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

Abstract

Background

Large-scale disasters, such as the February 6, 2023, Kahramanmaraş-centred earthquakes, significantly affect healthcare systems and frontline professionals, including nurses. Understanding the ethical experiences of nurses’ in such contexts is crucial for disaster preparedness and nursing ethics.

Aim

This study aimed to explore the ethical challenges and moral distress experienced by nurses providing care after the 2023 earthquakes, as well as their coping strategies. The focus was on their lived experiences and professional responsibilities, and the influence of cultural and systemic factors.

Research design

A qualitative phenomenological approach was adopted to gain an in-depth understanding of the experiences of nurses.

Participants and research context

Seventeen nurses were interviewed. The interviews were conducted between June and August 2024. They used a semi-structured guide. All coding and theme development were conducted manually to ensure close engagement with the data.

Ethical considerations

Ethical approval was obtained from Adiyaman University Social and Human Sciences Ethics Committee (Decision No: 69, 05.06.2024), and all participants provided informed consent, and anonymity was maintained throughout the study.

Findings

The main theme of ‘Staying in Limbo’ reflects nurses’ feelings about being in a state between their personal needs and their professional duties. Three subthemes were identified: (1) Professional Responsibility, which encompasses moral distress, motivation, and ethical values; (2) Managerial Problems, which highlight resource scarcity, organisational deficiencies, and training gaps; and (3) Lessons Learned and Recommendations, which emphasise teamwork, collective ethical decision-making, and systemic preparedness. As they navigated ethical dilemmas within personal, cultural, and institutional frameworks, nurses experienced moral ambiguity, temporal disorientation, and identity fragmentation.

Conclusion

Factors such as culture, structure, and institutions affect nurses’ ethical decision-making in disasters. The findings show the importance of disaster preparedness and response strategies that support nurses in making ethical decisions and provide them with the necessary support.