Managing behavioral issues can sometimes be overlooked especially in emergency situations. This method is very
important in order to keep control of the situation and be allowed for a more effective means to deal with people who are affected by such appalling events. Although most people pull together and function during a disaster, both people and communities suffer immediately and sometimes long-term physical trauma.
When managing behavioral issues especially during stressful disaster situations the health care team charged with the care should anticipate the common responses to a mass incident disaster. Moreover, an effective emergency operations plan should include a list of potential responses of victims and their families in order for the health care personnel to be equipped with the proper approach in managing behavioral issues that might arise during such stressful times.
Common responses to a disaster include the following:
- Depression
- Anxiety
- Somatization (fatigue, general malaise, headaches, gastrointestinal disturbances, skin rashes)
- Post traumatic stress disorder
- Substance abuse
- Interpersonal conflicts Impaired performance
Other factors leading to the onset of behavioral issues
Factors that influence and lead to the onset of behavioral issues results from an inadequate response to a disaster which include the degree and nature of the exposure of the disaster, loss of friends and loved one, existing coping strategies, available resources and support and the personal meaning attached to the traumatic event. Other factors, such as loss of home and sentimental physical possessions, extended exposure to danger as well as exposure to toxic contamination can also influence the risks of impaired adjustment problems leading to behavioral issues which could become a psychological impairment later on if not properly addressed. Those exposed to the dead and injured, those endangered by the event, the elderly, children, emergency first responders and health care personnel caring for victims are considered to be at a much higher risk of emotional sequelae.
Effective approach in handling behavioral issues following a disaster situation
Members of the health care team, particularly the charge nurse of the emergency department is mainly responsible in assisting disaster victims through active listening and providing emotional support, giving information and referring patients and their families to therapists or social workers. Health care workers must refer people to mental health care services, because experience has shown that few disaster victims seek the aforementioned services and early intervention can greatly minimize psychological consequences. Furthermore, ED nurses can help discourage victims from unconsciously subjecting themselves to repeated exposure by limiting their exposure through media replays and news articles and bolstering their normal routine and social roles when appropriate.
Managing behavioral issues within the medical staff
One of the most complex challenges faced by committee heads and team leaders in an emergency situation is not only overseeing behavioral issues of incoming patients from a disaster event but more importantly controlling and managing professional conduct and behavioral issues of the medical team when faced with such hostilities and stressful situations. Although the emergency health care team is expected to have a high tolerance to disruptive behavioral responses of patients during emergency situations, these professionals are also prone to human responses and have certain limits. Therefore, the key aspect in the effective management of behavioral issues of both medical staff and the surge of incoming patients in an emergency disaster situation is balancing accountability to patients and appropriate advocacy for colleagues. Managing behavioral issues is a daunting task for the health care provider as he/she is also susceptible to the having a disruptive behavioral response in the care of patients of such magnitude.