Role and Mandate of Nurses in Disasters in German-Speaking Countries – A Modified Delphi Study

Introduction: Given the global increase in disasters, the International Council of Nurses calls for every nurse to be a disaster nurse, and the Royal College of Nurses in the UK even considers nursing to be a safety-critical profession. In the DACH countries (Germany, Austria, and Switzerland), however, the role and mandate of nurses in disaster preparedness and response have so far received little attention. This study aimed to investigate this observation from the perspective of experts. Methods: A modified multi-stage Delphi study was conducted. The initial stage involved an in-person roundtable symposium to identify positions and assumptions on nurses’ roles and mandates in disasters in the DACH countries. This was followed by three successive and increasingly standardized online surveys (stages 2-4). Originally consisting of experts from nursing, disaster relief organizations, politics, the armed forces, and the education sector, the group was gradually expanded to include experts from related fields and professions (from n = 28 to n = 74). Results: Participants considered it highly relevant to clearly define the role and mandate of nurses in disasters. A consensus was reached that nurses in the DACH countries should play a key role in maintaining the health and safety of the population. To enable nurses in German-speaking countries to fulfil their safety-critical mandate before, during, and after disasters, experts with a nursing background called for the inclusion of nurses in decision-making bodies. However, the participants believed the development of competencies in disaster nursing must be improved at all levels. Conclusion: The modified Delphi study showed that a clarification and an agreement must be reached on the role and mission of nursing in disasters in the DACH region. Realizing the safety-critical potential of nurses before, during, and after disasters requires addressing both policy and educational gaps in the three countries.