Nurses’ Disaster Readiness Hinges on Both Hospital Resources and Psychological Strength, Study Finds

When disaster strikes, whether an earthquake, a mass-casualty event, or a large-scale epidemic, nurses stand on the front line of the health system’s response. Yet a new study suggests that whether those nurses are truly ready has as much to do with the psychological makeup of the individual and the daily conditions of the hospital ward as it does with formal emergency training. The research, published in BMC Nursing, offers one of the most detailed pictures yet of how organizational resources and personal psychological capacity jointly shape disaster preparedness among hospital nurses, and it reveals that the two dimensions of readiness, operational and psychological, are driven by surprisingly different factors.

The study was conducted by Omar Afeef Wattad of Assuta Medical Centers and the Emergency Department of Hillel Yaffe Medical Center, together with Merav Ben Natan of Tel Aviv University and the Hillel Yaffe Academic School of Nursing. Between May 2023 and May 2024, the researchers surveyed 300 registered nurses employed at a tertiary medical center in Israel, a country where the health system maintains a high state of alert for emergencies ranging from armed conflict to natural disasters. Participants completed validated self-report questionnaires measuring disaster preparedness, psychological disaster preparedness, the organizational work environment, resilience, optimism, and trait anxiety.

A central conceptual contribution of the work is the distinction it draws between two related but separate constructs. Operational disaster preparedness refers to the practical readiness to perform during an emergency: knowing the protocols, having the technical skills, and being able to function within a coordinated response. Psychological disaster preparedness, by contrast, captures the mental and emotional readiness to face a catastrophic event, including the ability to tolerate stress, anticipate one’s own emotional reactions, and remain psychologically stable under extreme pressure. The researchers found that the two dimensions were moderately correlated, with a correlation coefficient of 0.56, statistically significant at p less than 0.001. In plain terms, a nurse who feels operationally ready is somewhat more likely to feel psychologically ready, but knowing the drill does not guarantee emotional readiness, and vice versa.

To understand what drives each dimension, the team used descriptive statistics, correlation analyses, and multiple regression models that allowed them to isolate the independent contribution of each variable while controlling for the others. The results were striking. The full model predicting operational disaster preparedness explained 45.4 percent of the variance, a substantial share for a behavioral outcome in a real-world clinical population. Within that model, several factors emerged as positive independent correlates: workplace disaster training, optimism, lower trait anxiety, participation in organizational decision-making, adequate staffing and resources, good collegial nurse-physician relations, and completion of an advanced nursing course.

The picture for psychological preparedness was markedly different. The full model for that outcome explained 45.1 percent of the variance, almost identical in strength, but the predictor pattern diverged in important ways. Age, ward experience, resilience, staffing and resource adequacy, positive nurse-nurse interaction, and male gender were all positive independent correlates of psychological readiness. Most notably, workplace disaster training, which strongly boosted operational preparedness, was a negative correlate of psychological preparedness, and higher trait anxiety also predicted lower psychological readiness. In other words, the very training programs that make nurses technically proficient may, in some circumstances, leave them feeling less emotionally equipped, perhaps by heightening awareness of how overwhelming a real disaster could be.

These findings carry significant implications for how hospitals prepare their nursing workforce. For decades, disaster preparedness programs have concentrated on drills, protocols, and technical competencies, treating readiness as a matter of knowledge and skill. The new data suggest this approach captures only half the picture. A nurse can complete every training module and still feel psychologically unprepared to face mass casualties, and the regression results indicate that psychological readiness depends more on accumulated clinical experience, personal resilience, and the quality of daily working relationships than on formal instruction alone.

The organizational findings are equally consequential. Staffing and resource adequacy appeared as a positive independent correlate of both operational and psychological preparedness, making it the one organizational factor that bridges the two dimensions. This suggests that nurses who feel their ward has enough staff and adequate resources are not only better positioned to execute emergency procedures but also more confident in their own emotional capacity to cope. Participation in decision-making and collegial nurse-physician relations contributed to operational readiness, while nurse-nurse interaction contributed to psychological readiness, indicating that different facets of the professional practice environment matter for different aspects of preparedness.

The psychological variables tell a coherent story of their own. Optimism and lower trait anxiety both independently predicted stronger operational preparedness, while resilience was the standout psychological predictor of psychological preparedness. Trait anxiety, a stable disposition toward experiencing worry and tension, was associated with lower scores on both outcomes, and it appeared as a negative correlate of psychological preparedness even after adjustment. This pattern implies that anxiety management deserves a place alongside clinical skills in disaster education, and that interventions designed to build resilience could pay dividends in nurses’ emotional readiness for catastrophic events.

The demographic findings add further nuance. Older nurses and those with more ward experience reported greater psychological preparedness, consistent with the idea that emotional readiness for disaster is cultivated over time through repeated exposure to demanding clinical situations. The association between male gender and higher psychological preparedness was an independent correlate in the adjusted model, a finding the authors report without overinterpreting. Completion of an advanced nursing course, meanwhile, strengthened operational preparedness specifically, reinforcing the value of continuing professional education for technical readiness.

Taken together, the study argues that nurses’ disaster preparedness is fundamentally multidimensional, reflecting both the resources the organization provides and the psychological capacity each nurse brings to the ward. The authors conclude that interventions should combine adequate staffing and collaborative practice environments with disaster training that explicitly addresses psychological responses, resilience, and anxiety management. As health systems worldwide confront an era of pandemics, climate-driven disasters, and geopolitical instability, the message for hospital leaders is clear: building a genuinely prepared nursing workforce means investing not only in drills and protocols but in the daily working conditions and inner psychological resources that determine whether nurses believe, deep down, that they can face the worst.

Subject of Research: Predictors of operational and psychological disaster preparedness among hospital nurses in Israel

Article Title: An integrated predictive model of nurses’ disaster preparedness: the joint role of organizational resources and psychological capacity

Article References: Wattad, O. A., & Natan, M. B. (2026). An integrated predictive model of nurses’ disaster preparedness: the joint role of organizational resources and psychological capacity. BMC Nursing. https://doi.org/10.1186/s12912-026-05264-w

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05264-w

Keywords: disaster preparedness, nurses, psychological preparedness, organizational work environment, resilience, trait anxiety, optimism, hospital staffing, emergency response, BMC Nursing, cross-sectional study, Israel