state has to be willing to pay double time or critical pay to encourage nurses out of retirement, nurses to pick up extra work, in fact businesses owners can offer the flu vaccine for free, encourage volunteerism.
A pandemic can bring on a cascade of problems and issues for a city, county, state, or country. With the most current epidemiological facts, federal resources, the CDC, and local resources accurate and current information may be disseminated. Development of a professional group of medical reserve corps to respond to any disaster. Education remains vital before, during, and after a pandemic.
Stanhope, M & Lancaster, J (2016) Stanhope and Lancaster’s Public Health Nurses Population-Centered Health Care in the Community (10ed.)
Virginia Department of Health. More Than A Quarter of Virginians Vaccinated Against H1N1. 2010. https://www.vdh.virginia.gov/news/archived-news-releases/2010-press-releases/more-than-a-quarter-of-virginians-vaccinated-against-h1n1/
There are a few things that the administration can do to continue to run smoothly while influenza racks the community. One thing that would be cost effective to the hospital is to encourage the managers to work on their units if able to help with the staffing needs. Not just managers, but nurses not working on the floor, like abstractors, coordinators, and educators. This will encourage others to pick up and boost the moral on the unit. It also helps to ensure that patients receive the best care they can by reducing nurse to patient ratio. My second recommendation would be to allow nurses from other units that are empty or need to be called off due to lower work levels in their area, to help on areas that are short staffed. This would be a challenge if the nurse is not familiar with caring for that type of patient, but they could be helpful regardless. They could be sent to perform tasks they are comfortable with, like stocking areas, isolation gear, answering call lights, passing medications and tasking for the nurses.
Some of the resources available in my community during a disaster are Disaster 911 (Disaster Response, 2022) the American Red Cross, Emergency Prescription Assistance Program (EPAP), and the Salvation Army (Find Help, 2022). Some agencies in the area available to lead and assist in response to a disaster would be the local fire department and paramedics in the community. Also, the fire departments and paramedics in the surround areas and volunteers. The police department, public health department and hospitals are also available to assist the community during a disaster.
It would be most efficient to determine those that need assistance and disperse it based off the needs in the community. I believe it would be difficult to determine what assistance is needed and where. I believe it would be beneficial to send out information to those that could use the assistance as well, so they know what they need to apply for or ask for help with. It would also be helpful to put someone in charge of each aspect of the disaster response to ensure that everything is taken care of.
Disaster Response. (2022). https://www.disaster911.net/ne/kearney/Links to an external site.
Find Help. (2022). Disaster Response. https://www.findhelp.org/care/disaster-response–kearney-ne
A solution for the grocery stores and pharmacies in the area with a high rate of flu would be to start an online grocery and medication service where consumers can pay online, and groceries can be no contact delivery, or no contact pick up. This is an appealing option to avoid contact with potentially sick or exposed people. Employees would certainly need to mask up and the stores should require consumers to mask up as well. The managers of the stores that are running low on supplies could reach out to their regional/corporate headquarters to request assistance with staffing and stocking of shelves along with delivery drivers. The stores should be cleaned and disinfected frequently, especially high touch areas like doors and carts. Sanitizer should be made available throughout the store.
As a PHN in the Health Department with a sudden jump in positive cases, it’s obvious that quick intervention is needed to stop/slow the spread. Education would need to be put out on a widespread basis regarding vaccinations, masking, and isolation when demonstrating flu like symptoms. All public health nurses, such as school nurses, should be providing education and assessment at their schools. Education should be provided to the community regarding disinfection of business/schools/high traffic areas to prevent further spread due to contact. Vaccination is key and can limit the severity of the course of the illness.
It truly takes a community to combat illness that is taking over the community. Stanhope and Lancaster (2020) stress that it to be as prepared as possible all levels of the community must be on the same page including hospitals, EMS personnel, schools, health department, health care providers and businesses with evidence-based practices on how to stop the spread of an illness like the flu. The health department should take the lead with guidance from CDC in response to pandemic levels of illness. Unfortunately, certain gaps in care are not realized until the system is under strain from a pandemic. I feel as if the biggest barrier in my community would be having the budge to provide necessary items and education to the community. We are a small county, very poor and very rural. Many people tend to go to the ER for primary care as opposed to health departments or primary doctors. This is an issue because busy ER’s are not the best place for prevention as usually the illness has already arrived by the time a patient makes their way to an ER. Having a very strong primary care system in place would absolutely help this community. We are facing a shortage of providers which leads to turning down of new patients, appointments scheduled months out and patients having nowhere to turn except the ER for care. I hope to be part of the solution by becoming an FNP in my community that can provide not only PCP services but urgent care services as well.