When disaster strikes-whether it’s a hurricane, wildfire, pandemic, or chemical spill-nurses are among the first to respond. But not all patients experience these events the same way. Individuals with Access and Functional Needs (AFN) face unique challenges in emergencies, and nurses play a pivotal role in ensuring that disaster response is equitable, effective, and inclusive for this population.
Who Are Individuals with Access and Functional Needs?
Access and Functional Needs (AFN) is an inclusive term used to describe individuals who may require additional assistance before, during, or after a disaster. This includes:
- People with disabilities (mobility, cognitive, hearing, vision)
- Older adults
- Children
- Individuals with chronic health conditions
- Pregnant individuals
- People with limited English proficiency or low health literacy
- Those reliant on durable medical equipment, assistive technology, or caregivers
AFN is not just about disability-it’s about ensuring everyone can access care, communication, shelter, and support during a crisis.
The Nurse’s Role in AFN Disaster Response
Nurses are uniquely positioned to advocate for and care for AFN populations because of their expertise in patient-centered care, assessment, and communication. In disasters, their role becomes even more critical.
1. Assessment and Triage
Nurses must rapidly identify patients with AFN and assess their needs beyond the standard triage categories. This includes understanding how a disaster has impacted a person’s ability to access medications, assistive devices, oxygen, or caregiver support.
2. Communication and Education
Individuals with AFN may require tailored communication. Nurses may need to:
- Use picture boards, interpreters, or plain language to explain medical instructions.
- Provide written or visual materials in multiple languages or accessible formats.
- Educate caregivers and patients about disaster-related health risks in a culturally and linguistically appropriate way.
3. Sheltering Support
In general population shelters, individuals with AFN may not have access to the equipment, space, or support they need. Nurses often assist in:
- Setting up Functional Needs Support Services (FNSS) areas within shelters.
- Monitoring chronic conditions and administering medications.
- Advocating for privacy, hygiene, and mobility accommodations.
4. Continuity of Care
Disasters disrupt routine care. Nurses help bridge that gap by:
- Replacing lost medications or medical records.
- Coordinating with pharmacies, durable medical equipment providers, and home health agencies.
- Ensuring safe discharge plans from hospitals to shelters or temporary housing.
5. Advocacy and Inclusion in Planning
Nurses can help shape emergency plans by bringing the AFN lens to the table. Their voice is crucial in:
- Training shelter staff on inclusive practices.
- Ensuring local disaster plans include resources for non-verbal, immobile, or medically complex individuals.
- Promoting universal design in evacuation and shelter planning.
Why It Matters
Disasters can disproportionately harm individuals with AFN when systems are not built with inclusivity in mind. Without intentional planning, people may be left behind, suffer preventable complications, or even die. Nurses ensure that no one is invisible in disaster response-and that every life is valued.
A Call to Action:
Caring for individuals with Access and Functional Needs is not an add-on in disaster response-it’s a core part of ethical, effective emergency nursing. Nurses must be trained, empowered, and equipped to identify and respond to the diverse needs of their communities during crises.
By centering equity and compassion, nurses turn crisis into care-for everyone.
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