The Lived Experience of Australian Public Health Nurses' Roles in Disasters

Author: Philippa Rokkas

Rokkas, Philippa, 2016 The Lived Experience of Australian Public Health Nurses' Roles in Disasters, Flinders University, School of Nursing & Midwifery

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Abstract

Disasters are increasing their impact on Australian communities, challenging the surge capacity of local and national health systems and simultaneously challenging the nursing profession to (re)consider their disaster roles and functions. While nurses are considered to be ‘frontline’ workers in disasters, minimal research has been undertaken within Australia regarding public health nurses’ disaster roles in the out-of-hospital setting. Perspectives on their actual disaster experience and what a disaster means to this group of nurses are therefore largely unknown. This study explores the lived experience of Australian public health nurses’ disaster roles to further understand what this may mean for disaster nursing practice. An interpretative qualitative approach using hermeneutic phenomenology was adopted to investigate the research question. A hybrid methodology combined the hermeneutic phenomenology of the philosophers Martin Heidegger and Hans-Georg Gadamer. Eighteen nurses from five different States within Australia, who identified as being public health nurses, were interviewed by the researcher. The interviews explored these nurses’ personal experiences regarding their roles in disasters; their perspectives and understandings of being a public health nurse in a disaster, and the meanings they drew from this. The participants’ narratives were analysed using the thematic data analysis process offered by Max van Manen, and engagement in a hermeneutic dialogue, informed by Gadamer. The research found that the public health nurses’ understanding of their roles in disasters remained innately connected to and informed by their culture of nursing, but was also expanded by their broader purview of care in the community. The salient theme and the main finding identified was having a public health mind. This refers to the specific way of thinking these nurses had adapted from their backgrounds in nursing to address the spatial challenges concomitant with providing disaster nursing preparedness and response at the population level of health. Quintessentially, having a public health mind was found to be the public health nurse worldview for their nexus of care, their dasein - as protectors of their communities at the population level of health. This theme was central to understanding how they experienced their roles in disasters. The remaining themes all revealed the public health nurses’ adherence to the key public health mandate of protection and prevention through: being sentinels, making sure, being advocates, being bridges and connectors, being adaptors, and being unknown protectors. This research provides insight into understanding how Australian public health nurses’ experience their disaster roles through their unique worldview of a public health mind. This particular way of thinking presents an opportunity to (re)consider disaster nursing education and practices. It may be used as a different way to educate public health nurses to understand their own roles, and also to promote their roles to other disaster responders and relief agencies. This research presents a deep inquiry into the meanings and perspectives which inform and underpin public health nurses’ experiences of their roles in disasters. Ultimately gaining an understanding of these experiences provides an opportunity for more informed disaster planning, education and disaster policy making for this group of nurses in the out-of-hospital setting.

Keywords: Disaster, Public Health Nurse, Nurse, Public Health, Community, Population Health, Disaster Nursing, Hermeneutic phenomenology, Hans-Georg Gadamer, Martin Heidegger, Lived Experience, Disaster planning.
Subject: Nursing thesis

Thesis type: Doctor of Philosophy
Completed: 2016
School: School of Nursing & Midwifery
Supervisor: Professor Paul Arbon