Nurses' Experiences Following Disaster: Moral Distress and Relational Loss

Area of Science:

• Disaster nursing
• Psychological impact of disasters
• Moral distress in healthcare

Background:

• Nurses in disaster-affected areas faced prolonged and complex stressors.
• Previous research indicated persistent posttraumatic negative cognitions among affected nurses.
• This study aimed to explore the underlying experiences qualitatively.

Purpose of the Study:

• To describe nurses' subjective experiences and conflicts following the Great East Japan Earthquake and radiation disaster.
• To interpret these experiences through the lenses of moral distress and relational loss.
• To deepen the understanding of nurses' psychological responses in a compound disaster setting.

Main Methods:

• Qualitative descriptive study using open-ended responses from repeated questionnaire surveys.
• Data analyzed using qualitative content analysis with iterative theme synthesis.
• Nurses from two healthcare facilities described disaster-related stress over two years.

Main Results:

• Six themes emerged, detailing disrupted foundations, sustained emotional labor, and constrained choices.
• Nurses' narratives reflected moral distress and potential moral injury.
• Relational loss included eroded trust, team fragmentation, and reduced workplace support.

Conclusions:

• Nurses' compound disaster experiences involved intertwined moral suffering and relational loss.
• Organizational support validating nurses' responses and repairing relationships is crucial for well-being.
• Preserving professional integrity through empathetic presence is vital in extreme, constrained situations.