FUKUSHIMA Lives on the Line

109chap.IIFukushima Medical University Record of Activities [Notes and Messages]FUKUSHIMA: Lives on the LinePhoto 1: Radiation decontamination treatment simulationtreatment. They provided nursing care while keeping our patients out of danger.(2) Management of Nurses as a Full-Time Member of the Emergency Radiation Decontamination Treatment GroupAbout a month after the earthquake, the Fukushima Daiichi nuclear power plant had emerged from the worst of its predicaments. However, even today, patients with radiation contamination appear at the hospital. This seems to be a long-term problem; thus, we must start creating systems that can function despite a change of personnel within the systems. Under these considerations, given my experience with emergency radiation decontamination drills, on April 18, I was assigned to manage nurses as a full-time member of the Emergency Radiation Decontamination Treatment Group. Three students pursuing their masters in radiology nursing from Nagasaki University joined us as support nurses. We were able to create an environment for emergency radiation decontamination treatment. We gradually laid the groundwork by exploring a treatment room setup while referencing the Nuclear Safety Council’s pocket manual. We worked with physicians to prepare examination materials necessary for radiation decontamination treatment based on our hospital’s systems.Emergency radiation decontamination treatment requires constant preparation for the worst-case scenario and cannot be done by a few people. Moreover, cooperation from the nurses throughout the hospital is indispensible. Because it is also necessary to have sufficient hands-on staff for casualties during the night and on weekends, we decided to have rotational shifts for nurses. Initially, certain nurses had little experience in radiation-related work. However, this work requires a high level of skill to ensure that critical care is given with proper radiation protection so that the entire hospital is not contaminated. Thus, we placed the head nurse and a mid-level nurse on their shifts. Despite this, many concerns such as “Can I even provide critical care while thinking about radiation exposure?” and “Is one person sufficient for both treatment and decontamination?” were voiced. There was much worry and lack of knowledge about this invisible radiation. Our problems continued to pile up. We were concerned about how the staff would come to have faith in the emergency radiation decontamination treatment. Since the nurses on shift were veterans of everyday nursing procedures, we expected them to provide care without getting flustered, growing accustomed to the flow of decontamination treatment each time they repeated the procedure.Then, in mid-May, we decided to conduct weekly treatment simulations with people from many different professional backgrounds (Photo 1). We recorded the simulations using a video camera so that we could review and discuss them the following week. The simulations were extremely beneficial in getting people from different professions work together on a treatment. Other benefits included the smooth flow of procedural knowledge, such as “a set of gloves should be used on only one patient,” and the identification of areas for improvement using the video review.(3) How to Treat Unprecedented Long-Term, Low-Dose Radiation ContaminationToday, three months after the earthquake, the Fukushima Nuclear accident has gradually taken shape as a problem of low-dose, long-term radiation exposure—a type of nuclear disaster the world has never seen before. Attention has shifted toward residents’ and aid workers’ concerns about the effects of radiation. From a nursing perspective, sharing accurate information and lending an empathetic ear helped those struggling with this mental and physical anguish. The least that is expected of us is to listen to and care for each afflicted person. We are expected to understand their emotions, such as the anxiety of a parent whose child is in the Activity Records of the Fukushima Medical University Hospital