Chaos, Teamwork, Compassion, and Leadership

Disasters and Nursing's Finest Hours

Karlene M. Kerfoot


Nurs Econ. 2019;37(5):265-267. 

In This Article

Teamwork, Compassion, and the Human Side of Disasters

Bonnie and Mark Barnes, co-founders of the DAISY Foundation (, have heard many stories of heroism and exceptional compassion in the 20 years since the foundation was started to honor nurses who provide extraordinary care, just like the nurses who cared for their family and son. Bonnie Barnes, FAAN, notes that while mock drills and education for disasters are essential, the real essence of success in disasters is teamwork. Chief nursing officers (CNOs) and nurses who participate in disasters often name teamwork as the key to successfully creating excellence in care for patients and each other during and after these horrific events. These testimonials from DAISY Award nominations and many others support Bonnie's conclusions that "Teamwork creates miracles."

  • Liz Dickinson, CNO, Adventist Feather River Hospital, Paradise, CA, noted teamwork is the essence of successful outcomes in disasters and was vital as heroic nurses evacuated patients at the facility during the California fires of 2018.

  • Emory Hospital faced the crisis of caring for the first patients in the United States with Ebola virus. Emory "Team Ebola" received the DAISY Team award for its robust, highly professional team functioning in a competent, collaborative manner, working together to achieve excellent outcomes which exemplifies teamwork as the key feature of success (The DAISY Foundation, 2019a).

  • In the aftermath of the Pulse Nightclub shooting in Orlando, FL, Sarah Duran, BSN, RN, said that there was nothing but cooperation and commitment that night at Orlando Regional Medical Center as the victims came to the hospital. "I remember standing in the trauma bay as it was beginning, thinking that I couldn't believe this was happening," she said. "I think we were all like that. There was no stopping point, they just kept coming in, but there was no one yelling at each other – just teamwork" (Jimenez, 2016, para 9).

  • When a car crashed through a wall into the emergency department at Vidant Medical Center-Greenville, NC, the nomination for the DAISY Award stated: "Thank you for doing what you always do, even when there was smoke, and screaming, and doors slamming, and people running. We saved the day. And we should live in pride that as a team we are always saving the day, in little ways and big! You all are my heroes, my coworkers, and my family. And I am proud of you. And of our team" (The DAISY Foundation, 2019b, para 3).

Compassion and caring are also important for teamwork and the ability to create excellence in outcomes at the time of disasters. Compassion is one of the essential characteristics of excellence in nursing but can also lead to distress. According to Todaro-Franceschi (2019), the ability to feel as others do and to deliver person-entered care because of compassion motivates people to go out their way to help others. Compassion helps us see others as human beings and gives us the ability to suspend stereotypes and see the human being. After the Pittsburgh Synagogue shooting, several Jewish doctors and nurses cared for the shooter. Ari Mahler, a Jewish nurse who cared for the assailant, said "The fact that I did my job, a job which requires compassion and empathy over everything, is newsworthy to people because I'm Jewish. Even more so because my dad's a rabbi" (Pengelly, 2018, para 5).

Secondary traumatic stress along with burnout is known as compassion fatigue and is a sequela common among people who work closely with victims of disaster and trauma. It was first diagnosed in nurses in the 1950s. When the disaster is over, nurse leaders are obligated to help people through the aftermath of what they have experienced. Often nurses have difficulty living with the memories of the events they witnessed. And for other nurses who did not participate in the disaster, survivors' guilt will often haunt them. Debriefing and utilizing professional teams to help people work through the challenges of the disasters is important. For many, finding meaning in the disaster is often hopeful (Todaro-Franceschi, 2019). After the Pulse Nightclub shooting, Susan Duran said her recovery began when she later saw her patients alive in the hospital due to the incredible work she and her colleagues did that night. She saw how important nurses are (Jimenez, 2016).