Exploring the demands on nurses working in health care facilities during a large-scale natural disaster: often an invisible role within a highly visible event

Nurses are pivotal to an effective societal response to a range of critical events, including disasters. This presents nurses with many significant and complex challenges that require them to function effectively under highly challenging and stressful circumstances and often for prolonged periods of time. The exponential growth in the number of disasters means that that knowledge of disaster preparedness and how this knowledge can be implemented to facilitate the development of resilient and adaptive nurses and health care organisations represents an important adjunct to nurse education, policy development and research considerations. While this topic has and continues to attract attention in the literature, a lack of systematic understanding of the contingencies makes it difficult to clearly differentiate what is known and what gaps remain in this literature. Providing a sound footing for future research can be facilitated by first systematically reviewing the relevant literature. Focused themes were identified and analysed using an ecological and interactive systems framework. Ten of the twelve retained studies included evacuation revealing that evacuation is more likely to occur in an aged care facility than a hospital. The unpredictability of an event also highlighted organisational, functional, and competency issues in regards to the complexity of decision-making and overall preparedness. The integrative review also identified that the unique roles, competencies and demands on nurses working in hospitals and residential healthcare facilities during a natural disaster appear invisible within the highly visible event.