Reporting for Duty During Mass Casualty Events: A Survey of Factors Influencing Emergency Medicine Physicians

Abstract

Background Academic medical centers play a major role in disaster response, and residents frequently serve as key resources in these situations. Studies examining health care professionals' willingness to report for duty in mass casualty situations have varying response rates, and studies of emergency medicine (EM) residents' willingness to report for duty in disaster events and factors that affect these responses are lacking. Objective We sought to determine EM resident and faculty willingness to report for duty during 4 disaster scenarios (natural, explosive, nuclear, and communicable), to identify factors that affect willingness to work, and to assess opinions regarding disciplinary action for physicians unwilling to work in a disaster situation. Methods We surveyed residents and faculty at 7 US teaching institutions with accredited EM residency programs between April and November 2010. Results A total of 229 faculty and 259 residents responded (overall response rate, 75.4%). Willingness to report for duty ranged from 54.1% for faculty in a natural disaster to 94.2% for residents in a nonnuclear explosive disaster. The 3 most important factors influencing disaster response were concern for the safety of the family, belief in the physician's duty to provide care, and availability of protective equipment. Faculty and residents recommended minimal or no disciplinary action for individuals unwilling to work, except in the infectious disease scenario. Conclusions Most EM residents and faculty indicated they would report for duty. Residents and faculty responses were similar in all but 1 scenario. Disciplinary action for individuals unwilling to work generally was not recommended.

How Do Doctors and Nurses in Emergency Departments in Hong Kong View Their Disaster Preparedness? A Cross-Sectional Territory-Wide Online Survey

“…Other frequently cited barriers to willingness include fear and concern for family and personal ill-health and safety, 12,38 distance from home to the facility, 12 lack of transportation, 39 and caring for children, the elderly, or for pets. 6,7,[39][40][41] Studies have shown that a sense of duty is an influential factor in staff willingness to respond. 7,42 Two important characteristics of the respondents are noteworthy in our study.…”

“…6,7,[39][40][41] Studies have shown that a sense of duty is an influential factor in staff willingness to respond. 7,42 Two important characteristics of the respondents are noteworthy in our study. First, many respondents turned to social media for information and communication during a disaster.…”

“…have been published. [3][4][5][6][7][8][9][10][11][12][13][14] Most studies were surveys conducted in North America, Europe, and Australasia and many focused on chemical, biological, radiological, nuclear, and explosive (CBRNE) incidents or on terrorism. [9][10][11]13,14 Almost all studies concluded that HCW are not well prepared for disaster, regardless of staff group, clinical setting, and geographical region, and most studies called for more training.…”

Obstetrician-Gynecologists’ Role Conflict in a Natural Disaster: Professional Versus Family Responsibilities

“…Conflicts between family concerns and obligations to duty have been expressed by emergency room physicians when surveyed on their willingness to respond to various disaster scenarios. 5 Similar feelings of role conflict have been described by police officers and perinatal nurses responding after hurricane Katrina in 2005. 3,11 Greater than 90% of individuals at-home indicated the storm affected their ability to go to work.…”

“…1 Research has demonstrated that the primary concerns of police officers, emergency room nurses, and physicians working as first responders during disasters, such as hurricanes, are for family safety. [2][3][4][5] Yet, no information is available assessing obstetrician-gynecologists' perceptions of role conflict during a disaster. On August 26, 2017, Hurricane Harvey made landfall on the Southeast Texas coast.…”