When Disaster Strikes: Lessons in Nursing Preparedness and Recovery

In this episode of Nursing EDge Unscripted, Dr. Kellie Bryant is joined by disaster nursing experts Dr. Tara Heagele and Dr. Jamla Rizek to discuss how nurse educators can better prepare students for disasters, emergencies, and disruptions. They emphasize that disaster nursing is a professional responsibility for every nurse and that preparedness requires more than classroom instruction, including experiential learning, simulation, drills, and interprofessional collaboration. The guests offer practical strategies for integrating disaster nursing competencies throughout the existing curriculum, including clinical judgment, leadership, triage, incident command, ethical decision-making, and psychological first aid. They also stress the importance of recognizing that disasters do not affect all communities equally and preparing nurses to identify and address barriers related to social determinants of health, disability, transportation, language, and other sources of vulnerability. The episode concludes with a call for nurse educators to use the NLN's disaster and emergency preparedness resources and to make disaster readiness an integral part of nursing education and professional identity. 

Learn more about disaster preparedness:

NLN Vision Statement: Disaster Mitigation, Preparedness, Response, and Recovery available at https://www.nln.org/docs/default-source/default-document-library/nln-disaster-vision-statement.pdf?sfvrsn=6715683d_1.

Rizek J. (2025). Disaster Nursing for Early Career Emergency Nurses. Journal of emergency nursing, 51(4), 537–547. https://doi.org/10.1016/j.jen.2025.03.020

Morante, Pedro E., "Recovering After Disaster: Practical Strategies for Responder Well-Being" (2026). General Webinars. 95. https://www.sigmarepository.org/general_webinars/95

Dedicated to excellence in nursing, the National League for Nursing is the leading organization for nurse faculty and leaders in nursing education. Find past episodes of the NLN Nursing EDge podcast online. Get instant updates by following the NLN on LinkedIn, Facebook, Instagram, Bluesky, and YouTube. For more information, visit NLN.org.

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Welcome to another episode of the Nursing EDge Unscripted. Today we are exploring resilience, recovery, and how nurse educators prepare our future nurses on how to respond to disruption. And especially timely conversation as we look ahead to our NLN summit which is going to be focused on disaster preparedness, emergency preparedness and our theme is beyond the storm reshaping resilience and recovery. I am joined here by two experts in this area. We have Dr. Tara Heagele who is an associate professor at Hunter Belleview School of Nursing and we also have Dr. Jamla Rizek who is a international speaker on the topic of global health and disaster nursing. So I want to say thank you both for being here with me today and I can't wait to talk about this very important topic. Thank you for having us. So we're going to dive right in. I'd like to know a little bit just about you and how you got into this field. So what led you to become involved in disaster and emergency preparedness? Well, I guess I'll go start first. You know, I am a child of immigrants and so I started out my career going back and home back and forth from the states to overseas and you know, there really was a gap in regard to how patients get access to care. And so disaster nursing wasn't really something that I went out to specialize in. It kind of just came organically. You know, I was an emergency nurse and I found that my experiences in regard to disasters were really just an extension of what nurses were doing every day. And so for me it was seeing how drastically and dramatically those changes grow as far as like the disparities in responding to disasters when you know what we rely on really is doesn't exist anymore. And so that really started to shift my mentality from you know how do we respond to this emergency to you know how do we prepare nurses for the emergency happening. And I think that's what shaped a lot of my career and how I got into this because I really don't think we should be introducing nurses to disaster nursing for the first time when that disaster is actually happening. Very good point. Tara, tell us your story. How did you get into this field? Yes, absolutely. So, as a child who grew up in a city next to the ocean in New Jersey, I lived through a bunch of extreme weather events. And then when I was 16 years old, I actually became an emergency medical technician. And at that point, pretty young, I became a disaster responder. And since, I want to say 1999 now, I have either worked or volunteered during every major weather event in New Jersey, either as an EMT or as a nurse. And I frequently observed preparedness gaps in our community members which resulted in preventable patient surges to our emergency medical services and for our hospitals to handle. And so that is what really motivated me to become a disaster nurse researcher and a disaster nurse educator. Excellent. I'm trying to go back and think about when I was in nursing school and I don't remember any content about disasters emergency preparedness and then skip to 2020 all of a sudden you know we all had to you know step in and do our part when COVID hit. So my question my next question is how prepared do you think the nursing students are now that are graduating for disaster and emergency preparedness? Are we doing a better job because we did go through COVID 19 or there's still work to be done? Who'd like to take that one first? I can if you'd like. Yeah. So I want our students and our current nurses to understand that disaster nursing is not a specialty skill for a few nurses. It's really it's part of our professional nursing practice for every single nurse. That being said, many nurses and students do not feel adequately prepared to provide care during disasters due to kind of this inconsistent education and very limited experiential learning. And that all contributes to this low self-efficacy and uncertainty about their role in disasters. So the strengths that nurses have, we have skills with direct clinical skills. We will take care of that patient that you put in front of us to the best of our abilities and we'll seek assistance when needed. But we're less confident with disaster nursing leadership roles and with injuries and illnesses that we do not routinely see. Right? And all of this lack of confidence actually has been shown to affect nurses willingness to report to work during disasters. And of course, all of this is understandable because disaster nursing competency really does require lifelong learning. You know, I couldn't have said it better myself. I think the one thing I do want to stress that Tara did mention was that preparedness piece. And I think one of the biggest failures is assuming that preparedness on paper equals preparedness in practice. And so we saw this during co as you mentioned but I think that the more that we practice what we are preparing for I think that's going to help us be prepared for the next pandemic the next big large scale incident because while I am a very optimistic person it is not a matter of if it happens it's a matter of when and what can we do better for the next time. Mhm. Very good point. And Tara, you mentioned a very important key word, competencies. So, what competencies do you think that the nursing student whether it's a pre-licensure or in student NP student, what competencies should they be graduating with so that they can be better prepared for disaster preparedness? We as nurse educators really need to progressively build clinical judgment, leadership, communication, teamwork, and ethical decision-m skills while also instilling confidence. And that has to be done throughout the curriculum. We should not simply teach a single disaster nursing lecture in a public health course, right? So really before graduation it's my dream that students are going to demonstrate competence with personal and family preparedness and community hazard and vulnerability recognition. Nursing roles related to all phases of the disaster which is mitigation preparedness response and recovery. I would like the students to have risk communication skills. Of course we need to teach them the triage. I think that one's pretty routinely included in our curriculum. What about incident command system awareness though? We want them to be able to work on a team. We need to give them opportunities to kind of learn about ethical scarce resource decision making and of course how to adapt when our normal systems fail. Very good point. That is a good point. And something else that you mentioned. In regard to incident command, I think that's really important because as nurses sometimes we are isolated from a lot of preparedness and planning and so in part of that incident command structure nurses should be intimately involved with that HVA that hazard vulnerability assessment that you mentioned Tara. I think that during a disaster it shouldn't be the first time that people have to work with different partners. You know interoperability should be included and practiced right from the beginning. So I completely agree with you and as a simulationist of course I'm going to say well simulation is the best place to practice these skills but do you have other recommendations on how faculty can build this into curriculum where they actually are not just learning about it from a didactic standpoint but actually being able to maybe practice some of these skills. I do have recommendation. Shall we take this one Jamla? Absolutely. Okay. So we definitely nursing faculty need to integrate not add right because we already have a very crowded curriculum like we said. So the way you do that is curriculum mapping first find your natural course connections and then scaffold disaster knowledge and skills across the program. Let me give you some examples of what I'm talking about. So in the fundamentals class we're going to teach disaster nursing foundational concepts. So emphasizing disaster nursing is an essential component of professional nursing practice. We're going to emphasize that disaster readiness is a core responsibility of every nurse regardless of their role or practice setting. We want to introduce the American Nurses Association's Code of Ethics for Nurses, the scope and standards of practice, healthcare accreditation and emergency preparedness standards and the International Council of Nurses Core Competencies in Disaster Nursing as the foundational frameworks that support this professional practice. Moving on to the curriculum, you go to med surge, right? Let's teach triage and how to manage a surge in patients. In pharmacology, let's talk about mass prophylaxis and vaccinations. Let's talk about antidotes in nutrition. Teach about non-perishable ready to eat food options that should be in every home disaster supply kit or even patients who have to miss a dialysis treatment due to disaster conditions in the community. How they can alter their diet to slow that toxin buildup until they can get in for treatment. In community health, we can teach nurse-led preparedness interventions for our community members. we can illustrate that disaster related morbidity and mortality risk is not the same for all community members in leadership. That's when we can bring in our incident command system. We can also introduce them to the hospital-based emergency operations center. I'll give you one more example in psych teach about psych first aid or disaster related mental health morbidity which actually is far larger than physical illnesses and injuries and disasters. So, how do we assess patients for mental health issues and how do we refer them? And I would I would also encourage you to use disasters that have happened locally as your case studies in your classes. So, that makes it more real for the students. And fortunately, I've got some great news for you. The NLN has a toolkit that provides a very thorough roadmap to help you integrate disaster nursing content into every undergraduate class and into the core courses of graduate nursing education. So, I want to put a plug in. We will add not only is there a toolkit, we have a vision statement that was released a couple months ago. So, we're going to put a link to that and then a toolkit will be coming soon. So, stay tuned. And thank you Tara for giving us those strategic you know steps that we can take as faculty. That was very thorough. So you already have your curriculum right there. So, thank you for that. Jamla, you have anything you want to add? You know, I completely understand and I agree with Tara that, you know, there isn't more that you can cram in, right? The curriculum is already crowded. And so, you know, my answer isn't going to be the opposite of Tara where we need to create another three credit course, right? And she perfectly outlined how we can integrate disaster concepts into what's already being taught. So, it's not like it's going to take a lot of effort to change things. It's really just incorporating what faculty is already doing. And you know, she mentioned one and just excuse me, she mentioned multiple examples throughout the courses, the curriculum for nurses. And I think that's what faculty should take advantage of. You know, not only use that toolkit, but listen to what she said. And I think one thing I will stress is the psychological first aid, not just for our patients that we're caring for, but also for ourselves. You know, this is something Yeah. This is something that I don't think that we teach in nursing schools. And not even a good job of teaching it or even talking about it when those nurses actually, you know, get to the field or or get to their place of where they're working and then they have that ethical issue that now we see nurses as you mentioned are burnt out. So, I think this is absolutely important to include that. It has to include us as well as responders and as nurses. So that would be the only other thing that I would add to that is that psychological first aid and that mental health first aid for nurses. So I have another question. What advice or tips do you have for faculty who say I agree with everything you said. I know this is an important topic and I want to embed it in the curriculum but I don't have the expertise and nobody on our faculty has the expertise. So what do you do in those situations where you want to deliver that content but you don't have someone who's skilled in that area? What advice would you have for them? I think one of the challenges and I really appreciate this question is one of the challenges that I see is that we are reaching out to individuals who perhaps may not have that experience. And so what they're doing is they're putting their own information in. And sometimes that's actually not helpful. And so I will say within the nursing community, it's really not hard to find individuals that are passionate, who have had boots on the ground, that are willing to volunteer and give their time to offer their subject matter expertise. So I will personally advocate for individuals to reach out to myself if you need help finding other individuals. I think that the more we work together and less in silos, you know, faculty don't have to look far, you know, far and wide to find somebody. We're literally neighbors. We're working next door to each other. we just don't take the time to know each other and what our expertise is. Yes, and I agree with Jamla and I've got a few things to add. In the toolkit that will be available, there's also many free online classes for nurses to take or nursing faculty I should say to help improve their knowledge, their skills. And then they need to push themselves out of their comfort zones and participate in a disaster drill. Become a local responder. A lot of colleges close due to weather events. What are these professors doing? Go volunteer for one of the local disaster response agencies, provide nursing care in the storm shelter, and get that real life experience. Nothing like firsthand experience. So speaking of experience, would you mind sharing a story where you have participated in disaster emergency preparedness and particularly if you brought any students along? What was that experience like? I this is quite challenging for me because I don't know where to I don't know how to just give you one answer. I will just say that I have spent over 20 years in healthcare and disaster response and I have seen students volunteer for some of the events. I have just 25 stories that I actually published in a book of mine, Disaster Diaries, Stories and Reflections from the Field. These are just 25 stories that have impacted me as a result of patients that have gotten encountered with. But I will say one in particular was when Hurricane Sandy hit Long Island. They had nursing students come down and they were not used to, you know, sleeping in a shelter in a tent that was outside. It was also freezing. You know, there are pictures on some of my social media accounts from back then from what I brought to what they brought. And it's really just to highlight how you're not going to be in a hotel and being able to have your three, four suitcases and go out for food. And I think it was a very eye opening opportunity. So, Hurricane Sandy in Long Island, we had students there. And then also in Broom County, we had students that literally the schools were flooded, everything was flooded. And so what they did was they had students who were willing to help us with med reconciliations for patients or reposition patients. You know, kind of manual labor, but at the same time getting exposed to what it's like to work alongside a disaster responder. And I think that is eye opening and I think that echoes what Tara said in regard to, you know, we can't work in silos. People have to go ahead and put themselves out there. I also think that in preparation for this, I think having some tabletop exercises would be great, or some just in time training. I know those are in the toolkit, but I think also for students who are getting ready to go out the door, that's something that would behoove them to kind of get prepared for what to expect. Okay. And Tara, you had mentioned you've done a lot of work in this area. Was there any story in particular that stands out that really influenced the work that you that are you're currently doing or the research that you're doing? Oh, yeah. I mean loads. I'm trying to think of number one. All of my experiences related to rescuing or providing care to patients from my EMT and my nursing work has influenced my work and interest in this. I did have to evacuate an entire nursing home twice as an EMT as well as community members who were in a flood zone. I think number one for me though was actually Hurricane Katrina. I was a brand new nurse when that happened. I was not in New Orleans or Louisiana or anywhere near that area. I was living in New Jersey, but I had just graduated and I was watching all the news coverage about what was happening to the hospitals and the patients down in in New Orleans. And I was absolutely horrified and kept thinking to myself, I don't want this to ever be me. I don't want this to be my colleagues. I don't want this to be my patience. We need to learn from this. And I do think that in my mind, the whole country was also watching what happened there and learning lessons and drafting emergency operations plans and policies. And if we kind of fast forward to a more res more recent local disaster, Hurricane Sandy was back in 2012. It was a much, much larger storm and it hit in a much more densely populated area. But the level of casualties was far lower than what was what happened in Hurricane Katrina. So I saw that as a positive sign that we're moving in the right direction. We're putting resources in place. We are doing more work on preparedness. And I thought I took all of that as positive that we're learning lessons. Of course, I don't want to minimize any loss of life, but the to to compare the two disasters, I think that Hurricane Sandy the whole community fared much better. Mhm. Yeah. And you're making me think, you know, I always say, well, I'm not I don't really do a lot of work in disaster preparedness, but as you were telling your story about Super Storm Sandy, I forgot that during Superstorm Sandy, I was living in New York City and we turned that into a clinical experience for our students. We actually went into a high-rise building and provided care. And I remember climbing up those stairs and going to visit patient, I shouldn't say patients, they were residents that had real medical issues and they could not get to the hospital. And I still remember visiting families where, you know, they were providing caregiving to someone had cancer and she was so stressed and burnt out from being in this space and he's not able to get to his treatments and I could see the stress in her as a caregiver and just, you know, providing support to her and another person who I think was on a ventilator and was concerned about the power and it's just it opened my eyes to how important this topic was. So I got to experience that firsthand. So I have to give myself credit. I have done some work in this area. Absolutely. And it was the students, you know, and it's a great learning experience. Obviously, this is not something we want to occur, but the fact that we were able to take this, you know, tough situation, horrible situation and make it into a a very useful learning opportunity for the students, I think was invaluable. So, thank you for sharing those stories. And believe it or not, I mean, we can talk about this for hours and hours, but we are running out of time. But I do want to end on one last question. What is that one action, that one thing that nurse educators can take away or add to their nursing program that can strengthen their disaster preparedness, resilience and recovery and incorporate that into their curriculum. Yeah. So, I can take this one. I think the toolkit, the NLN toolkit that we've developed gives a very clear answer here. You've got to start with your curriculum mapping along with the International Council of Nurses disaster competencies. Figure out what you're already teaching in your program. Identify your gaps and then integrate the disaster nursing concepts and skills covering all four phases of the disaster cycle and make that disaster readiness part of the nursing identity. So step one after reading the toolkit of course is doing that curriculum mapping. And I just want to pause because we have mentioned the four stages. Do you mind just giving us a brief overview of those four stages disaster? I don't I don't mind or would you like to jamla? No, go ahead. Me? Okay. The four phases of the disaster cycle that nurses may not be aware of and they do have a part to play in each of them is first mitigation. That happens hopefully long before a disaster hits. And this is where we as nurses decrease risk to our community members by knowing about and sharing the resources that the community has with our patients like evacuation assistance and storm shelter locations priority utility restoration lists which is of course very important for our community members that have devices that rely on electricity. And the mitigation phase also includes health care facilities drafting their emergency operations plans, perhaps moving generators far above ground out of flood zones, planning for supply chain disruptions with either stockpiling or partnering with multiple vendors. The next stage is preparedness, and that's where we participate in training and education, taking classes on disaster nursing, participating in those disaster drills, and teaching our patients how they can be prepared. Response is where we do our regular thing, right? Triaging and taking care of our patients. And recovery is where we can help community members gain stability in their lives. Again, referring them to mental health practitioner if they've screened positive for mental health concerns, getting them connected to government partners for housing or rebuilding assistance, those kind of things. That's what nurses can do for recovery. Thank you. And what's your one takeaway, Jamla, that you can provide to nurse educators? I think that we need to move beyond simply saying and you know this is a vulnerability or this is a vulnerable community because we really need to start focusing on asking the question of what caused or created that vulnerability in the first place. So if we you know if there's an evacuation order but individuals don't have access to transportation it's not a failure of that person or that patient it's really the preparedness problem. So I know Tara went through the disaster life cycle but I think this is how we have to start reframing our mind. What is that vulnerability? She mentioned supply chain issues and she said you know we should partner with multiple vendors. That's absolutely important but we should also be including how we can evacuate individuals who perhaps have disabilities that are visible or invisible. The people that we don't necessarily always think of. And I think that's where we need to anticipate those barriers before the disaster actually happens. How should nursing programs prepare students for care of populations that may be disproportionately affected during disasters? You know, this has to be central to disaster education because disasters don't affect everyone equally. We've seen the disparities and the inequities throughout the disaster disasters that have happened. And so students really need to understand what happens to people who, as Tara mentioned, rely on electricity, for example, for medical equipment. people who rely on older adults who rely on their children or pregnant patients or people who are unhoused displaced populations people without transportation and of course people who don't speak English and we really have to move beyond as I mentioned calling people vulnerable we have to create the understanding that we have to understand what caused that vulnerability and so if emergency information is only being communicated in English you know we're creating another barrier and so preparedness really has to anticipate those barriers before that disaster occurs. And that's where that HVA or that hazard vulnerability assessment comes in. It's about knowing who's in the community. Are there individuals who take extra time due to some health issues? Those are the people that we need to be aware of, but then also community members need to support each other and find places where they can go if they had to evacuate. One thing we see a lot during disasters is when people have to evacuate to a shelter, but the shelter that is closest to them or where they're told they have to evacuate doesn't take animals, for example. And we see a lot of people unwilling to evacuate because they want to stay in their home with their pet and that is the only family that they have. So, these are some things that we absolutely need to think of when we're coming up with these plans. That's a good point because I don't think I could leave my animal. I'm one of those family. Family. Yeah. Yeah. The only thing I have to add to that is that yeah, start with start the lecture the conversation with disasters aren't equal and the social determinants will shape risk and recovery. And to mitigate the risks that these community members face, nurses really need to have that cultural humility and of course kind of think about disability inclusive disaster planning. And the best way to do this is to ask and listen, right? We want to hear the voices of our community members. is we want to hear their lived experiences and those voices, those lived experiences can inform our nurse-led disaster preparedness interventions. Very good point. On another note, I am happy to report that both of you are going to be presenters at our NLN Summit which is going to take place September 23rd to the 25th right here in Washington DC. So if you don't mind telling us a little bit about your presentation and when you're going to be presenting, I'll start with you Gemma. So, I'm excited to be presenting on Friday the 25th at 10:30. And the title is preparing nurses for the front line, a dialogue on disaster preparedness and response. And this is going to include real life stories and experiences. And so, there's going to be a lot of emphasis on how faculty can prepare students for that clinical readiness, that interprofessional collaboration, and then also understanding how nurses can contribute to resiliency and effective disaster management. So, I hope you will all take advantage of that presentation. Excellent. And Tara, tell us about your presentation. Yeah, I'll be presenting right after. Gemma, on September 25th, I'm going to be part of a panel presentation where we're going to discuss how to use the toolkit that I've mentioned quite a few times to ensure that disaster nursing education is integrated throughout undergraduate and graduate nursing education. So, we're going to give you guys some ideas for assignments, templates for the curriculum mapping, and loads of excellent free resources that you can start using immediately. All right, sounds like they have the opportunity to see both of our presentations. Y, there you go. And you will not want to miss both of them. So, if you're going to the summit, highly recommend, of course, with all our other wonderful presenters. But if you want to hear more about disaster preparedness, please make sure you attend Dr. Rizek and Dr. Heagele's presentation. But thank you for sharing. All right. So, unfortunately, this has come to an end. But the work does not end here. So, as we've discussed, please make sure you look at the NLN disaster and emergency preparedness toolkit and also the vision statement. I want to thank you again, Dr. Rizek and Dr. Heagele for providing all this guidance, tips, words of of wisdom for us nursing faculty on this very important topic that a lot of us, you know, I think have not really received enough in our nursing curriculum. So, thank you for sharing your information and your expertise. And for those of you watching, stay tuned for our next episode of the NLN Nursing EDge Unscripted. Thank you for being here with us today. We look forward to seeing you at the conference. Yes.