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

Abstract

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.

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

“…24 Indeed, it is their individual behavior and character, as well as their social and organizational surroundings, that may affect nurses' willingness to respond to such emergencies and the content of such a response. 10,25 Another conflict discussed in this research relates to the question of how to distribute scarce life-saving medical resources given the extensive and imminent need during the COVID-19 pandemic. Studies conducted outside Israel suggest that nurses working with physicians during the COVID-19 outbreak had to make care-provision decisions which have ethical implications.…”

“…24 Indeed, it is their individual behavior and character, as well as their social and organizational surroundings, that may affect nurses’ willingness to respond to such emergencies and the content of such a response. 10 , 25 …”

Nurses working in healthcare facilities during natural disasters: a qualitative enquiry

“…Nurses also work within high stress environments and some too, are faced with the effects of a natural disaster event. The work of nurses who choose to volunteer when disasters affect their country or region has been explored in several studies across the globe (Ganz et al 2019;McNeill et al 2019;Nash 2017) and some, as is the case with this study, were caught up by chance in a disaster that affected their healthcare facility. Yet, the collective willingness and duty to care was one core characteristic that was evidenced strongly in the interview data.…”

Which are overriding during a pandemic: Professional healthcare duties or personal interests?

“…Cultural and peer influences play a significant role in the nurses' willingness to work in threatening conditions. 6 Previous industrial action by healthcare professionals has taken place in different countries so that staff can express their grievances towards undesirable work conditions and resource allocation. However, unless the purpose is to enhance patient welfare, industrial actions that intend to withhold labour force, skills or services at the expense of the vulnerable patients without a moral ground are ethically unjustifiable.…”