1. Speraw, PSusan PhD, RN

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Dear Dr Chinn:


I am writing to voice my dismay at the publication of the article, Politics of Nursing Knowledge and Education, a piece in which our disaster nursing program at The University of Tennessee in Knoxville was attacked with the most volatile, incendiary language. Inaccurate, misleading, or otherwise erroneous statements were made about the program without any effort to verify the soundness of the authors' inferences. That the authors were allowed to put forward inadequately supported, unverified claims and conclusions is cause for concern.


In this brief space, I would like to address our program and provide an honest picture of what we teach. First, we are first and foremost a program that teaches nursing, with a goal of producing nursing leaders with advanced skills and knowledge appropriate to our times. As part of their course of study our graduate students are challenged to examine where disaster nursing as a specialty fits within nursing theory and practice, but they are also charged with analyzing how the language and paradigms of nursing, applied in a disaster setting, mesh with the care paradigms and terminology used by a myriad of other disciplines who are part of collaborative disaster response teams; it was in conjunction with this analysis that the 2008 paper by Persell (cited in the article) was written. This kind of critical appraisal is important because evidence in literature demonstrates that when responders understand and share common disaster-related language, psychological stress among care providers is reduced, effective intervention is enhanced, and more lives are saved. Second, as part of our approach to fostering crossdiscipline understanding and collaboration, students learn not only from nursing faculty, but also from scholars and experts from allied disciplines and agencies with a stake in disaster response. We have found that this interdisciplinary approach not only enhances students' experience and increases their fund of knowledge and comfort with language, but also that it also instills in other professionals a new appreciation for the breadth of what nurses know and can contribute to disaster leadership. Third, our curriculum is rich and complex. We teach about all hazards in equal measure, but in addition to nursing theory and research our emphasis is on things other than hazards: ethics, psychological impacts of catastrophic events on survivors and caregivers, public-health law that impacts response and intervention, economics and budgeting, crisis communication, providing care in mass-shelter settings, disaster triage. Fourth, our program is based on the realization that we are training nurse leaders to function in a global society. With that in mind, we as faculty develop and nurture a global world view among our disaster nursing students, teaching about world affairs, caring for the vulnerable domestically and abroad, international border issues that impact nursing practice in calamity, evaluation, and treatment of diseases linked to poor sanitation and poverty, and how to cope when the values orientations of the nurse are in conflict with those of the society in which the nurse provides care. Our doctoral students have conducted ground-breaking research into the psychological experiences of Haiti earthquake survivors and responders, nurses who provided care during Hurricane Katrina, perceptions of nurses who have served on humanitarian aid teams, caring within the context of faith-based disaster response, the development of situational awareness among health professionals, educational efficacy of modes of Basic Disaster Life Support training, and the lived experiences of atomic bomb survivors who subsequently immigrated to the United States. Students' and graduates' interests are as broad as what we teach.


Contrary to what the authors of the Politics article allege, our Tennessee disaster-nursing program has not been taken over by a military mindset. We are indeed unique, but what we are most of all is pioneering, preparing nursing scholars, and clinicians with advanced skills who can lead and practice during calamity-wherever it may be-as part of interdisciplinary teams, responding to the needs of our 21st century global society. It is my belief that every disaster response in recent memory could have been made more effective by the presence of a nurse with disaster expertise in a major leadership position. Yet, in order to be placed in major roles of authority, nurses must have the training and credentials required. Our doctoral program provides both, and prepares nurses to apply their core, expert, nursing knowledge in the context of a global world. That is something of which we are extraordinarily proud.


It is unfortunate that the authors chose the approach that they did to examine what they called the "militarization of nursing." Had they adopted a more scholarly stance, using language reflecting ethical consideration for presentation of well researched conclusions based on abundance of data, and absent personal attack, their argument might have generated the scholarly discourse that true scientists esteem. Instead, what they have written is an affront, not only just to our program but also to ethics, and all who value honest, dispassionate examination of ideas and thought.