By Sylvia Foley, AJN senior editor

Figure 1. Percentage of respondents indicating willingness to work during a flu pandemic according to self-reported perception of flu threat

During disasters and emergency situations, the public expects health care workers to show up and do their jobs. But this isn’t a given—there are always some who are either unable or unwilling to do so. So far, most of the research in this area has used convenience samples, hypothetical situations, or untested survey instruments, and very little has focused solely on nurses.

To learn more, Sharon Dezzani Martin and colleagues decided to explore further. This month’s original research CE, “Predictors of Nurses’ Intentions to Work During the 2009 Influenza A (H1N1) Pandemic,” reports on their findings. Here’s the abstract, which offers a brief overview.

Objective: This study examined potential predictors of nurses’ intentions to work during the 2009 influenza A (H1N1) pandemic.
Methods: A questionnaire was mailed to a random sample of 1,200 nurses chosen from all RNs and LPNs registered with the Maine State Board of Nursing during the second wave of the flu pandemic.
Results: Of the 735 respondents, 90% initially indicated that they intended to work during a flu pandemic. Respondents were significantly more likely to work if provided with adequate personal protective equipment (PPE) but significantly less likely without adequate PPE or if they feared family members could become ill with pandemic flu. They were also significantly less likely to work if assigned to direct care of a flu patient; if a colleague were quarantined for or died of pandemic flu; if they feared their own family members might die of pandemic flu; if they themselves were ill for any reason; if a family member or loved one were sick at home and needed care; if they lacked a written family protection plan; or if certain incentives were offered: antiviral medication or vaccine for nurse and family, double pay, or free room and board at work. About 7% of RNs reported that they would not be willing to work during a flu pandemic, regardless of incentives or other factors. An inverse relationship was found between the perceived level of threat posed by a flu pandemic and nurses’ willingness to work.
Conclusions: To maintain an adequate nursing workforce during a flu pandemic, employers should ensure that policies and procedures include providing adequate PPE for nurses and safeguarding the health of nurses and their families. The level of perceived threat is likely to affect the proportion of nurses willing to work. Some nurses will not work during a flu pandemic no matter what protections and incentives are offered; efforts intended to force or entice all nurses to work are unlikely to succeed.

The authors stressed the need for nurses to initiate and participate in discussions “regarding how things went during the most recent pandemic or other emergency situation and how emergency planning can be improved.” To learn more, read the article, which is free online, and listen to our podcast with the lead author. As always, we’d love to hear your stories and thoughts in the comments.