What is wrong with this picture? It is 6 a.m. and the nursing facility’s nurse supervisor receives a telephone call from a housekeeper who tells her that one of the dryers in the laundry room is on fire. The nurse runs downstairs, grabs an extinguisher and attempts to put out the fire herself.
What’s wrong? She should have called the fire department first.
In my past few years as a Fire Chief I have been involved in over two hundred nursing home incidents. I have seen numerous incidents in which lack of training for personnel resulted in problems or errors during an emergency situation and contributed to confusion during an already tense time. For example:
– Doors to a first-floor room on fire were left open, allowing smoke to travel up to the 2nd and 3rd floors.
– Personnel continued to use elevators during the fire.
– Doors to the electrical, gas, and sprinkler rooms were not marked. Fire personnel were unable to either find the locatiion or gain access to these rooms to shut off the utilities. This caused unnecessary damage to the building.
– Sprinkler valves were not tagged to indicae which zones they covered in the building. Waterflowed from the 3rd floor to the basement.
– Keys were not available to open certain rooms.
– Soiled laundry was piled too high and was too close to the dryers.
In addition, at various times when the Fire Department arrived, no one could give the location of the fire incident. When the employee says the alarm is going off, that is not enough information. Is there smoke showing or is there an actual fire? Where is its exact location?
In short, it has become very clear over the years that personnel in many healthcare facilities do not have adequate in-service training when an emergency occurs. What is more, most fire alarm incidents occur during the off hours: 3:00 to 11:00 p.m. and 11:00 p.m. to 7:00 a.m. on weekdays, and during all weekend shifts. Adding to the problem is the frequent turnover of help in all personnel areas, and some personnel are not fluent in English.
Both of these factors could be effectively dealt with if more training sessions were provided. These sessions should be implemented on all shifts with an emphasis on making sure that the instructions and procedures are understood by all employees. Quarterly training sessions, at least, are recommended, and should cover all personnel, especially those who work during the afternoon, night, and weekend shifts.
What The Staff Should Know
Pointers for staffers who discover a fire:
1. Remove the patient from the room.
2. Go to the nearest fire pull station and pull the alarm.
3. Pick up the nearest in-house phone and tell your supervisor of exact conditions.
4. Close doors, windows, vents; shut off fans.
5. Use extinguisher briefly, but only if you know how to use it.
Pointers for on-duty supervisors:
1. Immediately call the fire department and tell them you have fire or smoke in the building and tell them the exact location of the problem.
2. Call the maintenance man and necessary supervisory personnel.
3. Ensure that gas for life-support systems is secured.
4. Call the alarm company and sprinkler company to reset the systems.
5. Call utilities to ensure that gas/electricity are safe to use.
6. If you have a power failure, check emergency generator–have the telephone number of emergency generator company on the emergency call list.
7. Check an up-to-date patient list.
8. Make sure that the pull station, the telephone and the multipurpose extinguisher, along with a multilingual instruction sheet, are all placed together in the same location. Also, patients should have name tags and medication requirements pinned on the back of their clothing.
Cassidy, Donald J. “Involving the staff in fire safety.” Nursing Homes and Senior Citizen Care Sept.-Oct. 1991: 15+