Know the plan for the place you work
An emergency action plan explains what employees do when an emergency requires a coordinated response. For a nurse, its practical value is knowing how to raise the alarm, where to go, which duties apply, and how the organization accounts for staff.
The federal rule at 29 CFR 1910.38 applies when another OSHA standard in Part 1910 requires an emergency action plan. It establishes elements of those required plans; it should not be quoted as a standalone claim that every workplace has identical obligations.
Understand the required elements
Under that rule, an emergency action plan includes procedures for reporting emergencies, evacuation and exit-route assignments, critical operations performed before evacuation, accounting for employees, and rescue or medical duties. It also identifies a person or job title that can explain the plan.
The employer must maintain an employee alarm system with distinctive signals for its purposes and designate and train employees who assist with orderly evacuation.
The plan generally must be written, kept in the workplace, and available for employee review. The rule allows employers with ten or fewer employees to communicate it orally.
Translate the plan into your assignment
Reading a document is only the beginning of orientation. Ask how it applies to the unit, building, and shift where you work:
- How do I report an emergency and recognize the relevant alarm?
- What is my assigned role, and who directs changes?
- Which route or destination applies, and what if it is unavailable?
- How is my presence accounted for?
- What patient-care responsibilities and equipment procedures apply?
- Where do I obtain instructions when the usual communication system fails?
These questions do not establish a universal evacuation sequence. Healthcare plans must address the specific patients, building, hazards, and resources involved.
For example, a nurse floating to an unfamiliar area needs its location-specific information even if the organization's general emergency training is current.
Review changes that affect the job
Section 1910.38 requires review with covered employees when the plan is developed or the employee is initially assigned, when the employee's responsibilities change, and when the plan changes.
A new care area, altered route, or different assignment should prompt staff to ask whether their emergency instructions have changed. The employer's wider training and testing program may impose additional requirements.
Do not substitute a remembered alarm code or evacuation method from a previous employer.
Connect employee safety with patient continuity
Healthcare emergency preparedness is broader than employee evacuation. CMS guidance includes planning for continued care when essential services fail, communication, staff training, exercises, and revision of the plan.
Nurses should know how their emergency role connects with patient tracking, clinical handoffs, essential supplies, and the organization's response leadership. Those arrangements belong in the facility's approved planning and training.
See disaster preparedness roles for nurses for the wider cycle of preparation, response, and recovery.
Sources
- eCFR: 29 CFR 1910.38, Emergency Action Plans (accessed 2026-09-17) — Text current through September 15, 2026.
- CMS: Health Care Provider Guidance on Emergency Preparedness (accessed 2026-09-17).