Table 1.

Nursing’s Role in A Nuclear Response

Field-Based Centers Under the Nuclear Global Health Workforcea and U.S. Public Health Response	Nurse Roles & Responsibilities	Nurse Professionals
Nuclear Triage Centers/Community Reception Centers	Medical triage using “fast biological dosimetry” Initial medical stabilization Exposure vs Contamination-Decontamination Thermal vs Radiation Burn Assessment Peer education and radiation exposure mitigation (principles of working with radioactivity, appropriate use of PPE, etc.) Surveillance and data collection Psychosocial support Health education regarding self-decontamination Coordination of patient transfers Interdisciplinary collaborative practice with Radiation safety officers, physicians, EMS and emergency managers	RNs Occupational health nurses Nurse Practitioners (psychiatric/mental health NPs, acute care/trauma NPs, primary care NPs would all have different, but valuable roles to fill in initial triage)
Point-of-Distribution Clinics (PODs) for Rapid Radiation Medical Countermeasures Deployment	Establish and staff PODs Screening and assessment Radiation (protective) medical countermeasure administration Patient monitoring Interdisciplinary collaborative practice with State Strategic National Stockpile (SNS) Coordinators, Pharmacists, EMS and emergency managers	RNs School nurses Public Health nurses Occupational health nurses LPNs/LVNs
Nuclear Survival Centers	Secondary triage (biodosimetry/bioassay) Hospital-level unit staffing Isolation staffing Pain and symptom management Burn care- Initial assessment and stabilization, fluid/electrolyte management, infection control, debridement, nutrition support Psychosocial support Spiritual and culturally sensitive care of patients and their families Family Reunification	Acute and chronic care nurses and Nurse Practitioners (surgical nurses, burn nurses, oncology nurse, emergency and critical care nurses) Nurse Anesthetists Psych/Mental Health Nurses and Nurse Practitioners Infection Control nurses Occupational health nurses
Nuclear Palliative Care Centers	Pain and symptom management End-stage burn/acute radiation syndrome care Psychosocial support Spiritual and culturally sensitive care of patients and their families Patient education and advocacy Ethical and legal considerations Interdisciplinary collaborative practice with physicians, pharmacists, family counselors and social workers, clergy Loss and grief, bereavement care Engagement of community resources for family support post death	Hospice and palliative care nurses and nurse practitioners Primary care nurses and nurse practitioners Nurse anesthetists Psych/mental health nurses and nurse practitioners Parish nurses LPNs/LVNs
Health System Support Centers	Hospital/clinic/mobile facility staffing Rehabilitation Care of displaced, evacuated patients and families Patient education and advocacy Ethical and legal considerations Family Reunification Psychosocial support Spiritual and culturally sensitive care of patients and their families	Nurse Administrators Hospital and ambulatory clinic nurses Surgical nurses, burn nurses, oncology nurses Primary care nurses and nurse practitioners Rehabilitation Nurses Public Health nurses Psych/mental health nurses Occupational health nurses
Public Shelters	Temporary housing Feeding/Nutrition Safety/security Provision of essential supplies Child/infant care Infection control Population surveillance monitoring Psychosocial support Family reunification Manage volunteers Collaboration with non-governmental organizations (NGOs)	RNs Public Health Nurses LPNs/LVNs

^aBurkle, F. M., & Dallas, C. E. (2016). Developing a nuclear global health workforce amid the increasing threat of a nuclear crisis. Disaster medicine and public health preparedness, 10 [1], 129–144