Complex disaster and conflict-related civil defence – nurses’ role in European civil defence within the context of emerging threats and the European union preparedness union strategy – a scoping review

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Global instability and war in Europe mean that conflict is a significant concern for the European Union (EU). The nature of hybrid warfare leads to complex humanitarian emergencies which also encompass mass casualty events that must be managed by nurses through a civil defence structure. This scoping review investigates the current literature on the role of civilian-based nursing in civil defence in reference to emerging hybrid war threats to Europe and the evolving associated complexity referenced by the EU Preparedness Union Strategy (2025) and the Common Security and Defence Policy (CSDP). The aim of this review is to examine the existing literature on the role of nurses in Europe’s civil defence during times of conflict, war, and hybrid threats in reference to the EU’s evolving security and preparedness strategies, with a focus on literature published between 2000 and 2025. The scoping review followed the recommendations of the PRISMA extension for scoping reviews and was registered on the Open Science Framework platform on June 23, 2025. A comprehensive electronic search for relevant articles published between January 2000 and June 2025 was conducted across five databases: MEDLINE (PubMed), Embase (Ovid), CINAHL (EBSCO), PsycINFO, and Web of Science. Supplementary searching of Google Scholar was also undertaken. 836 articles were identified, and after screening, a total of 16 articles were reviewed. Few articles focused specifically on the role of nursing in civil defence within Europe and the current emerging threat landscape. Most literature emanated from the USA and Middle East. It was found that nurses possess essential attributes for civil defence but are under-prepared for conflict scenarios. There is a significant policy-practice gap in disaster nurse workforce planning and training for Europe’s security landscape. Within the EU Preparedness Union Strategy, there is a need to prioritise development and implementation of policies that promote a pan-EU standardized training that integrates the largest professional group within health services - nurses - if a comprehensive civil defence strategy that supports European societal resilience and people’s health needs during conflict is to be effective.