Prepared to Respond: How UB Nursing Students Are Training for Disasters

On the first Saturday in April, a Buffalo blizzard set the stage for a deadly traffic pileup resulting in serious injuries with the added risk of hypothermia. While a springtime snowstorm is nothing new in Erie County, this one was different: it was a first-of-its-kind simulation, organized and run by UB nursing faculty and students to gain real-world experience through hands-on emergency response training.

Joann Sands, DNP, RN, ANP-BC, NHDP-BC, a clinical associate professor at the UB School of Nursing, helped coordinate the event at the East Seneca Fire Company, where she also serves as a volunteer firefighter and EMT.

“This type of event is fairly new for an academic discipline, but when the Multicultural Nursing Student Association (MNSA) approached me with the idea for a disaster response training it was a natural fit for me to support them,” Sands said.

The daylong training event featured three key components: didactic stations featuring skills refreshers, a triage activity/exercise, and a three-part hands-on drill simulating an automobile extrication, casualty collection point (CCP) and a hospital setting to complete the transfer of care.

Bringing the event to life was also a collaborative exercise: Sands worked closely with Linda Chen ’25, secretary of MNSA; Sabrina Schwartz, PhD, RN, MNSA faculty advisor; and Clark Reinard, Fire Captain, and Bryan Goyette, EMS Coordinator and Paramedic, both of East Seneca Fire Company. Their goal was to provide nursing students with an opportunity to broaden their perspective while applying acute care skills in a setting they might not typically encounter in nursing school.

“We learn only a little bit about a nurse's role in disasters specifically, and we thought it would be a great experience if we can expand on that side of the profession,” Chen said.

Sands, who devotes one class session each semester to disaster preparedness, has a long-standing passion for disaster preparedness. Her doctor of nursing practice (DNP) project at UB focused on disaster response, and she earned a Master of Science in disaster preparedness and emergency management from Arkansas State University.

Preparedness, mitigation, response, and recovery are critical to the disaster management cycle, Sands said. Training like this event reinforces each phase, with an emphasis on strengthening communication skills.

“The other disciplines [firefighters, emergency medical services, and Mercy Flight crews, who were all on-hand at the event] are trained to respond in these environments where mortality and morbidity can be high. We look at it as disaster epidemiology, so when it came to designing this event for our nursing students, we are teaching risk reduction is in learning how we can respond based on previous disaster scenarios,” Sands said.

Twenty students  eased into the day-long simulation with didactic stations led by  Sands, Reinhard and Goyette. The sessions included skills refreshers on CPR and AED use, stopping bleeds and trauma assessment. And, appropriate to the event’s theme, instructors also covered hypothermia management and how prescribed medications could impact patient outcomes in a disaster setting. Throughout the day, these core skills were framed within the context of a chaotic mass casualty event.

On hand for the disaster drill were 10 EMS and fire personnel and eight volunteers playing the role of the disaster victims. The realism of the drill shed light on a patient’s full trauma experience in a way that many of the students had never considered. MNSA president Edwina Fang (BS ’25) especially valued how that lesson was paired with the hands-on triage activity.

“We observed a firefighter use the Jaws of Life tool to take the door off a car and that took a while, which showed us how long a patient might be trapped, bleeding or losing oxygen. Nurses are not on scene to see that, now we can have a better understanding of everything that patient has endured if we encounter them in the ER, and that makes a meaningful impact on our treatment choices,” Fang said.

The students were also able to get into the vehicle to hold C-spine stabilization for the victim during that extrication simulation.

The triage activity challenged students to make rapid decisions about how to tag each patient in a high-pressure setting with limited supplies and personnel. Fang said the exercise forced a shift of perspective on patient care in critical situations.

“The EMS personnel and the crew from Mercy Flight posed deep questions about our choices of who we wanted to send to the hospital and why. We had to make those choices, quickly, based on survivability,” Fang said. “We learned that if someone is not breathing in a mass casualty setting, we have to move on to the next patient. That was hard,” she added.

Sands noted that while training for nurses and first responders does not typically intersect, creating training events like this with intentional overlap is meant to develop essential emergency and disaster response skills in nurses. Interprofessional collaboration in high-pressure situations sharpens critical thinking skills and builds nursing students’ confidence for career readiness. The result: smoother care transitions and patient outcomes in the real world.

The simulated transfer of care to the hospital emergency room was staged inside the East Seneca Fire Company. Fang was assigned the role of charge nurse, coordinating the patients from the triage activity while also managing routine emergency department walk-ins.

“We had continuity with our mass casualty patients from the field, and many of my decisions as charge nurse still depended on how we should use our resources,” Fang said.

Under federal regulations, all Medicare- and Medicaid-participating health care providers must meet national emergency preparedness requirements. This includes conducting regular exercises to test emergency plans and ensuring staff are trained about their roles and the facility’s procedures. Established by the U.S. Centers for Medicare & Medicaid Services, these standards are designed to ensure organizations are ready for both natural and man-made disasters, and that they can coordinate effectively with emergency services at every level.

For future nurses at UB, this means developing the skills and judgment needed to adapt quickly and collaborate under pressure is essential – it also helps them stand out among their peers.

“This type of experiential learning and interdisciplinary collaboration is empowering for our nurses, whether it helps them to improve care flow for patients coming in from a mass casualty event, or if nurses are deployed to or simply find themselves in stressful triage situations with limited resources,” Sands said.

Fang, whose capstone clinical rotation was in intensive care at Millard Fillmore Suburban Hospital, agrees.

“A lot of critical thinking skills were involved as we had to consider everything happening to the patient. I not only better understand the role of other emergency caregivers, but I can also transfer the skills I learned today to working in an ICU,” Fang said.

The success of this simulation has sparked long-term goals. With Sands’ support, the Multicultural Nursing Student Association aims to organize two disaster drills each year: one focused on a natural disaster, the other on a man-made event. That momentum aligns with Sands’ goal to develop a full-semester disaster preparedness course at UB, ensuring that future nurses are trained not only to respond, but to lead.

By TERRA OSTERLING