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Crisis Management Experiences of Emergency Nurses in the Disaster of the Century: A Qualitative Study

Year 2024, Volume: 7 Issue: 3, 705 - 714, 01.12.2024
https://doi.org/10.38108/ouhcd.1380454

Abstract

Objective: It is a matter of curiosity what kind of a crisis emergency department nurses experienced regarding patient care and what kind of a solution method they developed to cope with this crisis during the two major earthquakes in Turkey, which were called "the disaster of the century". The problems experienced during patient care in a major disaster and the solutions developed need to be known to take precautions against greater threats. The research aimed to determine the experiences of emergency department nurses regarding the crises encountered in the disaster of the century by investigating them in depth.
Methods: This is a qualitative study. This study was conducted with 18 nurses working in the emergency department of the pilot hospital, which was the tertiary care center in the disaster of the century, using in-depth interviews, and a qualitative research method. The data were subjected to content analysis.
Results: As a result of content analysis, three main and five sub-themes were identified. The themes were: (1) problems related to safety; for patient and employee safety, (2) disruptions in patient care; teamwork, and support from other institutions, (3) psychosocial breakdown of emergency department nurses; burnout, anxiety, and helplessness.
Conclusion: According to the statements of the participants, all necessary precautions were taken in terms of patient and staff safety, number of personnel, and material support to prevent serious crises during patient care. With the facilities available and offered, emergency clinic nurses took part in patient care in the emergency clinic for days without interruption. In the disaster of the century, it was determined that emergency clinic nurses were ready for patient care, but especially women experienced a complete psychosocial collapse.

References

  • Afaya A, Bam V, Azongo TB, Afaya RA, Yakong VN, Kpodo GK, ... & Adatara P. (2021). We are left with nothing to work with; challenges of nurses working in the emergency unit at a secondary referral hospital: A descriptive qualitative study. Plos One, 16(2), e0247062. https://doi.org/10.1371/journal.pone. 0247 062
  • Akpınar NB, Ceran M. (2020). Current approaches to disasters and the roles and responsibilities of disaster nurses. Journal of Paramedic and Emergency Health Services. 1(1), 28-40.
  • Albury C, Pope C, Shaw S, Greenhalgh T, Ziebland S, Martin S, ... & Pilbeam C. (2021). Gender in the consolidated criteria for reporting qualitative research (COREQ) checklist. International Journal of Quality Health Care. 33(4), mzab123. https://doi.org/10.1093/ intqhc/mzab123
  • Al Harthi M, Al Thobaity A, Al Ahmari W, Almalki M. (2020). Challenges for nurses in disaster management: a scoping review. Risk Management Healthcare Policy, 2627-2634. http://doi.org/10.2147/ RMHP.S279513
  • Aliakbari F, Heidari M, Moezzi M. (2022). Designing a disaster training program and examining its impact on the level of competence of nursing students. Disaster and Emergency Medicine Journal, 7(3), 142-149. https://doi.org/10.5603/DEMJ.a2022.0023
  • Amberson T, Wells C, Gossman S. (2020). Increasing disaster preparedness in emergency nurses: a quality improvement initiative. Journal of Emergency Nursing, 46(5), 654-665. https://doi.org/10.1016/ j.jen.2020.05.001
  • Apornak A, Raissi S, Keramati A, Khalili-Damghani K. (2020). Optimization nursing employees in a hospital emergency department by using linear programming. International Journal of Management Concepts and Philosophy, 13(3), 184-95. https://doi.org/10.1504/IJMCP.2020.111026
  • Aykan EB, Fidancı BE, Yıldız D. (2022). Assessment of nurses’ preparedness for disasters. International Journal of Disaster Risk Reduction, 68, 102721, 1-8 https://doi.org/10.1016/j.ijdrr.2021.102721
  • Buljac-Samardzic M, Doekhie KD, van Wijngaarden JD. (2020). Interventions to improve team effectiveness within health care: a systematic review of the past decade. Human Resources for Health, 18(1), 1-42. https://doi.org/10.1186/s12960-019-0411-3
  • Brewer CA, Ranse J, Hammad K, Hutton A. (2022). Experiences of rural and remote nurses during and following disasters: a scoping review. Rural and Remote Health, 22(4), 1, 12. https://doi.org/ 10.22605/RRH7230
  • Coombs WT. (2020). Crisis management and communications. Institute for Public Relations, 4(5), 6. Accessed May 20, 2023. https://instituteforpr.org/wp-content/uploads/Crisis-Comms2-Revised2020.pdf
  • Clopton EL, Hyrkäs EK. (2020). Modeling emergency department nursing workload in real time: An exploratory study. International Emergency Nursing, 48, 100793, 1-9. https://doi.org/10. 1016/ j.ienj.2019.1007 93
  • Hammad KS, Arbon P, Gebbie K, Hutton A. (2017). Moments of disaster response in the emergency department (ED). Australasian Emergency Nursing Journal, 20(4), 181-5. https://doi.org/10.1016/j.aenj. 2017.10.002
  • Hospital Disaster and Emergency Plans Implementation Regulation (2015). T.R. Official Gazette, 29301, Accessed Jan 14, 2024. https://www. resmigazete. gov.tr/eskiler/2020/03/20200318-2.htm
  • James R, Gilliland B. Crisis intervention strategies, 2012. Belmont, CA: Cengage Learning. Accessed May 15, 2023. https://books.google.com.tr/books/about/ Crisis _Intervention_Strategies.html?id=d5V4CgAAQBAJ&redir_esc=y
  • Jun J, Ojemeni MM, Kalamani R, Tong J, Crecelius ML. (2021). Relationship between nurse burnout, patient and organizational outcomes: Systematic review.” International Journal of Nursing Studies, 119, 103933. https://doi.org/10.1016/j.ijnurstu.2021 .10393
  • Kang JS, Lee H, Seo JM. (2023). Relationship between nursing students’ awareness of disaster, preparedness for disaster, willingness to participate in disaster response, and disaster nursing competency. Disaster Medicine Public Health Preparedness, 17, e220. https://doi.org/10.1017/dmp.2022.198
  • Lincoln YS, Guba EG. (1986). But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Direction for Program Evaluation, (30), 73-84. https://doi.org/10.1002/ev. 1427
  • Loke AY, Guo C, Molassiotis A. (2021). Development of disaster nursing education and training programs in the past 20 years (2000–2019): A systematic review. Nurse Education Today, 99, 104809, 1-19. https://doi.org/10.1016/j.nedt.2021.104809
  • Loke AY, Li S, Guo C. (2021). Mapping a postgraduate curriculum in disaster nursing with the International Council of Nursing's Core Competencies in Disaster Nursing V2. 0: the extent of the program in addressing the core competencies. Nurse Education Today, 106, 105063. https://doi.org/10.1016/j.nedt.2021.105063
  • Longo BM. (2022). Earthquake preparedness and knowledge of recommended self-protective actions: A survey of nursing students. Disaster Medicine and Public Health Preparedness, 16(2), 495-499. https://doi.org/10.1017/dmp.2020.422
  • Marshall C, Rossman GB. (2014). Designing qualitative research. Sage publications. Morrow R, Rodriguez A, King N. (2015). Colaizzi’s descriptive phenomenological method. The Psychologist, 28(8), 643-644.
  • Murphy JP, Kurland L, Rådestad M, Magnusson S, Ringqvist T, Rüter A. (2021). Emergency department registered nurses overestimate their disaster competency: A cross-sectional study. International Emergency Nursing, 58, 101019. https://doi.org/10.1016/j.ienj.2021.101019
  • Polit DF, Beck CT. (2008).Nursing research: Generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins.
  • Rowland M, Adefuye AO, Vincent-Lambert C. (2021). The need for purposeful teaching, learning and assessment of crisis resource management principles and practices in the undergraduate pre-hospital emergency care curriculum: A narrative literature review. Australas Journal of Paramedicine, 18, 1-9. https://doi.org/10.33151/ajp.18.820
  • Said NB, Chiang VC. (2020). The knowledge, skill competencies, and psychological preparedness of nurses for disasters: a systematic review. International Emergency Nursing, 48, 100806, 1-9. https://doi.org/10.1016/j.ienj.2019.100806
  • Savioli G, Ceresa IF, Gri N, Bavestrello Piccini G, Longhitano Y, Zanza C, Bressan MA. (2022). Emergency department overcrowding: understanding the factors to find corresponding solutions. Journal of Personalized Medicine, 12(2), 279. https://doi.org/10.3390/jpm12020279
  • Sultan MAS, Løwe Sørensen J, Carlström E, Mortelmans L, Khorram-Manesh A. (2020). Emergency healthcare providers’ perceptions of preparedness and willingness to work during disasters and public health emergencies. Healthcare 8(4), 442. https://doi.org/10.3390/healthcare8040442
  • Tas F, Cakir M. (2022). Nurses' knowledge levels and preparedness for disasters: A systematic review. International Journal of Disaster Risk Reduction, 103230, 1-10. https://doi.org/10.1016/j.ijdrr.2022. 103230
  • Tas F, Cakir M, Kadioglu S. (2020). Identification of the preparedness level of nurses for disasters in Turkey: A university hospital example. International Journal of Disaster Risk Reduction, 44, 101441, 1-9. https://doi.org/10.1016/j.ijdrr.2019.101441
  • Taşkıran G, Baykal Ü. (2017). Disasters and nurses’ preparedness for disasters in Turkey: Literature review. Journal of Health and Nursing Management, 4(2), 79-88. https://doi.org/10.5222/SHYD.2017.079
  • Taşkıran G, Baykal U. (2019). Nurses’ disaster preparedness and core competencies in Turkey: a descriptive correlational design.” International nursing review, 66(2), 165-175.
  • The Republic of Turkey Disaster and Emergency Management Presidency. Accessed May 15, 2023. https://deprem.afad.gov.tr/assets/pdf/Kahramanmaras%20%20Depremleri_%20On%20Degerlendirme%20Raporu.pdf
  • The Republic of Turkey, Presidency of Strategy and Budget. Accessed May 15, 2023. https://www.sbb. gov.tr/wp-content/uploads/2023/03/2023-Kahramanmaras-ve-Hatay-Depremleri-Raporu.pdf
  • Younis NM, Ahmed MM, Hussein AA. (2020). Nurses’ knowledge, attitude and practice towards preparedness of disaster management in emergency of Mosul teaching hospitals. Medico-Legal Update, 20(3), 775-779.
  • Zhang Z, Brazil J, Ozkaynak M, Desanto K. (2020). Evaluative research of technologies for prehospital communication and coordination: a systematic review. Journal of Medical Systems. 44, 1-14. https://doi.org/10.1007/s10916-020-01556-z

Yüzyılın Afetinde Acil Klinik Hemşirelerinin Kriz Yönetimine İlişkin Deneyimleri: Niteliksel Bir Çalışma

Year 2024, Volume: 7 Issue: 3, 705 - 714, 01.12.2024
https://doi.org/10.38108/ouhcd.1380454

Abstract

Amaç: Ülkede yaşanan ve “yüzyılın felaketi” olarak adlandırılan iki büyük depremde acil klinik hemşirelerinin hasta bakımı konusunda nasıl bir kriz yaşadıkları ve yaşanan krizde nasıl bir çözüm yöntemi geliştirdiği merak konusudur. Büyük afette hasta bakımı sırasında yaşanan sorunların ve geliştirilen çözüm önerilerinin yaşanacak daha büyük tehditlere karşı tedbir alabilmek için bilinmeye ihtiyacı vardır. Bu çalışma, acil klinik hemşirelerinin deprem felaketinde karşılaşılan krizler ve bu krizler ile nasıl baş ettiklerini derinlemesine belirlemeyi amaçladı.
Yöntem: Çalışma niteliksel tiptedir. Bu çalışma, Yüzyılın felaketinde pilot hastane olarak seçilen üçüncü basamak bir hastanede 18 acil klinik hemşiresi ile derinlemesine görüşme yöntemi kullanılarak yürütüldü. Veriler içerik analizine tabi tutuldu.
Bulgular: İçerik analizi sonucunda üç ana ve beş alt tema belirlendi. Ana temalar; (1) güvenlikle ilgili sorunlar; hasta ve çalışan güvenliği açısından, (2) hasta bakımında aksamalar; ekip çalışması ve diğer kurumların desteği, (3) acil servis hemşirelerinin psikososyal sorunları; tükenmişlik, kaygı ve çaresizlik.
Sonuç: Katılımcıların ifadelerine göre, hasta bakımı sırasında ciddi krizler yaşanmaması için hasta ve çalışan güvenliği, personel sayısı, malzeme desteği açısından gerekli tüm tedbirler alınmıştı. Mevcut ve sunulan imkanlar ile acil klinik hemşireleri günlerce kesintisiz olarak acil klinikte hasta bakımında yer aldı. Yüzyılın felaketinde acil klinik hemşirelerinin hasta bakımına hazır olduğu ancak, özellikle kadınların psikososyal yönden tam bir çöküş yaşadıkları belirlendi.

References

  • Afaya A, Bam V, Azongo TB, Afaya RA, Yakong VN, Kpodo GK, ... & Adatara P. (2021). We are left with nothing to work with; challenges of nurses working in the emergency unit at a secondary referral hospital: A descriptive qualitative study. Plos One, 16(2), e0247062. https://doi.org/10.1371/journal.pone. 0247 062
  • Akpınar NB, Ceran M. (2020). Current approaches to disasters and the roles and responsibilities of disaster nurses. Journal of Paramedic and Emergency Health Services. 1(1), 28-40.
  • Albury C, Pope C, Shaw S, Greenhalgh T, Ziebland S, Martin S, ... & Pilbeam C. (2021). Gender in the consolidated criteria for reporting qualitative research (COREQ) checklist. International Journal of Quality Health Care. 33(4), mzab123. https://doi.org/10.1093/ intqhc/mzab123
  • Al Harthi M, Al Thobaity A, Al Ahmari W, Almalki M. (2020). Challenges for nurses in disaster management: a scoping review. Risk Management Healthcare Policy, 2627-2634. http://doi.org/10.2147/ RMHP.S279513
  • Aliakbari F, Heidari M, Moezzi M. (2022). Designing a disaster training program and examining its impact on the level of competence of nursing students. Disaster and Emergency Medicine Journal, 7(3), 142-149. https://doi.org/10.5603/DEMJ.a2022.0023
  • Amberson T, Wells C, Gossman S. (2020). Increasing disaster preparedness in emergency nurses: a quality improvement initiative. Journal of Emergency Nursing, 46(5), 654-665. https://doi.org/10.1016/ j.jen.2020.05.001
  • Apornak A, Raissi S, Keramati A, Khalili-Damghani K. (2020). Optimization nursing employees in a hospital emergency department by using linear programming. International Journal of Management Concepts and Philosophy, 13(3), 184-95. https://doi.org/10.1504/IJMCP.2020.111026
  • Aykan EB, Fidancı BE, Yıldız D. (2022). Assessment of nurses’ preparedness for disasters. International Journal of Disaster Risk Reduction, 68, 102721, 1-8 https://doi.org/10.1016/j.ijdrr.2021.102721
  • Buljac-Samardzic M, Doekhie KD, van Wijngaarden JD. (2020). Interventions to improve team effectiveness within health care: a systematic review of the past decade. Human Resources for Health, 18(1), 1-42. https://doi.org/10.1186/s12960-019-0411-3
  • Brewer CA, Ranse J, Hammad K, Hutton A. (2022). Experiences of rural and remote nurses during and following disasters: a scoping review. Rural and Remote Health, 22(4), 1, 12. https://doi.org/ 10.22605/RRH7230
  • Coombs WT. (2020). Crisis management and communications. Institute for Public Relations, 4(5), 6. Accessed May 20, 2023. https://instituteforpr.org/wp-content/uploads/Crisis-Comms2-Revised2020.pdf
  • Clopton EL, Hyrkäs EK. (2020). Modeling emergency department nursing workload in real time: An exploratory study. International Emergency Nursing, 48, 100793, 1-9. https://doi.org/10. 1016/ j.ienj.2019.1007 93
  • Hammad KS, Arbon P, Gebbie K, Hutton A. (2017). Moments of disaster response in the emergency department (ED). Australasian Emergency Nursing Journal, 20(4), 181-5. https://doi.org/10.1016/j.aenj. 2017.10.002
  • Hospital Disaster and Emergency Plans Implementation Regulation (2015). T.R. Official Gazette, 29301, Accessed Jan 14, 2024. https://www. resmigazete. gov.tr/eskiler/2020/03/20200318-2.htm
  • James R, Gilliland B. Crisis intervention strategies, 2012. Belmont, CA: Cengage Learning. Accessed May 15, 2023. https://books.google.com.tr/books/about/ Crisis _Intervention_Strategies.html?id=d5V4CgAAQBAJ&redir_esc=y
  • Jun J, Ojemeni MM, Kalamani R, Tong J, Crecelius ML. (2021). Relationship between nurse burnout, patient and organizational outcomes: Systematic review.” International Journal of Nursing Studies, 119, 103933. https://doi.org/10.1016/j.ijnurstu.2021 .10393
  • Kang JS, Lee H, Seo JM. (2023). Relationship between nursing students’ awareness of disaster, preparedness for disaster, willingness to participate in disaster response, and disaster nursing competency. Disaster Medicine Public Health Preparedness, 17, e220. https://doi.org/10.1017/dmp.2022.198
  • Lincoln YS, Guba EG. (1986). But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Direction for Program Evaluation, (30), 73-84. https://doi.org/10.1002/ev. 1427
  • Loke AY, Guo C, Molassiotis A. (2021). Development of disaster nursing education and training programs in the past 20 years (2000–2019): A systematic review. Nurse Education Today, 99, 104809, 1-19. https://doi.org/10.1016/j.nedt.2021.104809
  • Loke AY, Li S, Guo C. (2021). Mapping a postgraduate curriculum in disaster nursing with the International Council of Nursing's Core Competencies in Disaster Nursing V2. 0: the extent of the program in addressing the core competencies. Nurse Education Today, 106, 105063. https://doi.org/10.1016/j.nedt.2021.105063
  • Longo BM. (2022). Earthquake preparedness and knowledge of recommended self-protective actions: A survey of nursing students. Disaster Medicine and Public Health Preparedness, 16(2), 495-499. https://doi.org/10.1017/dmp.2020.422
  • Marshall C, Rossman GB. (2014). Designing qualitative research. Sage publications. Morrow R, Rodriguez A, King N. (2015). Colaizzi’s descriptive phenomenological method. The Psychologist, 28(8), 643-644.
  • Murphy JP, Kurland L, Rådestad M, Magnusson S, Ringqvist T, Rüter A. (2021). Emergency department registered nurses overestimate their disaster competency: A cross-sectional study. International Emergency Nursing, 58, 101019. https://doi.org/10.1016/j.ienj.2021.101019
  • Polit DF, Beck CT. (2008).Nursing research: Generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins.
  • Rowland M, Adefuye AO, Vincent-Lambert C. (2021). The need for purposeful teaching, learning and assessment of crisis resource management principles and practices in the undergraduate pre-hospital emergency care curriculum: A narrative literature review. Australas Journal of Paramedicine, 18, 1-9. https://doi.org/10.33151/ajp.18.820
  • Said NB, Chiang VC. (2020). The knowledge, skill competencies, and psychological preparedness of nurses for disasters: a systematic review. International Emergency Nursing, 48, 100806, 1-9. https://doi.org/10.1016/j.ienj.2019.100806
  • Savioli G, Ceresa IF, Gri N, Bavestrello Piccini G, Longhitano Y, Zanza C, Bressan MA. (2022). Emergency department overcrowding: understanding the factors to find corresponding solutions. Journal of Personalized Medicine, 12(2), 279. https://doi.org/10.3390/jpm12020279
  • Sultan MAS, Løwe Sørensen J, Carlström E, Mortelmans L, Khorram-Manesh A. (2020). Emergency healthcare providers’ perceptions of preparedness and willingness to work during disasters and public health emergencies. Healthcare 8(4), 442. https://doi.org/10.3390/healthcare8040442
  • Tas F, Cakir M. (2022). Nurses' knowledge levels and preparedness for disasters: A systematic review. International Journal of Disaster Risk Reduction, 103230, 1-10. https://doi.org/10.1016/j.ijdrr.2022. 103230
  • Tas F, Cakir M, Kadioglu S. (2020). Identification of the preparedness level of nurses for disasters in Turkey: A university hospital example. International Journal of Disaster Risk Reduction, 44, 101441, 1-9. https://doi.org/10.1016/j.ijdrr.2019.101441
  • Taşkıran G, Baykal Ü. (2017). Disasters and nurses’ preparedness for disasters in Turkey: Literature review. Journal of Health and Nursing Management, 4(2), 79-88. https://doi.org/10.5222/SHYD.2017.079
  • Taşkıran G, Baykal U. (2019). Nurses’ disaster preparedness and core competencies in Turkey: a descriptive correlational design.” International nursing review, 66(2), 165-175.
  • The Republic of Turkey Disaster and Emergency Management Presidency. Accessed May 15, 2023. https://deprem.afad.gov.tr/assets/pdf/Kahramanmaras%20%20Depremleri_%20On%20Degerlendirme%20Raporu.pdf
  • The Republic of Turkey, Presidency of Strategy and Budget. Accessed May 15, 2023. https://www.sbb. gov.tr/wp-content/uploads/2023/03/2023-Kahramanmaras-ve-Hatay-Depremleri-Raporu.pdf
  • Younis NM, Ahmed MM, Hussein AA. (2020). Nurses’ knowledge, attitude and practice towards preparedness of disaster management in emergency of Mosul teaching hospitals. Medico-Legal Update, 20(3), 775-779.
  • Zhang Z, Brazil J, Ozkaynak M, Desanto K. (2020). Evaluative research of technologies for prehospital communication and coordination: a systematic review. Journal of Medical Systems. 44, 1-14. https://doi.org/10.1007/s10916-020-01556-z
There are 36 citations in total.

Details

Primary Language English
Subjects Emergency Nursing
Journal Section Araştırma
Authors

Özlem Şahin Akboğa 0000-0002-6767-4195

Dilek Gelin 0000-0002-4079-3776

Early Pub Date November 12, 2024
Publication Date December 1, 2024
Submission Date October 24, 2023
Acceptance Date February 5, 2024
Published in Issue Year 2024 Volume: 7 Issue: 3

Cite

APA Şahin Akboğa, Ö., & Gelin, D. (2024). Crisis Management Experiences of Emergency Nurses in the Disaster of the Century: A Qualitative Study. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi, 7(3), 705-714. https://doi.org/10.38108/ouhcd.1380454