A Conflict of Values: Nurses' Willingness to Work Under Threatening Conditions.

PURPOSE: The purpose of this study was to determine the willingness of Israeli registered nurses to work under threatening conditions, their perceived level of threat, and perceptions of peer willingness to report to work.

DESIGN: This descriptive study was based on a convenience sample of registered nurses working in four hospitals throughout Israel from internal medicine, surgical, emergency, and intensive care units.

METHODS: A questionnaire designed by the investigators was administered to registered nurses while on duty. The questionnaire consisted of three sections: personal characteristics, perceived level of personal threat from five situations (caring for a patient with a dangerous infection, terror attack, war, radiation or chemical disaster, or natural disaster), and perceived personal and peer willingness to work under these threats.

FINDINGS: A convenience sample of 249 registered nurses from four hospitals responded. The highest level of perceived threat was a natural disaster (earthquake; M = 2.15, SD = 0.9). Terror (M = 0.83, SD = 0.6) and war (M = 1.01, SD = 0.6) received the lowest mean perceived threat scores. Most respondents were not willing to work during a natural disaster but were willing to care for patients with dangerous infections and during times of war. Weak positive statistically significant correlations were found between the level of perceived threat and willingness to work for all of the threats, except for terror (Spearman rank correlation = .16-.35).

CONCLUSIONS: Local culture, perceptions of the level of threat, and perceived peer responsiveness are associated with registered nurses' willingness to work under threat.

CLINICAL RELEVANCE: When faced with a threat to personal safety or security, many registered nurses might not be willing to work as usual. What is perceived as threatening is influenced by the local culture and environment. Therefore, managers should be aware of potential cultural and peer influences on this possible conflict of values.