Learning From History
Nurses have always worked the front lines of global outbreaks. In 1918, a deadly influenza strain spread worldwide and killed an estimated 50 million people, striking young adults harder than other flu viruses did. American nurses visited patients at home, treating up to 40 a day at risk to their own lives, while student nurses staffed the hospitals. Some caught the virus and died.
The World Health Organization defines a pandemic as a disease with exponential growth that produces more cases each day across many countries or populations. The 1918 flu and COVID-19 share the same brutal pattern: rapid spread and a climbing death toll, too few tests and vaccines, heavy reliance on isolation and hygiene, and health systems pushed past capacity. The past century brought flu vaccines, antivirals, and global surveillance that softened later pandemics in 1957, 1968, and 2009, and SARS and MERS research helped guide the COVID-19 vaccine. COVID-19 made the need for trained nurses impossible to ignore. Nurses treated patients, taught the public how to slow transmission, and led efforts to make hospitals safer, down to assembling masks and face shields.
Skills Nurses Bring to the Table
Beyond fighting disease and responding to disasters, nurses prevent and manage other public health problems, including obesity, tobacco and substance use, sexually transmitted infections, and the effects of unsafe drinking water. RNs assess symptoms, take histories, administer medications and vaccines, and assist with tests and procedures. NPs add leadership, research, and policy analysis to crisis management and disaster response, and they practice independently in many states. Both teach infectious disease prevention, emergency preparedness, and treatment for chronic conditions and addiction.
In hospitals, clinics, schools, and organizations like the Red Cross, nurses activate operations plans, oversee personal protective equipment, staff shelters, run blood drives, and check on older adults. Some clinics employ a surveillance nurse to track outbreaks through contact tracing. Nurses also work to close health disparities in emergencies, helping underserved communities prepare and advocating for equal access to tests, treatments, and vaccines.
Nursing Shortages
A Health Affairs workforce analysis found RNs dropped by more than 100,000 in 2021, a stark measure of the national shortage. Short staffing does more than strain patient care: it makes public health emergencies more likely and more severe. Even apart from the pandemic, adding just one patient to a nurse's workload raises patient mortality by 7%, according to a 2014 Lancet study. The World Health Organization warned back in 2007 that under-resourced systems accelerate global disease transmission.
Understaffed facilities cannot educate patients, administer enough vaccines, or sustain community outreach, which lets infections spread further. And people are more likely to trust nurses on issues like vaccination than physicians or government officials, according to a 2022 Frontiers article.
Nursing Careers for Public Health Emergencies
Many roles help prevent and end public health emergencies.
Registered nurse. In physicians' offices, RNs teach patients about vaccines and prevention and offer telehealth to limit transmission. In hospitals, they triage, run infection-control plans, and diagnose and treat injuries and illness.
Respiratory nurse. These nurses treat respiratory disease from RSV and other viruses, smoking, and wildfire exposure, and they manage oxygen, ventilators, and medications.
Public health nurse. Community-focused nurses handle case investigation, contact tracing, mass vaccination, and education. They work in neighborhood clinics, in the field, and onsite with disaster response teams, and in some areas serve as school nurses.
Informatics nurse. Informatics nurses analyze and share data to monitor at-risk populations, identify priorities, shape policy, and evaluate care.
Pediatric nurse. Pediatric nurses care for children and counsel families on vaccines and health promotion, and they connect families with resources like childcare when a sick child has to stay home.
Geriatric nurse. Geriatric nurses work in offices, clinics, home health, and long-term care, focusing on health promotion and infectious disease prevention for older adults.
ER nurse. ER nurses are often the first contact for life-threatening illness and injury. They triage, monitor vital signs, stabilize patients, and administer first aid, medications, and treatments.
Frequently Asked Questions
What do nurses do during a public health emergency? They vaccinate and treat patients, run infection-control and triage, staff shelters and blood drives, trace contacts, and educate communities. Public health and emergency nurses train specifically in disaster preparedness, response, and recovery.
Why does the nursing shortage make emergencies worse? Understaffed facilities cannot educate patients, give enough vaccines, or sustain outreach, which lets infections spread. A Lancet study found each added patient on a nurse's workload raises 30-day mortality odds by about 7%, and NCSBN reports roughly 100,000 RNs left the workforce during the pandemic.
Which nursing roles focus on public health crises? Public health nurses, respiratory nurses, informatics nurses, and ER nurses all play distinct parts, alongside RNs, pediatric, and geriatric nurses. Nurse practitioners add leadership, research, and policy analysis, and practice independently in many states.
What can history teach nurses about pandemics? The 1918 flu killed at least 50 million people worldwide. It shares COVID-19's pattern of rapid spread, limited tests and vaccines, and overwhelmed systems, which is why isolation, hygiene, and trained staff still matter.
Why do people trust nurses on issues like vaccination? Nurses are consistently rated among the most trusted professionals, and research shows the public is more likely to trust nurses on vaccination than physicians or government officials, which makes their patient-education role central in an emergency.