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Hospitals have to protect patients and their visitors under any conditions. There are many ways to cope with difficulties and avoid negative outcomes in care organizations. Ethical decision-making and team-based leadership are methods that are frequently used in urgent situations and disasters. A flood is a natural disaster that is caused by extensive rainfall and the inability to predict water levels (Yusoff, Shafii, & Omar, 2017).
However, flooding events may not always result in a disaster if leaders and a team are able to take the necessary actions and manage risks properly (Tekin, Bayramoglu, Uzkeser, & Cakir, 2017). When a hospital with 70 dependent patients who suffer from depression, anxiety, and suicide risks experiences rising waters because of rainfall, a leader has to be ready to demonstrate effective, ethical decision-making and use team-based skills to deal with a flood and protect all patients and the staff.
Floods may be developed in a variety of ways, and leaders should react properly and stay alert. Each decision has to be properly weighted and be ethically appropriate until it is possible. Evacuation of a hospital occurs when it becomes insecure for patients and the staff to stay at this place. It is a leader’s responsibility to analyze all human resources and equipment. Ethical decision-making is based on the necessity to choose between the alternatives and follows such norms as commitment (doing right things), consciousness (acting consistently), and competency (evaluating information and analyzing possible consequences).
Evacuation should occur when it is clear that water can reach patients and cause certain discomfort and panic. Another important aspect includes the control and management of panic behaviors. A leader has to find enough nurses or other medical workers to make sure that evacuation is under control.
All mentally ill and dependent patients should be removed from lower levels to high grounds. Regarding the fact that the flood has already begun, depressed or anxious patients should not see the events around. A perfect evacuation shelter can be a room with high windows so that the daylight illuminates it, but people cannot observe what happens around. These actions are called partial or internal vertical evacuation (Tekin et al., 2017). From the period all patients reach the room, it is called a safe zone.
Leaders have to pay much attention to the process of transportation and the choice of supplies. Not to cause panic or anxiety among dependent patients, it is possible to use at least seven nurses to organize the transportation of 70 patients (one nurse per 10 patients).
If family members or other caregivers are present in a hospital at the moment of the disaster, their help can be appropriate, and nurses as group leaders should explain the rules and the roles to be performed. Safe zones should be equipped with rechargeable aspirators, O2 tubes, sterile clothing and sets, clean blankets, and at least one light source (Tekin et al., 2017). The disruption of electricity supply is possible during floods for some period of time (Yusoff et al., 2017). Therefore, people should be informed about possible electricity problems and invoked not to panic.
The monitoring of patients and other inhabitants of the safe zone is integral during floods. As a rule, one person can hardly observe the whole room where more than 50 people are. Therefore, a leader has to ask nurses or doctors who are not with their patients to make regular observations. The room can be divided into special zones, and each nurse should take responsibility for her/his own zone and people. It is required to check the number of people regularly.
Nurses can provide their patients with some topics for communication or even games not to make them think that something bad or dangerous is happening. No TV or radio is allowed for patients at the time of a disaster so that psychologically difficult patients stay unaware of the situation around them.
Teams of nurses, physicians, and volunteers have to understand that it is not enough to work hard, but it is necessary to promote compassion and safety. Team-based leadership is the solution for many unpredictable events and disasters. Human behaviors may vary, and a leader should be sure that there is a group of people who can control the situation. The application of a team-based approach is a complex task. The improvement of internal and external communication flows is required (Yusoff et al., 2017). Calm discussions have to be organized not to attract much attention in the room. Mutual accountability is another important aspect of team-based leadership.
Current leaders and their assistants should discuss recent changes, patients’ conditions, and other things that may influence staying in the safe zone. Finally, leaders need to know that their actions and words should be similar for all patients and the staff. It is not always easy to achieve fast assimilation, but a leader can use motivation and inspiration to promote an understanding and support each team member.
In general, human actions and decisions during floods or other natural disasters remain unpredictable. Some people are ready to pull themselves together and achieve the required positive results and control. Some groups of people are in need of a strong leader. Ethical decision-making and team-based leadership are integral to modern hospitals. It is not easy to take responsibility for a number of people and make sure that each decision is ethically correct. Therefore, team-based leadership is a solution that can save many lives and survive floods in hospitals.
Tekin, E., Bayramoglu, A., Uzkeser, M., & Cakir, Z. (2017). Evacuation of hospitals during disaster, establishment of a field hospital, and communication. The Eurasian Journal of Medicine, 49(2), 137-141. Web.
Yusoff, N. A., Shafii, H., & Omar, R. (2017). The impact of floods in hospital and mitigation measures: A literature review. Web.