Impact of Earthquake Trauma on Nurses' Compassion Fatigue: A Study From Kahramanmaraş, Turkey

On 6 February 2023, two earthquakes with magnitudes of approximately 7.7 Mw and 7.6 Mw occurred at 04:17 and 13:24 local time, centred in Kahramanmaraş, Turkey. These earthquakes affected a wide geographical area encompassing 11 provinces of Turkey (Kahramanmaraş, Hatay, Adıyaman, Gaziantep, Malatya, Kilis, Diyarbakır, Adana, Osmaniye, Şanlıurfa, and Elâzığ), leading to significant destruction. As a result of this disaster, more than 50,000 people lost their lives, and over 100,000 were injured. Emergency service nurses, in particular, were at the forefront of this catastrophe, witnessing moments of intense trauma. Nurses working in emergency services had to care for patients with open wounds, closed and open fractures, vascular injuries, compartment syndrome, crush syndrome, amputations, and more. Such traumatic experiences have caused emergency service nurses to suffer from earthquake trauma to a greater extent. Consequently, stress disorders following trauma caused by the earthquake are a serious and common condition among emergency service nurses working in the earthquake zone. Another issue encountered by emergency service nurses serving people exposed to trauma during the earthquake is compassion fatigue. Compassion fatigue, a term coined by Joinson (1992) to describe the state of burnout experienced by nurses working in emergency services, is known in the international literature as "compassion fatigue" and is referred to as "şefkat yorgunluğu," "merhamet yorgunluğu," and "eş duyum yorgunluğu" in Turkey. Compassion fatigue is also known as secondary traumatic stress disorder, secondary victimisation, and indirect trauma. It is characterised by a reduced capacity for empathy following repeated exposure to traumatic situations experienced by others. Exposure to such stressful and traumatic workplace events can lead to burnout, post-traumatic stress disorders, depression, anxiety, and other mental health issues related to trau. A systematic review reported significant symptoms of post-traumatic stress disorder and psychological distress among nurses working in the earthquake zone. Another study showed that 25% of emergency service nurses experienced severe depression and sleep disorders, with their anxiety levels being higher than those of nurses working in other unit. A systematic review covering the years 1989-2019 reported that 25.8% of emergency service nurses showed symptoms of post-traumatic stress disorder following experienced traumas. Looking at related studies on compassion fatigue, it is indicated that professionals exposed to trauma victims, such as emergency service workers, disaster workers, emergency service nurses, doctors, and social workers, are at a high risk of compassion fatigue. In light of the current information, it is clearer that nurses serving in emergency services are at high risk for earthquake trauma and compassion fatigue. Especially in disaster situations like earthquakes, exposure to such conditions reaches its peak, significantly increasing this risk. It has been shown that nurses experiencing psychological health problems may have a decrease in care quality and an increased likelihood of making medical errors. Therefore, determining the level of earthquake trauma and compassion fatigue symptoms among nurses exposed to the 6 February Kahramanmaraş earthquakes, identifying the relationship between these two conditions, and determining their long-term effects will make significant contributions to the effective and efficient implementation of rehabilitation efforts. Given the limited number of studies examining post-traumatic stress disorder and compassion fatigue issues among emergency service nurses, this study is expected to make a significant contribution by identifying the level of earthquake trauma and compassion fatigue among nurses who experienced the 6 February Kahramanmaraş earthquakes and determining the relationship between them. The aim of this study is to determine the impact of earthquake trauma on compassion fatigue among nurses working in emergency services following the 6 February Kahramanmaraş earthquakes. The following hypotheses will be tested within the scope of the research.