Fight or Flight: Emergency Healthcare Workers’ Willingness to Work during Crises and Disasters: A cross-sectional multicentre study in the Netherlands

Abstract

ObjectiveExpanding staff levels is a strategy for hospitals to increase surge capacity. This study aimed to evaluate whether emergency healthcare workers (HCWs) are willing to work (WTW) during a crises or disaster and which working conditions would influence their decision.MethodsHCWs of emergency departments (ED) and intensive care units (ICU) of five Dutch hospitals were surveyed about elevens disaster scenarios. For each scenario, HCWs were asked about their WTW and which conditions would influence their decision. Knowledge and perceived risk and danger was assessed per scenario.Results306/630 HCWs completed the survey. An influenza epidemic, SARS-CoV-2 pandemic and natural disaster were associated with highest WTW rates (69.0%, 63.7% and 53.3% respectively). WTW was lowest in nuclear incident (4.6%) and dirty bomb (3.3%) scenarios. WTW was higher in physicians than in nurses. Male ED HCWS, single HCWs and childless HCWs were more often WTW. Personal protective equipment (PPE) and safety of HCWs’ family were the most important working conditions. Perceived knowledge scored lowest in dirty bomb, biological and nuclear incident scenarios. These scenarios rated highest with regards to perceived danger.ConclusionsWTW depended on disaster type, profession and working department. Provision of PPE and safety of HCWs’ family were found to be predominant working conditions.