The Impact of the Syrian Refugee Crisis on Nurses and the Healthcare System in Lebanon: A Qualitative Exploratory Study.

Abstract

To explore Lebanese nurses' perspectives on the impact of the protracted Syrian refugee (SR) crisis on nurses working in hospitals and primary healthcare centers in Lebanon. A qualitative research design drawing on a semistructured in-depth interview approach. We recruited participants through the Order of Nurses in Lebanon. We interviewed six primary healthcare nurses and six nursing directors working in regions with high concentration of SRs. We used the thematic inductive approach to analyze the data. Two themes emerged. In Theme I, nurses and nursing directors described the SR health profile as poor at baseline, and as the crisis was protracting the type of diseases shifted from acute to chronic with convoluted complications. As for determinants of health, SRs had poor health literacy and poor living conditions. In Theme II, nurses and nursing directors voiced the impact of the SR crisis on nurses, nursing practice, healthcare system, and host community. They cited fatigue, burnout, and depleted compassionate care at the individual level; rationing and stressed interpersonal relationships at the practice level; shortage in resources and poor performance at the healthcare system level; and a shift in the patient population that led the host community to seek health care elsewhere. Alternatively, more money was injected, and new services and clinical programs were introduced. Lebanese nurses bore a profound burden as a result of the SR crisis. Should this crisis be replicated in other contexts, the important lessons learned encompass (a) increasing access to care to refugees, coupled with an emergency plan to increase human health resources; (b) improving preparedness of nurses in handling priority health conditions; (c) documenting and reporting the challenges and resilience of health workers, especially nurses facing the crisis; and (d) engaging more nurses to be at the policy table. There is a need to prepare nurses for efficient response to crisis related to refugee health by increasing human resources and training them to be competent in delivering safe and high-quality care necessary to respond to the special healthcare needs of the refugees.