Experiences of nurses involved in natural disaster relief: a meta-synthesis of qualitative literature.

AIM: To explore nurses' experiences in natural disaster response.

BACKGROUND: Nurses are key to disaster response. There is a growing body of qualitative research exploring this emerging nursing issue. However, there is a need to synthesise and summarise this body of knowledge to identify the overarching elements of how nurses experience working in disaster situations to reflect on their experiences so that we may help shape future clinical practice, research and education.

DESIGN: Qualitative meta-synthesis METHOD: Following PROSPERO guidelines (Moher et al, 2015), an exhaustive and systematic literature search and quality appraisal was undertaken in December 2019 to reveal nurses'experiences during natural disaster response. Sandelowski and Barroso's systematic retrieval, analysis, and interpretation of findings method was used to produce a meta-summary of findings from 10 papers evaluating experiences across 9 disasters. A meta-aggregation was used to synthesise the findings from the studies and was methodically quality assessed with PRISMA and CASP.

RESULTS: Our findings aggregated data from 42 sub-themes, into the following four themes to capture nurses' experiences after responding to disasters. These included; agile response; leadership and innovative problem solving; building resilience; positive communication and need for psychological /emotional support.

DISCUSSION: This meta-synthesis provides evidence to illustrate nurses' resilience and leadership capabilities as means to manage and perceive their disaster relief response. Factors such as emotional intelligence, capacity to react to changing situations, to manage scant resources in extreme situations were highlighted in nurses practising in highly stressful environments. Managers can use these examples to support ways to improve disaster management policies, but also, to engage in support for their staff.

RELEVANCE TO CLINICAL PRACTICE: The role of nursing staff in disaster rescue is receiving significant attention. Understanding nurses' experiences during disaster rescue can help future leaders to improve capacity to respond and nursing preparedness through education, training and management, but also for continuing emotional support after the event.