Subscribe to Notes on Nursing, our monthly news digest.
Thank you for subscribing!
Please fill in your email to continue.
Nursing News HighlightsJ&J + Nurses: Partnering with a Purpose

Innovative Toolkit Empowers Nurses in Natural Disasters

George Armstrong/FEMA Photo by George Armstrong
Across the country, registered nurses (RNs) play a critical role in the medical preparedness and response to natural disasters of all kinds, working to safeguard the health and wellbeing of the at-risk public. Nurses are uniquely qualified to manage emergency situations — which can come at a cost to themselves and their families.

In 2017 alone, there were more than 120 federally declared disasters in the United States, including Hurricanes Harvey, Irma, and Maria that devastated parts of Texas, Florida, and Puerto Rico, respectively. During the devastation of Hurricane Harvey, Texas hospitals asked nurses from across the country to lend a hand in assisting the overwhelmed staff who had been working overtime to care for survivors. Within days, hundreds of nurses from around the country flew to Texas to provide relief to nurses wearied by the storm.

“Many of the nurses who responded during the 2017 hurricanes were distraught, if not traumatized,” says Danita Alfred, PhD, RN, nursing professor at University of Texas Tyler and an expert in disaster management. “I listened to some of their stories and wanted nurses to have easy and fast access to help them respond to and recover from events like these that no one plans to ever experience.”

In addition to mental and physical fatigue, nurses may experience moral distress related to ethical concerns arising from conflicting values and obligations inherent in the disaster work environment, such as having to decide which patients receive necessary resources when supplies are low. Nurses working in compromised environments may experience what is known as compassion fatigue, which has been described as secondary traumatic stress. Some may even be affected by post-traumatic stress disorder (PTSD).


In 2018, with help from nurse innovators like Danita and nurses with disaster and research experience, the Johnson & Johnson Foundation, the Texas Nurses Association, and the Texas Organization of Nurse Executives partnered to develop Care for the Caregiver — a collection of free, online self-help resources to prepare nurses and their families for before, during and after natural disasters. These tools include:

  • Before a disaster. Pre-incident videos offer strategies for preparing both at home and at work for a disaster, such as a hurricane, earthquake, flood or wildfire.
  • During a disaster. Care for the Caregiver explains techniques for mitigation of stress responses during disasters. By understanding how their personality may affect their resiliency, nurses can be prepared to recognize and treat stress.
  • After a disaster. After assisting in a natural disaster, it’s common for nurses to be affected by stress, compassion fatigue, and even PTSD. Care for the Caregiver resources show how personal resilience can affect responses to stressful situations.

The Care for the Caregiver toolkit offers online education, a peer support network, informational tip sheets for downloading, and a comprehensive collection of additional resources from organizations such as the American Red Cross and FEMA, all available for free and geared towards nurses not just in Texas but around the country.

Jane Le Vieux, PhD, RN-BC, LPC-S, NHDP-BC, clinical manager at Children's Medical Center in Dallas, was one of the nurse innovators behind the Care for the Caregiver toolkit. Because of her experience as a nurse on the National Disaster Medical Response Team, she was uniquely positioned to create a toolkit that offers a comprehensive approach to nursing during a natural disaster. “I have seen firsthand the impact of disasters,” she says. “Nurses must be able to adapt their skills from focusing on individuals to large numbers of patients and understand the consequences that disaster can have on public health emergencies.”

To best care for patients, nurses must care for themselves. “Your own reactions to the situation play a role in decreasing heightened emotional responses that may affect patient care,” Le Vieux says. The toolkit provides guides for nurses to evaluate personal resilience before a disaster, relieve stress and relax during a disaster, and recognize indicators of compassion fatigue and PTSD after a disaster.

If you’re interested in learning more about Care for the Caregiver, or accessing resources, visit

Photo credit: George Armstrong/FEMA Photo by George Armstrong

This site uses cookies as described in our Cookie Policy . Please click the "Accept" button or continue to use our site if you agree to our use of cookies