Policy and Political Action

Policy & Political Action

Provincial Nuclear Emergency Response Plan (PNERP)

The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses (RN), nurse practitioners (NP) and nursing students in all settings and roles across Ontario. It is the strong, credible voice leading the nursing profession to influence and promote healthy public policy. RNAO, in collaboration with its expert Ontario Nurses for the Environment Interest Group (ONEIG) are delighted to respond to the Provincial Nuclear Emergency Response Plan (PNERP).

The role of RNs and NPs in nuclear disasters

We welcome this opportunity to comment on revisions to the Provincial Nuclear Emergency Response Plan (PNERP). It goes without saying in a post-Fukushima world that a precautionary approach is essential when planning for nuclear emergencies. Health services are central to disaster mitigation and emergency response, and RNs and NPs are in the front lines when any disaster does strike. RNs and NPs play key roles in responses to nuclear incidents including: radiation exposure screening; triage; decontamination; treatment for radiation; treatment for exacerbations of existing  medical conditions; assistance with evacuation; and attending to the health and psychological needs of evacuees. Problems during the Fukushima nuclear disaster demonstrated the need for authorities to ensure adequate supports are in place for nurses in the event of emergencies. That includes a continuous effort in providing RNs and NPs with training and materials. Inadequate preparation at Fukushima also contributed to: deaths of vulnerable people due to rapid evacuation; deaths due to displacement of elderly people requiring nursing care; and adverse impacts on affected individuals’ lifestyle and mental health. This is reminiscent of how the 2003 SARS outbreak revealed Ontario’s lack of preparation for public health emergencies.

It is crucial to have comprehensive planning so that RNs and NPs can be ready for all the above roles, and they must be involved in the detailed planning processes. Planning must identify and commit all necessary resources, including:  key hospitals and other health facilities; decontamination centres; equipment; materials; and personnel. To ensure resources can be rapidly mobilized in the event of a disaster, it is essential that personnel likely to be involved receive appropriate and adequate training. For example, public health, primary care, long term care, and acute care nurses must learn to identify vulnerable populations in the shadow of nuclear plants. Nurses trained to screen for acute radiation syndrome can identify people with the highest priority for treatment. Nurses will also need to know how to best decontaminate exposure victims, how to handle contaminated clothes and water, how to treat and cover wounds, and how to protect food and water from radiation.

Recommendations

RNAO was a signatory of A Call for Public Safety: Addressing Nuclear Risks on the Great Lakes, and along with ONEIG we echo the key precautionary demands of the letter in this submission:

  • Protective measures must be based on a Fukushima-scale accident (International Nuclear Event Scale 7 (INES 7)), including alerts, potassium iodide pre-distribution and preparation for evacuation zones of 20 km or greater.
  • Prepare for full health support of all displaced populations, including health practitioner staffing at evacuation centres and health teams to visit reception centres without health teams.
  • Ensure on-going emergency training of key health care providers in primary and acute care, long-term care and public health, including RNs and NPs.
  • Ensure all necessary policies, procedures and documentation are in place to support health professionals in the event of a significant nuclear incident.
  • Identify vulnerable groups within 30 km of nuclear facilities and require plans to assist those groups, whether they are evacuated or not.
  • Ensure alternate sources of drinking water are identified and available, given the possibility of contamination of Great Lakes water.
  • With respect to transparency and public participation, require the public availability of detailed information on nuclear emergency planning, and require five-year reviews and detailed public consultation on emergency response planning.
  • Require emergency response measures to meet or exceed international best practices.
  • “Regularly review and publicly report on international developments and best practices in offsite nuclear emergency planning as well as on plans to adjust and improve Ontario’s plan to meet or exceed the best practices in other OECD jurisdictions.”

We believe that the case against building new nuclear power plants and refurbishing old ones is very strong. But unless Ontario plans to shut down its nuclear reactors soon, it is incumbent on the province to provide a significant margin of safety for survivors of a major nuclear disaster. Registered nurses and nurse practitioners will be there on the front lines in the event of a catastrophe, but they want to know they will have the tools to immediately help vulnerable populations.

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RNAO PNERP submission520.22 KB
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