Nurses' feelings about work attendance during the 2009 A/H1N1 flu pandemic: Qualitative analysis of a Maine state-wide survey

Background: Studies of health care worker unwillingness or inability to work during disasters have been reported but few have focused on nurses during a flu pandemic. Objective: This study reports qualitative themes affecting nurses' ability and willingness to work during the 2009 A/H1N1 flu pandemic. Methods: A survey was mailed to a random sample of 1,200 Maine nurses during the second wave of the A/H1N1 flu pandemic, October through November 2009. Qualitative comments added by respondents were analyzed. Results: Qualitative themes negatively affecting nurse ability and willingness to work included concern for safety of family and self, fear of illness and death, anger at administrative techniques designed to compel work attendance, mistrust of administration, and conflicting work/home obligations. Qualitative themes positively affecting nurse's ability and willingness to work included professional duty and ethical duty to care. Conclusions: In order to maintain a nursing workforce during a disaster, administrators must behave in ways that may not be immediately intuitive. For example, they may need to address the safety of employees' families, avoid policies that suggest mandatory work attendance at risk of job loss or license revocation, and develop policies and resources to assist nurses to meet home obligations.