The Planning for Trauma-Related to Disaster in Riyadh Hospitals


The topic that is being researched in the presented paper is concerned with the role of senior nursing (SN) in disaster-related trauma (DRT) in Riyadh hospitals, KSA. It has been chosen since it appears to be underrepresented in the field of disaster nursing.

The latter is a relatively new field in nursing research that has been developing rapidly in the past decade. Since the WHO call for action, the aim of reducing the disaster-related risks became a worldwide agenda on the national and local levels (Achora & Kamanyire, 2016, p. 16). Disasters are a challenge to human society, and nurses are the frontline of the planning, response, and rehabilitation related to such occurrences (Arbon et al., 2013). However, to efficiently fulfill this role, they require acknowledgement and support. While they appear to have received the former to an extent, the latter still seems to be an issue.

Objectively, the potential contribution of nurses and SNs to disaster management (DM) and planning (DP) is critical, and the modern understanding of DP incorporates nurses as the key actors while the history of nursing proves their ability to contribute (Wall, 2015). As a result, the International Council of Nurses has created its “Disaster Management Continuum Model” to guide nurses and SNs in DM activities. DP is acknowledged as a major component of the second element of the model (disaster preparedness) that is vital for an adequate response (Achora & Kamanyire, 2016). The related nursing competencies include information sharing and education as well as the maintenance of ethical conduct, all of which define the successfulness of nurses and SN in DM, DP, and planning for DRT (Alfred et al., 2015).

In order to facilitate their work, nurses and SNs need to be provided with relevant education and training that ensure the development of leadership and management skills. Apart from that, they require the support of their institutions, governments, and other significant DM actors (Arbon et al., 2013; Moghaddam, Saeed, Khanjani, & Arab, 2014; Veenema et al., 2016). However, the worldwide nursing community is concerned with the fact that nurses in many countries all over the world remain under-skilled, under-experienced, and unsupported, which makes proper DP and response more difficult (Veenema et al., 2016, p. 188). In order to deal with the issue, the growing bulk of DM evidence is being used to develop DM research (Giarratano, Savage, Barcelona-deMendoza, & Harville, 2013). However, disaster nursing research is still emerging nowadays, and a lot remains to be contributed (Aliakbari, Hammad, Bahrami, & Aein, 2014). In particular, the topic of KSA nursing and especially DRT planning in KSA is vastly underrepresented.

Therefore, the suggested topic is both acutely up-to-date and under-researched, and the study has the potential to contribute to the development of DM research and help SNs to navigate in their search for proper disaster and DRT planning techniques.

The present critical literature review is organized geographically: first, the worldwide DM is discussed, then the Middle East is dwelled on, and finally, KSA is considered. The study is aimed at determining the state of the nursing practice and research in disaster and DRT planning as well as its achievements and issues.

Critical Literature Review

The literature review dwells on the emerging field of nursing theory and practice, which is why the issues, barriers, and the things that are still to be done appear to be emphasised. However, the review also attempts to demonstrate the achievements and positive sides of SN planning for disaster and DRT.

Countries Worldwide

The world is getting increasingly concerned with DM, which was illustrated by the 2005 World Conference on Disaster Reduction. The United Nations have also proposed a Strategy for Proposal Reduction (Alshehri, Rezgui, & Li, 2014, p. 2223). A similar increase in related nursing research indicates that the countries all over the world attempt to contribute to the development of DM theories and practice (Yamamoto, 2013).

International nursing organisations like the Honor Society of Nursing, Sigma Theta Tau International aid the improvement of nursing competencies in DP and DRT and act as leaders in improving the quality of related healthcare worldwide (Mcglown, 2011). Similarly, nation-level disaster nursing has also achieved positive results. For example, there is a large number of studies devoted to Japanese DP and DM, which is apparently explained by the fact that Japan is very disaster-prone (Öztekin, Larson, Yüksel, & Altun, 2014; Yamamoto, 2013). As a result, the country has advanced in disaster nursing research, training, and practice. The Japanese Nursing Association has created a separate Disaster Nursing Network that is the third Disaster Network in the world. The other two include the one created by the International Council of Nurses and the Asia-Pacific Emergency and Disaster Nursing Network (Yamamoto, 2013, p. 164). The job of Disaster Nursing Networks consists in organising collaboration and partnership between authority, healthcare and research institutions in the mutual task of ensuring proper disaster management. A similar example of robust DM development is the US, where DM is considered to be a specific set of skills that is targeted in their education by many nurses. Similarly, the nursing journals of the US promote this tendency to pay specific attention to DM and DP (Rokkas, Cornell, & Steenkamp, 2014).

At the same time, it should be pointed out that the role of nurses in planning for disasters and disaster-related trauma varies around the world. In fact, certain countries (for example, Iran) restrict the participation of nurses in planning for different reasons, including their gender (Al Thobaity, Plummer, Innes, & Copnell, 2015, p. 163). Apart from that, the fact that SNs are a valuable resource that requires proper education, training, and relevant practice makes them especially rare and leads to the shortage of professional DP-capable SNs (Al Hosis, Plummer, & O’Connor, 2012).

In fact, the education of nurses in DP and DM appears to be a significant issue all over the world. For example, Yan, Turale, Stone, and Petrini (2015) report that the Chinese nurses receive no DM training, which limits their ability to plan and respond. Apart from that, they also experience shortages in equipment and do not receive proper training on teamwork, management, leadership, and critical thinking (Wenji, Turale, Stone, & Petrini, 2015). Moreover, they have been reporting the absence of proper DP and the lack of opportunity to contribute to it, which lowers their effectiveness in the sphere (Li, Turale, Stone, & Petrini, 2015).

Unfortunately, China is not the only country where nursing DP is underdeveloped. Usher et al. (2015) study a greater number of countries in the Asia-Pacific region (including Bangladesh, Bhutan, Cambodia, Laos, Nepal, and Solomon Islands) and conclude that the preparedness of nurses and their expected performance in DM is low to moderate in these regions. Labrague, Yboa, McEnroe-Petitte, Lobrino, and Brennan (2015) demonstrate that 80% of Philippine nurses perceive their skill level inadequate for DM and DP but are willing to continue education. The insecurity of nurses with respect to their ability of DM and DP that logically follows from the lack of training and education is a worldwide tendency, and it has been found out that disaster drills and mock disaster situations tend to increase nurses’ confidence and help them train their skills (Baack & Alfred, 2013). For the time being, though, an overwhelming number of nurses in developed and developing countries are similarly uncertain about their DM and DP abilities.

Middle East Countries

The unfavourable worldwide tendencies, unfortunately, do not leave out the Middle East. Apart from that, the Middle East countries are likely to restrict nurses’ and SNs’ participation in DP. Öztekin et al. (2014) researched the undergraduate students’ preparedness for disaster in Turkey and found that their educational and training plans needed to be more extensively focused on DM. Zarea, Beiranvand, Sheini-Jaberi, and Nikbakht-Nasrabadi (2014) evaluated the disaster nursing in Iran and concluded that its issues were similarly related to insufficient education and also included the limited roles of nurses and the lack of empowerment, leadership, and organization. As a result, nurses from Middle Eastern countries, unfortunately, tend to have rather low scores in disaster planning (Al Thobaity et al., 2015, p. 163).

Another issue of Middle East disaster nursing as well as nursing in general consists in the overwhelmingly large number of expatriate nurses in the market (Al Hosis et al., 2012). It tends to stifle the tempo of the development of local nursing and leads to the shortage of locally educated workforce. This issue has the potential to stifle the development of local nursing practice and research, but Middle East governments, for example, that of KSA, work towards resolving the problem.

Saudi Arabia

The problem of the underemployment of local nurses remains acute in Saudi Arabia today. As a result, there is a noticeable shortage of qualified local employees, which the government of the country seeks to change. The situation is further complicated by the fact that senior nurses are a costly and limited human resource that tends to be rather unsuccessfully substituted by under-skilled professionals (Al Hosis et al., 2012, p. 20). Apart from that, according to Alshehri et al. (2014), Saudi Arabia lacks a coherent DM plan and system. Also, the KSA nurses participate in disaster planning and have proved to make considerable contributions to it, but it has been claimed that the roles of nurses in KSA DM are restricted (Al Thobaity et al., 2015, p. 163; Al Thobaity, Williams, & Plummer, 2016, p. 15). Thus, the Saudisation and the enhanced education, training, and empowerment of SNs with respect to DP, and DRT are some of the goals of modern KSA nursing.

However, it should be mentioned that Saudi Arabia has many achievements in SN DP as well. According to Al Thobaity et al. (2015), most KSA nurses have at least the moderate level of preparedness for disasters, and military ones score even better. Apart from that, the same study demonstrated the nurses’ desire to improve their skills and continue their education. Unfortunately, Al Thobaity et al. (2015) also show that the key sources of disaster-related education for nurses include drill situations and continuing education courses, which prompts the authors to highlight the fact that the undergraduate and graduate education may be lacking in this respect. However, the fact that drills are a valid means of improving qualification for SN DM and DP is proved by this study. Moreover, the authors indicate that drills have a good chance of improving the nurses’ understanding of their roles in disaster management and enhance their leadership skills, which is a most important outcome (Al Thobaity et al., 2015, p. 163). However, the study of Al Thobaity et al. (2015) does show that nurses of KSA do not trust their DP abilities very much.

It is also noteworthy that Saudi Arabia is relatively underrepresented in the recent literature on the topic of DM and especially with regard to the role of SNs in planning for disaster or DRT. However, it appears that the nursing research in the field of DP in KSA is developing. For example, Al Thobaity et al. (2015) carried out the first study on the perceived disaster preparedness of nurses in KSA in 2015 (p. 157). Still, even though the authors discuss DP, they hardly mention DRT in SKA. In the same way, Alshehri et al. (2014) focus on DM in KSA, but they are mostly interested in organizational issues, and DRT does not appear in their research. Similarly, Al Thobaity et al. (2016) consider the core competencies of KSA nurses that are needed for them to contribute to DP, but they barely mention DRT. In general, even though the study of Al Thobaity et al. (2016) was carried out with the help of KSA nurses and to facilitate their work, it is rather theoretical and universal than KSA-cantered. Al Thobaity et al. (2016) also point out that these competencies are underrepresented and underdeveloped in modern research worldwide. The need for fulfilling this gap in nursing research, therefore, seems to be apparent.


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