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Nursing in trauma and disasters

Photo: NCCTRC trauma coordinator Bronte Martin at Tacloba
The National Critical Care and Trauma Response Centre is at the forefront of Australia’s disaster and trauma care. Karen Keast takes a look at the organisation providing clinical and academic leadership in the specialised fields of trauma and disaster nursing.


Bronte Martin worked as a critical care nurse and specialised in emergency nursing, before becoming the trauma coordinator at the National Critical Care and Trauma Response Centre (NCCTRC).

Originally from Broken Hill in country New South Wales, Ms Martin concedes her position at the centre is her “dream job”.

“Trauma and disaster are both areas that I’m very passionate about,” she says.

“I’d like to see further growth and development in this field, and have it (disaster response) recognised as a nursing specialty, and see a move towards professionalisation, of what is currently a primarily volunteer-led response.

“I hope to continue to provide education, to give nurses a voice in disaster response and to advocate for those who are most important, which are the patients.”

The Australian Government established the NCCTRC at the Royal Darwin Hospital (RDH) in 2005 in the wake of the Bali bombings.

The centre was designed to facilitate surge capacity, with the appropriately trained health professionals, in the event of a mass casualty incident in the Asia Pacific region.

It provides trauma and disaster training to enhance regional response and to research operationally-relevant aspects of disaster management and response, delivering 1300 training places in a range of short courses on trauma, remote area response and mass casualty management.

The centre also provides national training for Australian Medical Assistance Teams (AusMAT) - the multidisciplinary health teams, comprising doctors, nurses, paramedics, firefighters (logisticians) and allied health professionals.

This training is designed to create experienced, self-sufficient teams that can rapidly respond to a disaster zone and provide life-saving treatment to casualties.

Ms Martin, who balances her NCCTRC position with a role as a Squadron Leader for the Royal Australian Airforce Specialist Reserve, was deployed as a Reservist to Afghanistan in 2010 to support the Australian Defence Force and to the Solomon Islands in a 2004 peacekeeping mission.

More recently, she was involved through the NCCTRC in AusMAT’s disaster deployment to Tacloban, in the Philippines, in the aftermath of last year’s Typhoon Haiyan.

Ms Martin says the scale of the devastation was almost indescribable.

“A lot of people had lost absolutely everything, including family members, and had been waiting many days for medical aid and help to arrive,” she says.

“Given the actual physical devastation that happened in the region, it was quite difficult for people to gain access to deliver the support needed.

“They each equally had harrowing stories to tell but were incredibly resilient people, extremely grateful and thankful for any assistance that we could provide for them.

“They didn’t have food or shelter or water and some of them had quite severe injuries.”

Ms Martin says nursing in deployments requires you to constantly adapt your practice to the different demands of the unique environment.

“I like that it gives you the opportunity to focus in on what’s best for the patient and also doing the best you can with what you’ve got…and I guess the ability and challenge to use all of your skill sets all at once,” she says.

Ms Martin says the centre has focused on professionalising disaster medical response through its civilian medical teams.

“We have been working very hard at the centre towards an agreed national standard for training and preparedness for any medical person who might respond in a disaster situation,” she says.

“We offer a range of training packages and we are also working collaboratively with the other states towards identifying that minimum standard, in both your personal and professional preparedness.”

The centre also offers a range of training deployments, providing medical teams with experience in different events and environments, including the six-day Tour de Timor international mountain bike race and the V8 Supercars’ annual event at Hidden Valley Raceway to more public-health focused deployments at remote Indigenous communities.

The NCCTRC is also renowned for its Trauma Service, an extended-hour specialist nurse-led trauma service at RDH that case manages up to 700 patients a year.

Ms Martin advises nurses wanting to specialise in trauma to gain post graduate skills in either emergency or critical care.

“You need to be passionate about trauma care, willing to advocate for the patient and be a really good communicator, because you have to get all of the various medical specialties and allied health teams to agree on what’s the best plan of care for the patient.”

When it comes to disaster response, Ms Martin says there are opportunities in the field hospital environment for operating theatre nurses, midwives, paediatric nurses, emergency nurses, intensive care and specialised ward staff.

“We offer a range of different training opportunities on our training calendar, which can be found on our website,” she says.

“The Major Incident Medical Management and Support (MIMMS) program is a good starting point for anyone who is interested in disaster response, even if it’s not deployment, just at a local level within your own health facility.

“We offer, and each state is offering now, endorsed AusMAT training, which is a standardised package to make sure that we give you all the knowledge and skills that we think you might need in a deployed environment.

“Then there are obviously, dependant on which specialty you choose, further areas of study or short courses that you can pursue that would help you to be well prepared and ready to go.”

Ms Martin says nurses interested in volunteering for disaster deployments should have more than one skill set to offer and a broad range of experiences in multiple types of environments.

“They need to be flexible and adaptable, willing to work in quite austere and at times extreme circumstances,” she says.

“They need to be prepared to work for long hours with limited resources and really get back to the basics of what nursing care is, what’s appropriate for that particular environment and what’s of the best you can offer with what you have available when you’re delivering medical care in a crisis situation.

“I would also say pack your sense of humour for the deployment.”

While disaster deployment, along with trauma care, can take an emotional toll, Ms Martin says it’s also extremely rewarding.

“Whilst it’s challenging, it’s also very humbling and a privilege to be allowed to share that part of what is, often for most individuals, the most traumatic and devastating event of their lives,” she says.

“It’s not easy, and it’s not meant to be easy, but it’s by far no means easy for those who are suffering or enduring whatever it is they are going through.

“The least we can do is offer them some care and comfort, and the best nursing and medical care we have to offer.”

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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords