workforce
Mass casualty class
inclusion of mass casualty education in
undergraduate programs.
Nursing Review sat down with Currie
to learn more about the university’s mass
casualty exercises and how the skills
learned can be used in everyday practice.
How to prepare nurses for
pandemics, hospital fires
and global terrorism.
Jane Currie interviewed by Dallas Bastian
A
roof collapses at a party. A fire
breaks out in a hospital. A terrorist
sets off a bomb at a concert.
The number and severity of casualties may
be overwhelming, but the University of
Sydney is working to ensure nurses are as
prepared as possible to care for them.
Sydney Nursing School has been running
live simulations that cap off the First-Line
Interventions unit in the Bachelor of
Nursing (Advanced Studies).
In a study published in Nurse Education
in Practice, Jane Currie from the University
of Sydney and her co-authors said the
need for mass casualty incident education
is evident from the number and severity
of recent events in Australia and around
the globe.
“The increase in frequency and severity
of mass casualty incidents as a result of
extreme climate events, global terrorism,
pandemics and nuclear incidents has made
it important to prepare nurses with the
necessary skills and knowledge to manage
such incidents,” the authors said.
“Nurses are essential healthcare
workers during a mass casualty response,
but the performance of nurses at such
times relies heavily upon their training
and preparation.”
Despite this, Currie said there are
very few documented accounts of the
22 | nursingreview.com.au
NR: You say the need for mass casualty
incident education is evident from the
number and severity of recent events
in Australia and around the globe.
Is there now more need for this type of
training than ever before, and why is it
important that we dive into this now?
JC: It’s a very interesting question that
you ask. In the paper that we’ve published,
we do provide a definition of what we
mean by ‘mass casualty incident’. In the
media, we see that terrorist attacks in
densely populated areas are rising. In the
last 12 months there was the incident in
Manchester, several incidents that have
occurred in London, and of course in
Sydney we had our own incident involving
the Lindt café. Often these incidents
call for extraordinary resources, hence
the name ‘mass casualty incidents’.
They require extraordinary resources in
order to manage the number and severity
of casualties that result.
And what we’ve seen in education for
health professionals, in managing mass
casualty incidents, is that often this has
been the purview of health professionals
who are already qualified. So, a number
of courses are available, but we tend to
focus them on health professionals who
are qualified, and also often on health
professionals at work in specific areas,
such as the military or the emergency
department.
What we haven’t done yet, in Australia,
is have mass casualty management as a
core part of undergraduate training. And
there are a number of reasons for that, but
what we’re suggesting in this paper is that
it is a good idea to offer pre-registration
students – those health professionals,
nurses in this case, who aren’t yet
qualified – some rudimentary training in
management of a mass casualty incident.
Because although these incidents are
comparably rare, compared to lots of the
other illnesses and circumstances that we
educationally prepare our students for
once they’re qualified as registered nurses,
a lot of the skills that we can teach them in
managing a mass casualty have parallels
to the care they’ll provide in hospital
settings, even in the ward settings. Things
like prioritising which patients you care or
treat for first, based on the severity of their
injuries. Maybe using resources effectively,
those type of things.
The knowledge that the students learn in
an educational package focused on mass
casualty has lots of translational potential
into the more everyday roles that most
nurses will do.
What else should mass casualty
education home in on?
In the course that we developed at
Sydney Nursing School – and this course
runs as part of the Bachelor of Nursing
(Advanced Studies), which is a three-year,
pre-registration program – we looked at
the literature on how other universities and
other programs have run mass casualty
management training.
From that, we developed a course that
layers the complexity of managing a mass
casualty. We start with simple concepts
and layer up to more complex concepts,
so that we’ve underpinned the course
with Benner’s novice to expert theorem of
educational preparation. And within that,
we scaffold the learning, so that there’s
some theoretical learning scaffolded with
some practical activities that allow, then,
the student to embed and consolidate
their skills.