Ethical issues after the earthquake in Turkey: A qualitative study on nurses' perspectives.

Abstract

After natural disasters, the urgent need for survival and rescue operations for those trapped in the rubble results in a heightened demand for healthcare services. Nurses are pivotal in addressing the consequences of such calamities. Nurses operating in critical conditions encounter numerous challenges, including safety issues and ethical quandaries. The ethical considerations primarily revolve around the limitations, duties, and modified norms of care administered by nurses during disasters, presenting both significant and complex challenges. The study was designed to elucidate the nature and essence of nurses' care experiences and to offer an in-depth depiction of the ethical dilemmas while attending to individuals injured in the earthquake. A descriptive phenomenological design was used in this research. A total of 16 nurses who worked for at least 7 days in field hospitals in any of the earthquake regions after the 2023 earthquake in Turkey participated in the research. The research was conducted between March 13 and March 20, 2023. Data were collected by face-to-face interview method with a semistructured form. The steps of Colaizzi's phenomenological method were used to analyze the qualitative data. The study involved a group of 16 Turkish nurses, aged between 20 and 36 years. Through data analysis, four primary themes, 14 subthemes, and 25 codes were identified. The principal themes derived from the interviews included "humanitarian duties," "non-adherence to ethical principles," "respect for the injured," and "medical errors." In this intricate process, it becomes paramount to enhance support for nurses in the domains of management, education, and psychosocial assistance, thereby nurturing their individual and professional acumen, commitment, and ethical sensitivity. Refining the guidelines and professional standards that encapsulate the principles to be adhered to by nurses in disaster scenarios, coupled with providing comprehensive training in both medical and ethical competencies, represents a significant avenue for advancement. Focused training on crisis management will enable nurses to render ethically informed decisions and bolster their professional proficiency. Natural disasters, including earthquakes, pose significant ethical challenges for healthcare professionals, especially nurses who play a pivotal role in delivering care during these emergencies. Issues such as resource allocation and triage, the duty of care and ensuring continuity of care, informed consent and communication, cultural sensitivity, and providing psychosocial support are critical ethical considerations for nursing policies in earthquake situations. Addressing these ethical issues in nursing policies related to earthquakes is crucial for maintaining the integrity of healthcare delivery, preserving public trust, and ensuring the well-being of both the injured and healthcare providers during times of crisis.