Disaster dilemma: factors affecting decision to come to work during a natural disaster.

Natural disasters threaten the ability to staff a hospital. The objective of this study was to identify factors influencing decision to come to work during a fire disaster. The authors' hospital experienced a 17-fold increase in no-shows during a fire. Phenomenography was used to explore staff experiences immediately following wildfires. Factors affecting decision to work during a disaster included vulnerability of family, personal safety, and fire proximity. Modifiable factors were identified as follows: past experience with disasters, perceived importance, relationship with the organization, and caring connection with the organization. Employees experienced tension between obligations to family, community, and organization. Pets were seen as family and as important as biological family. Further research is indicated to determine predictive modeling and generalizability. Hospital leaders may influence disaster response by establishing a caring connection, providing resources for family members/pets, and promoting perceived importance of the employee.