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[ Recorded presentation ] Recorded presentation

Bioterrorism Preparedness: Procedural Heresy and The Nature of Uncertainty

Maria Gilson Sistrom, RN MSN, School of Nursing, Oregon Health Sciences University, 7764 SE 21st Av, Portland, OR 97202, 503 494-3869, sistromm@ohsu.edu

Public health nurses occupy a central role in bioterrorism preparedness. In most public health plans, PHNs administer smallpox vaccine, staff pharmaceutical dispensaries, engage in surveillance and outbreak investigations, and write or at least follow plans and procedures that detail myriad tiny actions associated with these activities. The Public Health Preparedness grants that pay for these activities require detailed written procedures for any possible emergency event. Indeed in nursing it is considered bad practice and even heresy to fail to follow written procedures, implying the same heresy for not having written procedures to begin with. PHNs rely on procedures to codify our work, train new nurses, and document appropriate actions. But what if detailed written procedures were exactly the wrong approach to take to be prepared for emergencies? The problem with written procedures and with over-specification in general is that procedures are directed at skills that can only be used in the circumstances imagined by the initial planning assumptions. The nature of bioterrorism, however, is one of uncertainty. The concept of Complex Adaptive Systems implies that planning and detailed written procedures are not particularly effective in preparing for uncertain events and should be kept to a minimum. Bioterrorism preparedness requires educated public health nursing judgment and action, not rote memorization of detailed procedures. The author, a public health nurse and casualty of bioterrorism preparedness planning will briefly explore other more effective and perhaps heretical approaches to preparing PHNs for their professional role in bioterrorism preparedness.

Learning Objectives:

Keywords: Education, Bioterrorism

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

[ Recorded presentation ] Recorded presentation

Be Prepared

The 132nd Annual Meeting (November 6-10, 2004) of APHA