Exploring the Relationship Between Registered Nurses’ Resilience and Disaster Response Readiness: A Cross-Sectional Analysis

As the largest and most trusted healthcare profession, nurses are essential to disaster response and readiness. Beyond their traditional role in immediate disaster response, registered nurses (RNs) contribute to fortifying health systems within communities (Castner et al., 2024; Fletcher et al., 2022). Disaster readiness involves the foresight and capability to effectively mitigate, prepare, respond, and recover during and after disasters (Shmueli et al., 2021; Su et al., 2022). The framework of mitigation, preparedness, response, and recovery is a recurrent cycle that reflects continual learning from previous disasters with pivoting to improve the cycle in the future. In alignment with United Nations (UN) Sustainable Development Goal 13, nurses have a vital role to address the impacts of climate change (Hawkins & Tremblay, 2023), which contribute to the increasing number and severity of natural disasters (Clarke et al., 2021; Smith, 2024).

Background

Disasters are defined as an event or events that pose severe danger to a community and may result in significant harm that overpowers community resources (UN Office, 2017). Disasters may encompass a wide range of risks and health emergencies, including infectious disease outbreaks, natural hazards, conflicts, unsafe food and water, chemical and radiation incidents, building collapses, transport accidents, disruptions to essential services like water and power supply, air pollution, and antimicrobial resistance (World Health Organization [WHO], 2019). Factors increasing the frequency, severity, and impact of such disaster emergencies include but are not limited to climate change, unplanned urbanization, population growth, migration, and state fragility (Clarke et al., 2021; WHO, 2019).

Although nurses have long been engaged in disaster response (Fletcher et al., 2022), they are often not well prepared to respond, even in countries that experience frequent disasters (Hasan et al., 2021; Labrague & Hammad, 2024). Prayag et al. (2021) found that psychological resilience was important to individual recovery after an earthquake. Further, psychological resilience has been found to help mitigate distress caused by climate change (Sahin Bayindir et al., 2024).

Resiliency, the ability to survive and thrive in the face of adversity (American Association of Colleges of Nursing [AACN], 2021), may be critical in nurses’ ability to respond effectively to disaster events.

Resiliency has been associated with higher levels of well-being, lower levels of psychological harm, reduced burnout, and increased job retention in nursing (Alameddine et al., 2021; Cooper et al., 2021). Considering cultural differences such as cultural norms, values, and communication styles is important, as these can significantly influence both resilience (Liu et al., 2021) and disaster response (Rahmani et al., 2022). While there is significant research that speaks to the importance of resiliency in the nursing profession, there is a lack of research specific to the relationship between resilience and disaster response readiness.

Purpose Statement and Research Questions
The purpose of this study was to examine the relationship between RN resilience and readiness to respond to disasters. The research questions for this study were:

1. What is the relationship between RNs’ resilience and personal characteristics of age, gender, race, years of experience, and income?
2. What is the relationship between RNs’ resilience and military status, feeling prepared, willing, trained, and registered to respond to disasters?
3. What is the relationship between RNs’ resilience and self-reported confidence in their ability to prepare for disasters?
4. What is the relationship between willingness to respond and feeling prepared and registered to respond to disasters?

Study Methods

Design and Sample
This descriptive correlational study used an anonymous online survey to examine the relationship between RN resilience and readiness to respond to disasters. After Institutional Review Board approval was obtained, we recruited a convenience sample of RNs using purposive and snowball methods. A recruitment letter with the shareable survey link was distributed via online methods, including email distribution lists, social media, and virtual nursing communities such as the AACN Connect and Sigma Circle. Participants were encouraged to invite others who may be eligible. Eligibility criteria included being an RN, aged 18 or over, and ability to read and write in English.

Data Collection
Data collection occurred online using Qualtrics (2025) software, Version XM, a password-protected, cloud-based platform commonly used for survey research. Informed consent was obtained on the first page of the survey. Those who indicated agreement to participate proceeded directly to the survey items. Identity of the participants was unknown to the researchers, and no personal identifying data were collected.

The survey tool included items related to demographics, disaster readiness, and resilience. Survey items were informed by current literature and developed by the research team with content expertise in disaster readiness, responsiveness, and climate change. Resilience was measured using the Brief Resilience Scale (BRS) developed by Smith et al. (2008). The 6-item BRS measures resilience, or the ability to bounce back after trauma or stress, with a 5-point Likert scale ranging from strongly disagree to strongly agree. Cronbach's alpha was reported as a range from .80 to .91 (Smith et al., 2008). Participant responses were exported for data analysis and stored on a password-protected computer. Statistical analysis was performed using IBM SPSS 27. Descriptive, non-inferential, and inferential statistics were used to describe the sample and compare groups.

Results

Sample
A total of 352 RNs were recruited for this study. Because participants were not forced to respond to every question, the sample size varied for each survey item. Participants represented 271 distinct postal codes from 9 different countries, with the majority from the United States, where the number of natural disasters has increased (Clarke et al., 2021). Other countries represented, such as Canada and Australia, have also experienced an increase in natural disasters (Clarke et al., 2021; Gissing et al., 2022).

Most participants (53.5%) lived in a suburban community; 23.6% lived in a rural community, and 17.5% lived in an urban community. Ninety percent were female. Seventy-eight percent reported their race as White, 6.9% as Black, and the remaining as Asian, Pacific Islander, two or more/other races, or preferred not to say. Approximately half were under the age of 45, and half were 45 or older. The number of years of experience ranged from less than one year to more than 20 years. Most participants had more than 10 years of experience and reported household yearly incomes of $75,000 or higher. Almost 7% reported service in the Armed Forces (see Table 1).

Table 1. Demographics

Most participants (93%) reported that they were willing to respond to a disaster, but only 54.8% felt prepared to respond, and less than half (48.4%) were trained to respond. Even fewer (23.9%) reported they were registered with a volunteer disaster response organization. Most (74.7%) were aware of an emergency plan for their workplace in the event of a disaster, and 69.1% were confident they could take steps to prepare for a disaster in their community. Overall BRS scores ranged from 1.5–5, with higher scores indicating higher levels of resilience. The overall mean BRS score was 3.66. The Cronbach's alpha for the BRS score for the 6 items in the questionnaire was 0.881.

Research Question 1: Resilience and Personal Characteristics
The first research question asked: What is the relationship between RNs’ resilience and personal characteristics of age, gender, race, years of experience, and income? When comparing age category to average BRS score, those who were 65 years old or older had statistically higher average scores than those who were between 25 and 34 years old and those who were between 35 and 44 years old (see Table 2). There was no statistically significant difference in average BRS score based on gender, race, years of experience, or income.

Table 2. Comparison of Average BRS Score to Age Category

Research Question 2: Resilience and Military Status
Question 2 asked: What is the relationship between RNs’ resilience and military status, feeling prepared, willing, trained, and registered to respond to disasters? In examining military status, those who had either previously served or were currently serving had higher BRS scores than those who had never served in the military. When comparing groups between those willing to respond and those not willing to respond to disasters, those who responded as willing had higher BRS scores than those who responded as not willing. In examining BRS scores from those who felt prepared to respond to disasters and those who did not, those who felt prepared had higher BRS scores. Furthermore, those registered to respond to emergencies were more likely to have higher BRS scores than those who were not registered. Likewise, those trained in disaster response had statistically higher BRS scores. Please see Table 3 for additional information about these comparisons.

Table 3. Comparison of Average BRS Score to Military Status, Feeling Prepared, Willing, Trained, and Registered to Respond to Disasters

(AUTHORS: Are we missing something in column 2 of Table 4? Let us know and if not, we will remove the blank column. Thanks!)

Research Question 3: Resilience and Self-Reported Confidence
Our third questions was: What is the relationship between RNs’ resilience and self-reported confidence in their ability to prepare for disaster? When comparing the average BRS scores and level of confidence, those who strongly agreed that they were confident to take steps had significantly higher mean BRS scores than all other groups, except those who strongly disagreed (see Table 4).

Table 4. Comparison of Average BRS Score to Level of Confidence to Prepare for Disaster

SD=strongly disagree, D=disagree, N=neutral, A=agree, SA=strongly agree

Research Question 4: Willingness to Respond And Feeling Prepared and Registered to Respond
Finally, question 4 was: What is the relationship between willingness to respond and feeling prepared and registered to respond to disasters? There was a significant association between feeling prepared for disasters and willingness to respond to disasters (see Table 5). In other words, those who were willing to respond were also those who felt prepared, and in turn, those who felt prepared were those who were more willing to respond.

Table 5. Comparison of Willingness to Respond and Feeling Prepared to Respond

In examining the association between willingness to respond to a disaster and being registered to respond, there was a significant association between being registered to respond and the willingness to respond. Those registered to respond were also those willing to respond; likewise those willing to respond were more likely registered (see Table 6).

Table 6. Comparison of Willingness to Respond and Being Registered to Respond

Discussion

This cross-sectional, descriptive correlational study sought to understand the relationship between resilience, as measured with the BRS, and nurses’ readiness and willingness to respond to disasters. Resilience has been shown to have a buffering effect on life adversity and contributes to overall well-being (Hsieh et al., 2024; Yildirim et al., 2023). We aimed to understand any associations between BRS scores and personal characteristics, which can inform future research projects about how certain groups may respond to and recover from a disaster event.

Our first research question explored the relationship between RN resilience and personal characteristics of age, gender, race, years of experience, and income. We did not find significant BRS score differences based on race, gender, or income. However, nurses who reported being 65 years or older had higher BRS scores than younger nurses. There is some conflict in literature related to age and resilience. Mallon et al. (2023) found that older age is a key predictor of increased resilience. Another study indicated that mean scores on a resilience scale showed no significant differences for any age group (Batı & Çelikkalp, 2025). More research is needed to understand other factors that contributed to resilience levels.

Our second research question explored the relationship between RN resilience and military status, feeling prepared, willing, trained, and registered to respond to disasters. Our results indicated that those who served in the military had higher mean BRS scores than their civilian counterparts. While there is little current literature that supports higher BRS scores among those in the military, a study of medical and nursing students found that those who had either military experience or were first responders demonstrated higher self-assessed levels of disaster-related medical knowledge (Robinson et al., 2023). It is possible that feeling knowledgeable enhances resilience. Further research is needed to understand the factors that influence resilience as it relates to disaster response readiness.

Our findings also indicated a statistically significant association between nurses who felt prepared to respond and who reported higher BRS scores. Additional research is needed to establish possible directionality and causative factors. As a nonexperimental, cross-sectional study, we are not reporting on causality; however, current literature supports that training improves BRS scores. A randomized control trial (RCT) that evaluated the effect of educational modules reported higher BRS scores among the intervention group that completed an 8-module training on disaster response compared to the control group (Yildiz & Yildirim, 2022). In a cross-sectional study conducted across Turkey, which has experienced significant disaster events, Alan et al. (2022) reported an above-average level of disaster core competencies among nurse respondents, which was positively correlated with their psychological resilience.

In our study, nurses who reported that they ‘strongly agreed’ that they had taken steps to prepare for a disaster had significantly higher BRS scores. Results from an RCT that evaluated a 16-hour training intervention indicated that readiness to respond was found to be greater in nurses who had undergone training compared to those who had no training. The differences in readiness remained even 3 months after the training. Collectively, these findings underscore the need for disaster preparedness and response training for nurses (Hasan et al., 2021; Lin et al., 2024). We found a significant association between nurses who were registered to respond to a disaster and their willingness to respond. This association appears to work bidirectionally. Meaning that those who were more willing to respond were more likely to be registered to respond as well.

In this study, we aimed to discover the relationship between RN resilience and self-reported confidence in ability to prepare for disasters. Our results indicated a statistically significant association between strongly agreeing that they are confident that they can take steps to prepare for a disaster and BRS scores. Self-reported confidence has been previously linked to higher levels of resilience (Nabilah et al., 2022).

Our last question sought to uncover the relationship between willingness to respond and feeling prepared and registered to respond to disasters. The results of our study indicated that feeling prepared for a disaster and willingness to respond to a disaster were associated. While this seems self-evident, it also points to the vital importance of ensuring that nurses have a clear understanding of personal preparedness and their role in the health system during a disaster. A review of literature on nurses’ ability to provide effective care in emergency response suggested that training and personal preparedness were important factors (Kimin et al., 2022). This study adds to the literature by identifying factors related to disaster preparedness and response of nursing professionals.

Our study adds to the growing literature that supports regular and ongoing training for nurses in disaster readiness, response, and recovery. We found a gap between nurses who were willing to respond to disaster but were not prepared or trained to respond. We recommend health system preparation and education for nurses to increase capacity for disaster response. We also recommend greater disaster training for nursing students. This study also provides information for nurse managers, disaster planners, and educators related to recruiting nurses ready to respond to disasters. Our findings help to identify some of the personal and professional characteristics of nurses who may already be engaged in personal preparedness as well as those who will need greater levels of training. We did not examine the many roles that nurses play in disaster response readiness. Further research is necessary to explore the roles of nurses across all phases of disaster management (Fletcher et al., 2022).

Limitations

There were some limitations to this study. First, convenience sampling methods are subject to sampling bias. Those who chose to participate may not represent the total population, and non-responder characteristics could not be assessed. Nurses who have an interest or are involved in disaster readiness may have been more likely to respond. However, the demographics for race, age, and gender were representative of the current nursing workforce (AACN, 2024). There was also strong representation of nurses across a number of unique zip codes. While we view the geographic dispersion of participants as positive, it also highlights another limitation of this study. We did not assess the potential impact of cultural differences that might influence how individuals perceive resilience and disaster readiness. The survey was further limited because it was accessible via the internet and available to participants who were able to read and write in English. Nurses without access to the survey and non-English speakers did not have equal representation. Also, because the survey did not force responses to all questions, missing data were not included in the analysis. Finally, social desirability bias may have artificially inflated BRS scores; the ability to complete the survey anonymously likely helped to mitigate this bias.

Conclusions

This study highlighted multiple factors that influence RNs’ disaster readiness and underscored the relationship of resiliency to feeling prepared, willing, trained, and registered to respond to a disaster. Our results add to the understanding of modifiable factors that may impact RN resilience. The findings support the need for regular and ongoing disaster training for nurses.

Disclosures: The authors received no funding or payment for this project. They declare that there is no conflict of interest.

Authors

Janice E. Hawkins, PhD, RN, CNS, FAAN
Email: Jhawkins@odu.edu
ORCID ID: 0000-0002-7204-0533

Janice Evans Hawkins is an Assistant Professor and Chair of Graduate Nursing Programs at Old Dominion University. Dr. Hawkins has contributed to infusing climate change content into nursing curricula. She has published and presented on common sense climate-friendly strategies to reduce waste, save money in healthcare, and address climate impact inequalities. She is also a former Liaison to the United Nations for Sigma Theta Tau International.

Beth Tremblay, PhD, RN, CCRN
Email: bmtremble@odu.edu
ORCID ID: 0000-0003-0723-1365

Beth Tremblay is an Assistant Professor in the Ellmer School of Nursing at Old Dominion University. Dr. Tremblay’s research and teaching is centered around social determinants that promote health equity with a focus on environmental and planetary health.

Robert Hawkins, PhD, DNP, MPH, CRNA, FAAN
Email: Rjhawkin@odu.edu
ORCID ID: 0009-0001-3365-3089

Robert Hawkins is an Adjunct Professor at the Elmer School of Nursing at Old Dominion University. Dr. Hawkins has decades of leadership experience ranging from public health to executive healthcare leadership. His scholarship interests include measurement, statistical analysis, and psychometrics.

Jessica Parrott, DNP, CPNP-PC, CNE
Email: Jmparrot@odu.edu
ORCID ID: 0000-0002-1774-3359

Jessica Parrott is an Assistant Professor in the Ellmer School of Nursing at Old Dominion University. Dr. Parrott's teaching and scholarship center on entrustable professional activities that foster interprofessional collaboration. Her goal is to prepare future healthcare professionals to effectively address the diverse needs of the community while enhancing quality access to healthcare through innovative educational and clinical practices.

Deborah Artman, PhD, RN, MPH, PHNA-BC
Email: deborah.artman@slu.edu
ORCID ID: 0000-0003-2706-1391

Deborah Horton is an Assistant Professor and the RN-BSN Option Coordinator in the Trudy Busch Valentine School of Nursing at Saint Louis University. Dr. Horton’s research interests involve disaster preparedness, school preparedness, and planning for infectious disease outbreaks.