FUKUSHIMA Lives on the Line

108patients, we learned that many patients had physical disorders that were more serious than their psychological ones. We explored the possibility of transferring them to the general ward. Finally, at 2 pm, we moved them to the 9th floor of the east ward. Thereafter, it was decided that they would be taken to Aizu City. Thus, on March 26 and 27, we bussed them there. By this time, we had received numerous phone calls and faxes from family members identifying the patients from the disaster-stricken areas and were able to verify their identities.(3) Looking Back on the Intake of the Patients from Disaster-stricken Areas During our experience, we faced various issues with the intake of the patients from the disaster-stricken areas. After speaking with the ward staff, I would like to share a few important points.First, either the information we received beforehand was markedly different from the patients’ actual conditions, or we did not receive patient information at all. This made us extremely anxious because, as nurses, we are accustomed to working with a sufficient amount of data. To effectively cope with such a situation, we first need a system that can quickly send the requisite, minimal patient information to evacuation hospitals.Second, it is essential to designate a leader when there are many support nurses. In a general scenario, it is acceptable for a ward nurse to take up the role of a leader. We tried to alleviate our situation—a shortage of ward nurses and a confused work environment—by appointing a leader from among the support nurses. The leader was fully capable of delegating work to the support nurses, even though this leader was a nurse from a different ward.Third, it is necessary to have a person experienced in mental health nursing to care for patients with serious psychiatric disorders, particularly in such pressing times. Nevertheless, by having the School of Nursing faculty treat severely manic-depressive patients, we were able to provide appropriate care and help stabilize the patients’ mental conditions. Thus, dividing the work on the basis of nursing experience can create an effective support system.Finally, staff from the hospital of origin did not accompany their patients while they were transported to our hospital. Given the state of the nuclear power plant, it may have been unreasonable to expect this of them. But we medical professionals are responsible for our patients. We must constantly think of measures to ensure the safety of our patients and ward staff and ask what we would do if they were in the same situation.(1) Implementation of the Program for Emergency Treatment of Radiation Contamination On March 12, while the emergency medical system was responding to the earthquake, hydrogen explosions were reported at the Fukushima Daiichi nuclear power plant. This caused an immediate increase in air radiation levels in the Hamadori and Nakadori areas of Fukushima. In the main hospital entrance, physicians, radiation technologists, and nurses with survey meters were frantically asking each other, “How many thousands of cpm are you getting?” Night-shift nurses in the emergency outpatient ward breathlessly gazed at the television ticker that displayed the μSv/h readings.The Fukushima Medical University Hospital is a treatment facility for secondary radiation exposure. We began our program for emergency treatment of radiation exposure according to the prefectural manual. The hospital houses a well-kept decontamination system that is used for annual emergency radiation decontamination drills. Though the emergency radiation treatment manual was written in 2002, the system was never used except for these drills. Therefore, we nurses believed a nuclear disaster would be an impossible, fanciful occurrence. The radiation decontamination treatment ward was an “empty box”; most of the equipment, emergency medical supplies, and medical instruments were loaned to other wards and departments. Meanwhile, it was officially decided that our hospital would receive support for emergency treatment of radiation exposure from a specialized medical team comprising the Radiation Emergency Medical Assistance Team (REMAT), Nagasaki University, Hiroshima University, and others. Our Emergency Radiation Decontamination Treatment Group collaborated with this team. The nurses from the critical care center and outpatient radiology division scrambled necessary materials together to conduct first response decontamination and general status observation and Role of Nurses during the Fukushima Nuclear Accident: Emergency Treatment for Radiation DecontaminationNoriko UezawaCertified Nurse, Cancer Radiation TherapyMichiko OotsukiDirector, Outpatient NursingCare during the Earthquake, Tsunami, and Nuclear Accident