A video of a presentation by Dr Erin Smith during the Community Resilience Stream of the 2016 People in Disasters Conference. The presentation is titled, "A Qualitative Study of Paramedic Duty to Treat During Disaster Response".The abstract for this presentation reads as follows: Disasters place unprecedented demands on emergency medical services and test paramedic personal commitment to the health care profession. Despite this challenge, legal guidelines, professional codes of ethics and ambulance service management guidelines are largely silent on the issue of professional obligations during disasters. They provide little to no guidance on what is expected of paramedics or how they ought to approach their duty to treat in the face of risk. This research explores how paramedics view their duty to treat during disasters. Reasons that may limit or override such a duty are examined. Understanding these issues is important in enabling paramedics to make informed and defensible decisions during disasters. The authors employed qualitative methods to gather Australian paramedic perspectives. Participants' views were analysed and organised according to three emerging themes: the scope of individual paramedic obligations, the role and obligations of ambulance services, and the broader ethical context. Our findings suggest that paramedic decisions around duty to treat will largely depend on their individual perception of risk and competing obligations. A reciprocal obligation is expected of paramedic employers. Ambulance services need to provide their employees with the best current information about risks in order to assist paramedics in making defensible decisions in difficult circumstances. Education plays a key role in providing paramedics with an understanding and appreciation of fundamental professional obligations by focusing attention on both the medical and ethical challenges involved with disaster response. Finally, codes of ethics might be useful, but ultimately paramedic decisions around professional obligations will largely depend on their individual risk assessment, perception of risk, and personal value systems.
A video of a presentation by Jai Chung during the Staff and Patients Stream of the 2016 People in Disasters Conference. The presentation is titled, "A Systematic Review of Compassion Fatigue of Nurses During and After the Canterbury Earthquakes".The abstract for the presentation reads as follows: Limited research is currently available about compassion fatigue of health professionals during and after disasters in New Zealand. The purpose of this systematic literature review was to provide a comprehensive outline of existing research. National and international literature was compared and contrasted to determine the importance of recognising compassion fatigue during and after disasters. Health professionals responding to disasters have played an important role in saving lives. Especially, during and after the Canterbury earthquakes, many health professionals cared for the traumatized public of the region. When responding to and caring for many distressed people, health professionals - particularly nurses - may strongly empathise with people's pain, fear, and distress. Consequently, they can be affected both emotionally and physically. Nurses may experience intensive and extreme distress and trauma directly and indirectly. Physical exhaustion can arise quickly. Emotional exhaustion such as hopelessness and helplessness may lead to nurses losing the ability to nurture and care for people during disasters. This can lead to compassion fatigue. It is important to understand how health professionals, especially nurses, experience compassion fatigue in order to help them respond to disasters appropriately. International literature explains the importance of recognising compassion fatigue in nursing, and explores different coping mechanisms that assist nurses overcome or prevent this health problem. In contrast, New Zealand literature is limited to experiences of nurses' attitudes in responding to natural disasters. In light of this, this literature review will help to raise awareness about the importance of recognising and addressing symptoms of compassion fatigue in a profession such as nursing. Gaps within the research will also be identified along with recommendations for future research in this area, especially from a New Zealand perspective. Please note that due to a recording error the sound cuts out at 9 minutes.
A video of a presentation by Professor David Johnston during the fourth plenary of the 2016 People in Disasters Conference. Johnston is a Senior Scientist at GNS Science and Director of the Joint Centre for Disaster Research in the School of Psychology at Massey University. The presentation is titled, "Understanding Immediate Human Behaviour to the 2010-2011 Canterbury Earthquake Sequence, Implications for injury prevention and risk communication".The abstract for the presentation reads as follows: The 2010 and 2011 Canterbury earthquake sequences have given us a unique opportunity to better understand human behaviour during and immediately after an earthquake. On 4 September 2010, a magnitude 7.1 earthquake occurred near Darfield in the Canterbury region of New Zealand. There were no deaths, but several thousand people sustained injuries and sought medical assistance. Less than 6 months later, a magnitude 6.2 earthquake occurred under Christchurch City at 12:51 p.m. on 22 February 2011. A total of 182 people were killed in the first 24 hours and over 7,000 people injured overall. To reduce earthquake casualties in future events, it is important to understand how people behaved during and immediately after the shaking, and how their behaviour exposed them to risk of death or injury. Most previous studies have relied on an analysis of medical records and/or reflective interviews and questionnaire studies. In Canterbury we were able to combine a range of methods to explore earthquake shaking behaviours and the causes of injuries. In New Zealand, the Accident Compensation Corporation (a national health payment scheme run by the government) allowed researchers to access injury data from over 9,500 people from the Darfield (4 September 2010) and Christchurch (22 February 2011 ) earthquakes. The total injury burden was analysed for demography, context of injury, causes of injury, and injury type. From the injury data inferences into human behaviour were derived. We were able to classify the injury context as direct (immediate shaking of the primary earthquake or aftershocks causing unavoidable injuries), and secondary (cause of injury after shaking ceased). A second study examined people's immediate responses to earthquakes in Christchurch New Zealand and compared responses to the 2011 earthquake in Hitachi, Japan. A further study has developed a systematic process and coding scheme to analyse earthquake video footage of human behaviour during strong earthquake shaking. From these studies a number of recommendations for injury prevention and risk communication can be made. In general, improved building codes, strengthening buildings, and securing fittings will reduce future earthquake deaths and injuries. However, the high rate of injuries incurred from undertaking an inappropriate action (e.g. moving around) during or immediately after an earthquake suggests that further education is needed to promote appropriate actions during and after earthquakes. In New Zealand - as in US and worldwide - public education efforts such as the 'Shakeout' exercise are trying to address the behavioural aspects of injury prevention.
