“We Are More Than Caregivers;We Are Witnesses": A Qualitative Study of Palestinian Nurses Navigating Dual Roles as Health-Care Providers and Survivors of Systemic Violence

Abstract

Aim

To explore the lived experiences of Palestinian nurses navigating their professional duties while simultaneously being survivors of the same systemic violence affecting their patients.

Design

A qualitative study using Interpretive Phenomenological Analysis (IPA).

Methods

In-depth, semi-structured interviews were conducted with 21 registered nurses from three governmental hospitals in the West Bank and Gaza. Data were analyzed using systematic IPA procedures, guided by frameworks of structural violence and sumud (steadfastness). Credibility was established through prolonged engagement, member checking, and peer debriefing.

Results

Analysis revealed three themes: (1) The Inextricable Link, describing the collapse of professional distance through shared trauma; (2) The Weight of Bearing Witness, highlighting the psychological and political burden of documenting systemic violence; and (3) Sumud as Clinical Practice, redefining resilience as collective resistance where caregiving becomes a political and moral act.

Conclusion

Palestinian nurses embody a dual identity that transcends conventional models of moral distress, revealing nursing practice as inherently politicized under occupation. Supporting these nurses requires moving beyond individual resilience interventions to dismantle the oppressive structures that create their reality.

Implications for the Profession

The findings challenge Western models of detachment and individualized resilience. Health-care systems must recognize the political dimensions of nursing in conflict zones and support nurses not only as caregivers but as human rights witnesses deserving protection, platforms for testimony, and solidarity in advocacy for structural change.

Keywords

Palestinian nurses structural violence moral distress resilience qualitative research interpretive phenomenological analysis nursing under occupation

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