In the aftermath of the tragic earthquake in Haiti, many nurses have responded to calls to volunteer their services. It is commendable that so many thousands of nurses (and doctors and other healthcare workers) are willing to travel to a devastated nation to offer what help they can. On the other hand, many who volunteer on the spur of the moment may need to rethink their plans.

I’ve been reading a few articles about this, and all of the experts agree on one thing–if you want to volunteer, do not do so on your own. Do not get on board a plane and expect that you will be cared for once you hit the ground. This is not the movies or TV. This is real life, and volunteers who arrive without a plan or contacts tend to become part of the problem rather than the solution.

Join a reputable group, such as Medecins san Frontieres (Doctors without Borders), Americares, Partners in Health, etc. National Nurses United is organizing nurses in the U.S. But please, find a group to support you and who will direct you once you arrive.

Next, reevaluate your skills. While all kinds of healthcare workers are needed, right at this moment, the greatest need is for surgeons, surgical nurses, anesthetists, trauma care specialists, post-op nurses–basically, trauma care is the greatest need right now. If you work in psych and have never worked in a surgical setting, now might not be the best time to go. Your skills may be needed later on, after the immediate crisis, but you need to think carefully if you can truly be of help right now.

Third, take a long hard look at the situation. There is nothing romantic about going to a devastated nation, especially one that was already on the edge. Conditions in Haiti were pretty deplorable before the earthquake hit–ravaged by hurricanes and storms over the past few years, civil unrest, abject poverty, poor infrastructure, high rate of infectious disease—well, you get the picture.

Conditions are pretty bad, and as a volunteer, you are not going to be housed at the Ritz Carleton and get catered meals by a fancy French chef. It’s rough going, and you are going to be putting yourself at risk of infection, and injury. In addition, there have been many aftershocks, so the earth has not yet settled down.

Violence and looting have taken hold, so you would also be at risk in that sense.

It will be dirty, with poor to no sanitation. There will be terrible sights to behold–thousands of people with nowhere to go. Injured people unable to get help and living in the streets. Corpses piling up. Unbearable smells.

Many volunteers who do go to war zones and to places where an extreme disaster has occurred experience post traumatic stress syndrome. Yes, it can be as traumatic for the helper as it is for the victim.

Anyway, this is not to discourage anyone from going, but just to go into with your eyes open. The developing world, even in the best of times, can be shocking for Americans who have not done much traveling.

I hope everyone had a happy new year, and now as we enter both a new year and a new decade, the same issues that we faced a week ago in 2009 are still with us.

I am curious how nurses, as a group, feel about the current form that healthcare reform has taken. I haven’t seen much news about nurses, but then, nurses are rarely interviewed and opinions from nursing groups aren’t usually sought–except for issues that are strictly nursing related.

So if any nurses are reading this, I would love to hear some comments. Personally, I don’t think it will have much of an effect in the workplace, at least not initially. More patients may seek medical care if they gain insurance, but then, it is difficult to say how insurance policies will change. Higher copays? Bigger deductibles? Less coverage? All of these things will affect the number of people seeking care, and the type of care.

And happy new decade. The first decade of the 21st century was quite an experience, beginning with the contested presidential election here in the US, and now ending with the fight for healthcare reform, a would be terrorist who managed to get an explosive on a plane due to the stupidity of our so-called intelligence agencies, and hope for economic recovery.

Oh yes, and the selection of an obese surgeon general at a time when obesity is fast becoming the number one health issue in this country (what were you thinking, Barack????).

I don’t have any predictions for this year, other than I hope that the healthcare reform bill is miraculously transformed into something that resembles reform and not a sweetheart deal for the insurance industry. It is difficult to say what this year will bring for nurses, but regardless, nurses need to stand up for themselves and make an effort not to take abuse and to demand respect.