Exploring staff willingness to attend work during a disaster: A study of nurses employed in four Australian emergency departments

doi:10.1016/j.aenj.2013.05.004

Australasian Emergency Nursing Journal

Volume 16, Issue 3, August 2013, Pages 103-109

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https://doi.org/10.1016/j.aenj.2013.05.004 Get rights and content

Summary

Background

Much of the literature about emergency nurses willingness to work during disasters has been from a non-Australian perspective. Despite the many recent disasters, little is known of Australian nurse's willingness to participate in disaster response. This paper presents findings from a study that explored nurses willingness to attend work during a disaster and the factors that influenced this decision.

Methods

Data were collected consecutively using a combination of focus group and interview methods. Participants in this study, registered nurses from emergency departments, were recruited through convenience sampling from four hospitals in Australia. Participant narrative was electronically recorded, transcribed and thematically analysed.

Results

The participants for both the focus groups and interviews compromised a mix of ages, genders and years of experience as emergency nurses from across four jurisdictions within Australia. Three major themes that influenced willingness emerged with a number of subthemes. Theme one reflected the uncertainty of the situation such as the type of disaster. The second theme surrounded the preparedness of the workplace, emergency nurse and colleagues, and the third theme considered personal and professional choice based on home and work circumstances and responsibilities.

Conclusions

The decision to attend work or not during a disaster, includes a number of complex personal, work-related and professional factors that can change, depending on the type of disaster, preparedness of the work environment and the emergency nurses’ personal responsibilities at that time

Introduction

The willingness of health care personnel such as emergency medical practitioners, nurses and paramedics, to work during disasters has been extensively researched; however, there is little research that specifically explores the perspective of Australian emergency nurses’ willingness to attend work in disasters.¹ This paper presents the qualitative component, the focus group and interviews, of a much bigger mixed methods study. The bigger study comprised consecutively, of a national survey, followed by focus groups and then individual interviews with emergency nurses from four Australian jurisdictions. The research aimed to understand the complex nature of the willingness of Australian emergency nurses to attend work during a disaster. The constructs of willingness explored in this study emerged from the literature; however, they have not yet been examined and given meaning to within the Australian emergency nurses’ perspective.

Section snippets

Background

Disasters challenge the ability of healthcare systems to respond to the needs of the communities they serve. Damage to infrastructure, lack of staff and increased demand for healthcare caused by the disaster may decrease the effective functioning of the healthcare system. For the purpose of this study, the term disaster includes an all hazards approach, from environmental to biochemical hazards. The healthcare demands during a disaster will increase, especially if these are protracted events,

Design

The bigger study used a mixed-method approach.²³ Data collection was in three consecutive stages using a combination of survey, focus group and interview methods. The purpose of using a mixed method approach was to both complement the survey method and to gain more in depth understanding of the factors that influenced emergency nurses’ willingness to attend work during a disaster. Preliminary findings from each stage informed questions in the following phases, using an explanatory sequential

Results

Five focus groups were held across the four participating hospitals with 41 participants (Participants – Site1 n = 9; Site 2 n = 11; Site 3 n = 13; Site 4 n = 8). There were 13 individual interviews conducted across all four hospitals. The participants in the focus groups and interviews comprised a mix of ages, genders and years of experience, 46.3% (n = 19) had worked 1–5 years as emergency nurses. Three major themes emerged with a number of subthemes summarised in the table below.

Discussion

This study of Australian emergency nurses highlights that the willingness to attend work during a disaster is multidimensional, affected by many competing factors. Changes to societal functions during a disaster may result in loss of power, water, closing of schools, transport restrictions, and increased risks to public safety. These changes could impact on emergency nurses’ lives in both their work and home environments.

This research confirms a number of factors already found in the literature

Study limitations

Though the national study included a survey from emergency nurses in both rural and metropolitan areas the focus groups and interviews were held with emergency nurses at four major metropolitan hospitals across Australia, therefore the findings for emergency nurses working in more isolated communities may be different.

Conclusion

Within the Australian context willingness of emergency nurses to attend work during a disaster is not a straightforward process of decision-making. Decision-making includes a number of complex personal, work-related and professional factors that can change depending on the context of the disaster, preparedness of the work environment and the emergency nurses’ personal responsibilities at that time. Willingness of an Australian emergency nurse to attend work is influenced by the type of

Authors’ contribution

All authors were responsible for the study conception, design and implementation of this research project. All authors contributed to the interpretation of the research findings. LC, JR and LB developed the initial publication outline. LC wrote the first draft manuscript. All authors contributed to the drafts and critical revisions for important intellectual content.

Provenance and conflict of interest

The following authors hold editorial positions within the Australasian Emergency Nursing Journal: Ramon Shaban is Editor-in-Chief; Julie Considine is Deputy Editor; and Jamie Ranse is Associate Editor (Disasters). Authors Shaban, Considine and Ranse had no role to play in the editorial management, peer review or editorial decision-making related to the paper whatsoever. Karen Hammad is a Company Director of the College of Emergency Nursing Australasia, which owns the Australasian Emergency

Funding

This research was partially supported through a Flinders University, Industry Partnership Grant. Additional in-kind support to complete this project was provided by the authors various institutions.

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Research paperExploring staff willingness to attend work during a disaster: A study of nurses employed in four Australian emergency departments

Summary

Background

Methods

Results

Conclusions

Introduction

Section snippets

Background

Design

Results

Discussion

Study limitations

Conclusion

Authors’ contribution

Provenance and conflict of interest

Funding

Nurs Outlook

J Emerg Med

Nurse Educ Today

Ann Emerg Med

Australasian emergency nurses’ willingness to attend work in a disaster: a survey

Australas Emerg Nurs J

Chemical, biological and radiological incidents: preparedness and perceptions of emergency nurses

Disasters

Willingness of frontline health care workers to work during a public health emergency

Aust J Emerg Manage

How would Australian hospital staff react to an avian influenza admission, or an influenza pandemic?

Emerg Med Australas

Paramedics and public health emergencies: is there a ‘duty to respond’ in Australia?

Aust J Emerg Manage

Mitigating absenteeism in hospital workers during a pandemic

Disaster Med Public Health Preparedness

Factors associated with motivation and hesitation to work among health professionals during a public crisis: a cross sectional study of hospital workers in Japan during the pandemic (H1N1) 2009

BMC Public Health

Health care workers’ ability and willingness to report to duty during catastrophic disasters

J Urban Health

Will they just pack up and leave? Attitudes and intended behaviour of hospital health care workers during an influenza pandemic

BMC Health Serv Res

Paramedics’ perceptions of risk and willingness to work during disasters

Aust J Emerg Manage

Research paper
Exploring staff willingness to attend work during a disaster: A study of nurses employed in four Australian emergency departments