Nurses' experiences with ethical challenges during earthquakes: Staying in Limbo

Area of Science:

• Disaster Nursing
• Medical Ethics
• Qualitative Research

Background:

• Large-scale disasters, like the 2023 Kahramanmaraş earthquakes, profoundly impact healthcare systems and frontline professionals.
• Understanding nurses' ethical experiences in disaster settings is crucial for effective preparedness and ethical practice.

Purpose of the Study:

• To explore the ethical challenges and moral distress faced by nurses post-earthquake.
• To identify nurses' coping strategies and lived experiences.
• To examine the influence of cultural and systemic factors on disaster nursing.

Main Methods:

• A qualitative phenomenological approach was employed.
• Semi-structured interviews were conducted with 17 nurses between June and August 2024.
• Manual coding and theme development ensured deep engagement with participant experiences.

Main Results:

• The central theme identified was 'Staying in Limbo,' reflecting nurses' conflict between personal needs and professional responsibilities.
• Key subthemes included Professional Responsibility (moral distress, motivation, values), Managerial Problems (resource scarcity, organizational deficiencies, training gaps), and Lessons Learned (teamwork, collective decision-making, preparedness).
• Nurses experienced moral ambiguity, temporal disorientation, and identity fragmentation navigating complex ethical dilemmas.

Conclusions:

• Cultural, structural, and institutional factors significantly influence nurses' ethical decision-making during disasters.
• Findings underscore the critical need for robust disaster preparedness and response strategies that actively support nurses' ethical decision-making and well-being.