title: Recommendations for nursing requirements at a field hospital, based on the Israel Defense Forces field hospital at the earthquake disaster in Turkey--August 1999.
abstract: On the 17th of August 1999, an earthquake of 7.4 magnitude on the Richter Scale struck the Marmara region in Turkey causing a massive casualties event with an estimated 2,680 deaths and 5,300 injuries just at the city of Adapazari alone. A field hospital was set up by the Israel Defense Forces at Adapazari in order to provide temporary medical services until regular medical forces recovered. The aim of the paper is to overview the requirements of the nursing staff at a field hospital based on our experience and analysis of the nursing activity at the field hospital at Adapazari. The methods implemented include interviewing all nurses and many of the doctors who took part in the field hospital as well as a review of medical literature about disasters. We found an inverted nurse:phycisian ratio of 1:1.77, as opposed to a 2.5-3:1 ratio in regular civilian hospitals. The nurses in our field hospital had to work longer and more intensive shifts than in a regular hospital. They had to overcome language barriers and cultural differences, and faced difficult hygiene conditions. Our overview analysis of results brought up several recommendations. Firstly, although it is not possible to predictthe number and types of casualties, it is necessary to provide an adequate number of nurses (1-1.5:1 nurse:physician ratio). Furthermore, the nurses should be specialized and rotated as needed. Secondly, the language and cultural barriers should not be undermined despite the abundance of translators. Finally, the hygiene status in a field hospital requires management by nurses with active participation of all members.
authors.affiliation: Medical Services Branch, IDF Medical Services and Supply Center, Or Yehuda, Israel.
authors.forename: Gila
authors.initials: G
authors.lastname: Margalit
authors.forename: Yitzhak
authors.initials: Y
authors.lastname: Rosen
authors.forename: Dorit
authors.initials: D
authors.lastname: Tekes-Manova
authors.forename: Maya
authors.initials: M
authors.lastname: Golan
authors.forename: Paul
authors.initials: P
authors.lastname: Benedek
authors.forename: Yehezkel
authors.initials: Y
authors.lastname: Levy
authors.forename: Giora
authors.initials: G
authors.lastname: Martonovits
authors.forename: Yaron
authors.initials: Y
authors.lastname: Bar-Dayan
mesh_terms: D003144:Communication Barriers; D004190:Disasters; D006772:Hospitals, Military / Q000458:organization & administration*; D006775:Hospitals, Packaged / Q000458:organization & administration*; D006801:Humans; D006920:Hygiene; D007391:International Cooperation; D007557:Israel; D009741:Nursing Staff, Hospital / Q000600:supply & distribution*; D010561:Personnel Staffing and Scheduling; D018635:Rescue Work / Q000458:organization & administration*; D014421:Turkey; D000078329:Workforce; D016526:Workload