Understanding Disaster Leadership: A Qualitative Study from the Perspective of UMKE Nurses

Understanding Disaster Leadership: A Qualitative Study from the Perspective of UMKE Nurses | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Understanding Disaster Leadership: A Qualitative Study from the Perspective of UMKE Nurses Nagihan KOROGLU KABA, Betül BAL, Gülcan TASKIRAN ESKİCİ, Serkan SAYAR This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7496702/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 14 You are reading this latest preprint version Abstract Introduction: Disaster environments demand rapid decision-making, interprofessional coordination, and adaptive leadership skills, particularly from frontline healthcare workers, including nurses. In Turkey, the National Medical Rescue Team (UMKE) nurses play a crucial leadership role during disasters, yet their leadership experiences remain underexplored in the literature. This study aims to explore UMKE nurses’ perspectives on disaster leadership to inform strategies for capacity building. Methods: This descriptive qualitative study employed a phenomenological approach to explore UMKE nurses’ experiences in Turkey’s 15 th regional unit. Data were collected via face-to-face, semi-structured interviews with 24 nurses selected through criterion sampling and analyzed using Colaizzi’s seven-step content analysis method. Methodological rigor was ensured through member checking, research triangulation, and adherence to the COREQ guidelines. Results: Three major themes and seven subthemes were identified: (1) Leadership Competencies, including personal (resilience, decisiveness, emotional control) and professional-disaster competencies (coordination, communication, task delegation); (2) Consequences of Leadership, highlighting both positive (morale, trust, effectiveness) and adverse outcomes (conflict, inefficiency, role ambiguity); and (3) Strengthening Disaster Leadership, which emphasized the need for individual/technical development, team and community-based strategies, and psychological support systems. Conclusions: UMKE nurses perceive disaster leadership as a multifaceted role that extends beyond clinical competence to encompass ethical responsibility, emotional resilience, and adaptive team coordination. Strengthening disaster leadership requires structured training, psychosocial support, and inclusive policy frameworks that recognize and develop nurses’ leadership capacities in high-pressure environments. The findings offer critical insights for disaster preparedness planning, nurse education, and leadership development initiatives in emergency health systems. Policy and Practice Implications: Formally defining individual and professional competencies in disaster leadership and making them the main criteria in leader selection and appointments; establishing merit- and talent-based, performance-driven dynamic task allocation systems in team management; and regularly evaluating leader performance through team feedback to strengthen delegation and flexibility mechanisms stand out as priority policy steps that will enhance the effectiveness of disaster leadership. Clinical trial number: Not applicable. Disasters disaster nursing leadership qualitative research emergency preparedness Introduction Disasters are sudden, destructive events that disrupt lives, public health, and healthcare continuity. Factors such as climate change, uncontrolled urbanization, mass migration, and weak infrastructure increase their frequency and complexity. 1 , 2 These crises go beyond physical damage, involving multiple stakeholders and uncertainty, and demand not only technical and logistical resources but also strong communication, coordination, strategic thinking, and rapid decision-making skills. 3 In particular, for healthcare professionals working on the front lines during disasters, leadership skills play a critical role in both effectively managing the crisis and enhancing community resilience. The preparedness, flexibility, and sustainability of health systems in emergencies largely depend on these professionals’ leadership capacities. 4 Disaster environments are complex settings where decisions are made under pressure, resources are limited, and multidisciplinary teams work together. Under such circumstances, effective leadership is crucial not only for operational success but also for maintaining team morale, sustaining trust, and ensuring the continuity of services. 5 During crises, leaders are not only decision-makers but also sources of morale and motivation, conflict managers, and information coordinators. 6 , 7 Therefore, leadership is not merely a managerial position but also a professional competency. 4 Indeed, poor leadership in disaster settings can lead to several problems, including task conflicts, disruptions in information flow, psychological burnout, and mistrust within the team, 6 , 8 whereas effective leadership yields positive outcomes such as maintaining morale, coordinating the team, managing resources, and fostering public trust. 9 Nurses, by serving on the front lines in disasters, assume leadership roles both in terms of clinical expertise and crisis management. 8 , 9 However, information in the literature regarding these leadership roles is limited and mostly theoretical. 3 Leadership in disasters requires functioning under distinctive conditions involving uncertainty, time pressure, and resource constraints. Examining leadership behaviors within their context is critically important for understanding the actual dynamics in the field. The National Medical Rescue Team (UMKE), which plays a critical role in Turkey’s disaster response capacity, not only provides clinical care but is also a healthcare force that actively assumes field leadership. 10 UMKE nurses fulfill multidimensional leadership roles in disaster settings, such as decision-making, team management, and psychosocial support. However, these leadership roles are often not systematically defined, supported, or formally recognized. The limited number of qualitative field studies in the literature addressing the disaster leadership experiences of UMKE nurses restricts knowledge production and policy development processes in this area. This study examined in depth the disaster leadership experiences of nurses working in Turkey’s 15th UMKE Region, revealing that leadership is not merely an administrative duty but a complex process that involves strategic decision-making, team coordination, and ethical responsibility in crises. The findings obtained are expected to contribute to educational, managerial, and structural improvements aimed at strengthening nurse leadership in disasters. Methods Design This study adopted a phenomenological approach, which aims to explore and make sense of a phenomenon from the perspective of the individuals who experience it. 11 The research aimed to examine in depth the disaster leadership experiences of UMKE nurses. The reporting of the study was based on the “Consolidated Criteria for Reporting Qualitative Research (COREQ)” guidelines. 12 Research Team and Reflexivity The research team consists of academics specializing in disaster studies and UMKE personnel with field and leadership experience. Two researchers (NKK, GTE) specializing in nursing management contributed to the in-depth analysis of the managerial, organizational, and leadership dimensions of disaster leadership experiences. In addition, an expert (BB) with disaster-related studies and previous experience as a UMKE volunteer strengthened the coherence between practice and theory. The field leadership experience of the UMKE Regional Coordinator (SS) brought strong practical perspectives to the study. This interdisciplinary and field-based expertise significantly contributed to the development of reflexivity during the processes of data collection, analysis, and interpretation. Participants The study population consists of UMKE nurses working within Turkey’s 15th UMKE Region (Trabzon, Rize, Artvin, Giresun, Gümüşhane). These provinces were included in the research scope because one of the researchers is the coordinator of the 15th UMKE Region, which facilitated access and coordination. UMKE teams, operating in Turkey through 30 Regional Coordinators covering all 81 provinces, are composed of volunteer healthcare workers who serve within the scope of emergency and disaster management. In the 15th UMKE Region, 134 nurses serve as volunteers. Participants were selected using the criterion sampling technique, one of the purposive sampling methods. The inclusion criteria for this study were (1) being a nurse; (2) having served actively within UMKE for at least three years; (3) having field experience (experience in disaster response); (4) having no barriers to communication; and (5) volunteering to participate in the study. In qualitative research, information saturation is deemed reached when the data obtained begins to repeat. 13 The sample size was determined when interview data began to repeat or no new information emerged, with the stopping method applied after three interviews yielded no new codes; 14 a total of 24 UMKE nurse interviews were completed. Data Collection Tools For data collection, a Demographic Information Form and a Semi-Structured Interview Form, developed by the researchers in line with the literature, were used. The Information Form consists of five questions covering demographic data such as participants’ age, gender, education level, years of professional experience, and duration of UMKE experience. When preparing the semi-structured interview form, the researchers (NKK, BB) independently reviewed the literature to create a pool of questions. 3 , 6 , 8 , 9 Based on this pool, an initial draft focusing on disaster nursing and leadership was prepared, and the 8-question form was submitted to three experts with studies in disaster nursing and leadership. Based on feedback from the experts, the questions were reviewed for scope, clarity, and comprehensibility, and the final version was determined. The resulting semi-structured interview form consists of a total of 6 questions that explore UMKE nurses’ disaster leadership experiences, difficulties encountered in disaster response, perceptions of leadership roles, and suggestions for improvement (See Table 1 ). Table 1 Interview Questions Regarding UMKE Nurses’ Disaster Leadership Experiences 1. How do you define the concept of leadership during a disaster? What words or examples come to mind when you think about leadership? 2. As a UMKE nurse, how do you evaluate the leadership roles you have taken on during disasters? What are the most challenging situations you face while fulfilling your disaster leadership role? If you think of a specific disaster you worked on, how did you demonstrate your leadership roles during that process? 3. What are the most important qualities an effective leader should have in disaster situations? 4. Have you experienced any situations in disasters where you thought there was a lack of leadership? How did these deficiencies affect the disaster response? 5. What can be done to improve the leadership roles of UMKE nurses in disasters? What kind of training, support, or resources do you think are needed? 6. Do you have any additional thoughts or personal experiences related to your leadership that you would like to share? Data Collection In this study, the fourth author (SS), who is the coordinator of Turkey’s 15th UMKE Region, identified UMKE nurses who met the inclusion criteria. SS contacted the nurses directly, providing detailed information about the study’s purpose, scope, and methodology, and explained that the research would be conducted in accordance with ethical principles. Care was taken to ensure sample diversity in participant selection, aiming to include nurses with varied characteristics regarding gender, education level (associate, bachelor’s, postgraduate), and UMKE experience (3–19 years). The goal was to obtain diverse perspectives on disaster leadership experiences. Participants were selected on a voluntary basis, and face-to-face interviews were conducted in a quiet room within the clinic where both the participants and the researcher were present, after obtaining their consent. During the interviews, the researcher kept reflective field notes alongside observational records to enhance the contextual interpretation of the findings. This process strengthened the comprehensiveness and reliability of the data. Data Analysis Since this study focuses on the disaster leadership experiences of UMKE nurses, Colaizzi’s seven-step content analysis method was used for data analysis. 15 In the first step, audio recordings were numbered (UH1, UH2...), and all data were anonymized and transcribed. Then, the transcripts were independently read multiple times by two researchers (NKK, BB) to become familiar with the texts. In the second step, the researchers independently identified meaningful segments directly related to the research questions among the statements of UMKE nurses. In the third step, 55 short codes representing the core meanings of UMKE nurses’ experiences were created from the identified meaningful statements. In the fourth step, codes were grouped based on content similarities, resulting in seven sub-themes and three main themes. In the fifth, relationships between themes were analyzed to holistically define the phenomenon of disaster leadership. In the sixth step, themes were presented to five UMKE nurses to gather feedback and evaluate whether the themes reflected their experiences. In the final step, the main and sub-themes were supported by direct quotes from nurses, providing detailed findings. While nurses’ personal contexts varied, common points regarding disaster leadership experiences were identified. Each interview lasted between 30 and 45 minutes, depending on the participant’s engagement. Rigor This study considered Tracy’s (2010) eight criteria to ensure rigor in qualitative research. 16 (1) Firstly, the study topic was deemed a worthy one, having the potential to fill a critical gap in healthcare by examining the leadership experiences of UMKE nurses working in disaster settings. (2) Rich rigor was ensured through purposive sampling, interview questions developed based on the literature, data analysis using Colaizzi’s method, and participant verification. (3) The research team, with expertise in disaster nursing and management, embraced the reflexivity process, enhancing sincerity and transparency throughout the research process. (4) Credibility was supported by participant verification, researcher diversity, and detailed descriptions. (5) Findings were linked to the literature, aiming for resonance with the experiences of UMKE nurses. (6) The study makes a significant contribution by offering educational, support, and policy recommendations for leadership development. (7) Ethical standards were upheld based on voluntariness, informed consent, and confidentiality. (8) Meaningful coherence was achieved among methodology, analysis, and findings, maintaining consistency between research questions, methods, and interpretations. Ethical Considerations The study was conducted with Bayburt University Non-Interventional Clinical Research Ethics Committee approval (Number: E-47535748-050.99-247862, Date: 16.01.2025). Prior to data collection, verbal and written consents were obtained from all nurses voluntarily participating in the study. Audio recordings of the interviews were securely stored on an encrypted computer accessible only to the researchers. To ensure the confidentiality of nurses’ identities, codes (e.g., UH1) were used instead of personal information. Throughout the study, the ethical principles of the Declaration of Helsinki were rigorously adhered to. 17 Results Nurses’ socio-demographic characteristics The mean age of the 24 nurses participating in the study was 35.45 years (min–max: 29–59 years). The majority of them were male (54%) and held a bachelor’s degree (58.3%). Their professional experience averaged 13.25 years (min–max: 4–29 years), and their UMKE experience averaged 7.60 years (min–max: 3–19 years) (See Supplementary file: Table S1 ). Identified themes and subthemes In line with the study’s objectives, three themes emerged from the perspectives of UMKE nurses: (a) competencies in disaster leadership, (b) outcomes of disaster leadership, and (c) strengthening disaster leadership (See Tables 2 and 3 ). Table 2 The codes of the UMKE nurses’ statements Themes Subthemes Codes competencies in Disaster Leadership Individual competencies Calmness, decisiveness, ability to cope with stress during crises, foresight to anticipate dangers, psychological resilience, ego control and delegation of leadership when necessary, sense of responsibility, being a role model, postponing emotional trauma, effective use of body language Team competencies Disaster experience and field expertise, strengthening leadership skills through training and drills, professional knowledge and technical proficiency, continuous learning and development, effective organization, planning and task delegation, recognizing and utilizing team members’ talents efficiently, maintaining discipline and authority, effective communication skills, ensuring inter-organizational coordination, fostering team cohesion and motivation, making fair task assignments, maintaining professionalism Outcomes of Disaster Leadership Effective Leadership Outcomes Maintaining calmness at the scene, reducing inter- or multidisciplinary conflicts, creating an environment of trust and solidarity, boosting morale and motivation, fostering an atmosphere open to feedback and learning, recognizing and effectively utilizing team members’ talents, and ensuring psychological comfort Ineffective Leadership Outcomes Decline in team morale and motivation, disruptions in work and coordination problems, repetitive tasks and inefficiency, breakdowns in communication and team cohesion, conflicts over roles and authority among disaster response teams Strengthening Disaster Leadership Individual and Technical Empowerment Participating in continuous education and development activities, gaining experience through hands-on learning methods, strengthening quick and accurate decision-making and problem-solving competencies, engaging in all stages of organizational processes to gain mastery over the process, acquiring knowledge about the characteristics of the disaster area, keeping equipment and method knowledge up to date by following technological developments, benefiting from mentorship and guidance support, determining individuals’ leadership styles Team- and Community-Based Empowerment Increasing effective communication to ensure team cohesion and trust, clarifying roles and task distribution, establishing training and feedback mechanisms, enhancing social awareness and participation, showing sensitivity to cultural and local characteristics, establishing effective communication and cooperation with the public, spreading disaster volunteering. Psychological Empowerment Increasing the team’s psychological resilience, enhancing emotion regulation, being sensitive to the psychological needs of disaster victims and the community, utilizing the knowledge and experience of experienced personnel, establishing psychological support and motivation systems Table 3 Trail of Codes and Representative Quotations from Interviews with UMKE Nurses Themes Subthemes Examples of Quotes Disaster Leadership Experiences from the Perspective of UMKE Nurses 1. Competencies in Disaster Leadership Individual competencies UH3: During a disaster, a leader is someone who can remain calm, think in a planned and multifaceted way, generate ideas, and manage and guide their staff effectively. A leader evaluates risk factors and accurately identifies needs. UH6: Leadership is not only about giving instructions; it requires being a person who supports the team both physically and psychologically, steps to the front line when necessary, and remains calm in times of crisis. A leader must suppress their own stress and lighten the team’s burden. The leader is responsible not only for task distribution but also for maintaining morale and motivation. UH24: Ensuring trust and motivation within the team is one of the leader’s most important duties. Team competencies UH9: In a disaster setting, having thorough knowledge of the equipment and using technology effectively strengthens leadership. UH13: A leader possesses knowledge and skills in on-site incident management. UH15: In leadership, experience and ability take precedence. Leaders should be chosen from UMKE’s experienced and active personnel. Being able to maintain stable leadership and ensure continuity in assignments is very important for team motivation and discipline. Training alone is not sufficient for leadership; practical experience is essential. UH20: In a disaster setting, leadership directs the team with accurate information and algorithms, assigns tasks, and manages the process. 2. Outcomes of Disaster Leadership Effective Leadership Outcomes UH1: An effective leader should have disaster experience and learn from the lessons of those experiences. They should be able to use body language well, remain calm, and make quick decisions. UH7: An effective leader should possess diligence and a sense of responsibility, psychological resilience, communication skills, ego control (and be able to hand over leadership if necessary), crisis management skills, and the ability to make quick decisions. They should also set an example—not only giving directions but also demonstrating tasks in practice. Ineffective Leadership Outcomes UH9: If a leader does not know their team members well and cannot allocate tasks fairly, it can lead to serious unrest and a lack of coordination within the team. UH15: Incompetent leaders cannot establish authority in the disaster area and cause a loss of trust within the team. UH20: Leaders lacking training and preparedness display indecisive and disorganized management during a crisis. 3. Strengthening Disaster Leadership Individual and Technical Empowerment UH6: To be effective in disaster zones, a leader should learn the characteristics of all regions, including technical knowledge about geography, climate, weather conditions, and transportation options. UH13: A leader should prepare not only to manage their own organization but also to oversee and coordinate all supporting groups. UH18: Individual empowerment comes through inclusive, dynamic, and continuously updated training. In particular, simulation-based training improves the ability to make quick and accurate decisions in chaotic environments. Incorporating technological advancements into equipment and gaining hands-on experience in using all available tools can significantly enhance disaster leadership effectiveness. Team- and Community-Based Empowerment UH7: A good leader should know the individuals in their team and provide support in areas where it is needed. UH11: They should be well-acquainted with the knowledge and skills of the organization team, provide skills training when necessary, and serve as a role model. UH23: They should develop their rhetorical skills in order to guide the community and utilize them effectively during disasters. They should engage with communities that have regional differences and be familiar with these differences. Psychological Empowerment UH8: A leader should consider not only their own psychology but also that of the team, the community, and the disaster victims. Therefore, they should possess knowledge and certifications that enable them to provide support to personnel and the public in acute psychological situations. UH10: Leaders’ abilities to cope with stress, pressure, loss, and uncertainty should be developed. For this purpose, training on psychological first aid, post-traumatic stress management, self-care, and emotional resilience should be provided. Psychological support should be offered to leaders after disasters, and rotation, leave, and support mechanisms should be established to prevent burnout. Participants; P. Theme 1. Competencies in Disaster Leadership This theme was addressed within the scope of professional and disaster competencies at both the individual and team levels. Subtheme 1.1. Individual competencies UMKE nurses possessed various characteristics regarding individual competencies in disaster leadership. Participants emphasized the importance of remaining calm during crises, demonstrating decisiveness, and managing stress effectively. They also stated that they could anticipate dangers, and had psychological resilience, and flexibility to delegate leadership when necessary. Most nurses expressed that they act with a sense of responsibility, value being role models, and can postpone dealing with emotional trauma if needed. Additionally, UMKE nurses highlighted the importance of effectively using body language in disaster settings for leadership purposes (See Tables 2 and 3 ). Subtheme 1.2. Team competencies UMKE nurses were aware of their professional and disaster competencies in disaster leadership. Some nurses noted that disaster experience and field mastery were important for leadership, while others stated that these competencies develop through training and drills. Additionally, most nurses expressed feelings responsible for maintaining professional knowledge, technical proficiency, and for continuous learning and development. The nurses emphasized their competence in effective organization, planning, and task distribution, and highlighted that recognizing and utilizing team members’ talents efficiently is critical in disaster management. Furthermore, they reported feeling responsible for maintaining discipline and authority, developing effective communication skills, coordinating inter-institutionally, and supporting team cohesion and motivation. Some nurses also stated that being fair in task distribution and maintaining professionalism in all situations are important attitudes in disaster leadership (See Tables 2 and 3 ). Theme 2. Outcomes of Disaster Leadership This theme focuses on the outcomes of disaster leadership and is examined under two subheadings: effective and ineffective leadership outcomes. Subtheme 2.1. Effective Leadership Outcomes The majority of UMKE nurses indicated that effective leadership in disaster settings yields several positive outcomes. They believed effective leadership contributes to maintaining calm at the stage, reducing conflicts at interdisciplinary and multidisciplinary levels, and establishing an environment of trust and solidarity within the team. They listed improved morale and motivation, having an environment open to feedback and learning, the recognition and effective utilization of team members’ talents, and the provision of psychological relief as other important outcomes of effective leadership (See Tables 2 and 3 ). Subtheme 2.2. Ineffective Leadership Outcomes According to the nurses, ineffective leadership in disaster settings leads to negative outcomes, loss of morale and motivation within the team, disruptions in work, and coordination problems. Additionally, repetitive tasks and inefficiency, breakdowns in communication and team cohesion, as well as conflicts over duties and authority among disaster response teams, were reported as significant negative consequences of ineffective leadership (See Tables 2 and 3 ). Theme 3. Strengthening Disaster Leadership This theme expresses a holistic approach to strengthening disaster leadership. Success in disaster leadership involves not only developing individual and technical competencies but also team- and community-based empowerment as well as psychological support elements. This theme is addressed under three subheadings: (i) Individual and Technical Empowerment, (ii) Team- and Community-Based Empowerment, and (iii) Psychological Empowerment. Subtheme 3.1. Individual and Technical Empowerment UMKE nurses emphasized the importance of participating in disaster leadership in training programs and sustaining professional development through in-service training, certification programs, and postgraduate education. They also stated that experience gained through drills, simulations, and field assignments plays a critical role in leadership success, and that nurse leaders need to enhance their ability to make quick and accurate decisions. Mastery of all organizational phases and effective learning and use of equipment and technological tools used in disasters were noted to support leadership success. UMKE nurses mentioned that having technical knowledge about disaster area characteristics, such as geography, climate, and transportation, and keeping equipment and methodology knowledge up to date by following technological developments increases leader effectiveness. They believed that developing analytical thinking, time management, and problem-solving skills, along with benefiting from mentoring and guidance support, positively influences leadership performance (See Tables 2 and 3 ). Subtheme 3.2. Team- and Community-Based Empowerment The majority of UMKE nurses emphasized the importance of team- and community-focused empowerment strategies in disaster leadership. They noted that team cohesion and trust should be supported by effective communication, fairness, motivation, and social activities. Additionally, the importance of organizing roles and task distribution within the team based on merit and hierarchy and reinforcing this through drills was highlighted. Nurses expressed the need for training and feedback mechanisms to develop team skills and address deficiencies. The necessity of education, awareness-raising, and volunteer support to increase community awareness and participation was emphasized. They reported that leaders should be responsive to social characteristics such as local culture, customs, traditions, and language, and take regional conditions into account. Effective communication and collaboration with the public and strengthening coordination with local governments, non-governmental organizations, and volunteers were listed as further critical factors (See Tables 2 and 3 ). Subtheme 3.3. Psychological Empowerment The majority of UMKE nurses stated that supporting personal psychological health in disaster leadership is critical for leadership success. They emphasized that leaders and team members should receive training on trauma management, coping with stress, and burnout prevention. Expanding psychosocial support training and responsiveness to disaster victims’ psychological needs were also highlighted. Nurses reported that knowledge sharing by experienced personnel, intra-team support mechanisms, and motivational approaches are effective in enhancing leadership performance (See Tables 2 and 3 ). Discussion Competencies in Disaster Leadership In this study, participants emphasized that individual competencies—such as calmness, foresight, and flexibility—demonstrated by leaders in crisis conditions play a critical role in disaster management. These competencies are also recognized in the literature as essential components of effective disaster leadership. 8 , 18 – 20 Deng et al. (2024) found that foresight and risk assessment skills enhance intervention effectiveness. 21 A notable finding of this study is the identification of "delegation flexibility" as a leadership behavior that strengthens team cohesion in crisis environments—a unique contribution to the limited literature on situational leadership approaches. 22 Participants regarded effective organization, comprehensive planning, and justice-based task distribution as priority leadership elements in disaster leadership. Previous studies also emphasize that leaders should efficiently manage resources and clearly define tasks through personnel guidance, communication, and coordination skills. 4 , 23 However, those studies do not provide a concrete framework for the principles underlying task distribution. In this study, basing task distribution on the principle of justice adds an ethical dimension to disaster leadership, thereby making a unique contribution to literature. Furthermore, participants noted that leaders have multifaceted responsibilities such as inter-organizational coordination, balancing discipline and authority, team motivation, and the use of body language. Härgestam et al. (2016) also demonstrated that body language in trauma teams enhances team trust and strengthens coordination. 22 These findings reveal that disaster leadership is not limited to operational tasks 5 but requires an ethical, multifaceted, and relationship-oriented approach. Outcomes of Disaster Leadership Our findings show that effective leadership supports team performance by strengthening trust and solidarity in the field. This aligns with studies reporting that leadership reduces anxiety, helps cope with uncertainty, accelerates decision-making processes, and supports maintaining task performance. 7 , 24 Additionally, leadership approaches that encourage feedback, support learning, and plan tasks according to abilities were identified as key components of effective leadership in this study. Previous research also emphasizes that open feedback and a strong learning culture increase information sharing in emergencies and disasters, supporting continuous improvement. 25 , 26 Furthermore, distributing tasks based on team members’ strengths optimizes resource use and speeds up interventions. 27 In this context, leaders need to develop flexible decision-making skills in disaster environments, adapt to rapidly changing conditions, and establish mechanisms that sustain learning and feedback within the team. According to the participants, ineffective disaster leadership is associated with negative consequences such as loss of morale in the field, communication problems, role ambiguity, task repetitions, delays in interventions, and conflicts between teams. Lack of clear and directive communication disrupts team cohesion in the disaster area and undermines the sense of trust. 19 , 27 When the chain of command is not clearly defined, authority conflicts arise among disaster response teams, impairing operational efficiency. 28 Additionally, insufficient leadership support raises burnout levels among team members working under disaster conditions and negatively affects task performance. 29 These findings reveal the impacts of leadership deficiencies on three main levels: managerial (role and task confusion, decision-making problems), communication (lack of communication, loss of trust), and psychosocial (burnout, decreased motivation). In this context, integrating transformational, agile, supportive, and ethical leadership models into disaster management processes emerges as a strategic necessity that can enhance both operational success and team resilience. 3 , 7 , 8 Strengthening Disaster Leadership The findings indicate that strengthening disaster leadership requires addressing technical, team/community-based, and psychological dimensions together. This multidimensional approach necessitates the integrated development of technical, communicational, and psychosocial skills. 28 , 30 Regarding technical empowerment, participants emphasized the importance of theoretical and practical training, certification programs, and field-based experiences. This finding aligns with studies showing that simulation-based training increases nurses’ disaster preparedness levels and leadership capacities. 27 , 31 , 32 Moreover, the literature highlights the importance of considering not only technical skills but also cognitive and emotional skills (such as decision-making, ethical sensitivity, and cultural competence) in disaster leadership processes. 33 Regarding team and community-based empowerment, literature shows that leaders’ inclusive communication styles enhance team solidarity and promote collaboration. 23 , 34 In our study, taking into account local cultural values and establishing effective communication with the public were also found to be critical for leadership success. However, structural and cultural challenges such as differences in local government capacities, resource shortages, centralized decision-making, and trust deficits linked to past negative experiences may arise when implementing such a holistic approach in the field. 33 Regarding psychological empowerment, participants emphasized the need to develop leaders’ and team members’ skills in trauma management, coping with stress, and preventing burnout. Mani et al. (2025) also highlight the importance of targeted training programs in trauma management and psychological first aid to strengthen emergency care competencies. 35 Furthermore, previous studies report that psychological resilience training improves performance under disaster conditions 7 , 36 and that structured debriefing and mentoring processes support post-disaster recovery. 20 In light of these findings, success in disaster leadership requires enhancing technical competencies, strengthening team- and community-based communication and collaboration mechanisms, and activating psychological support processes. Improvements in these areas will enable both leaders and teams to be more effective and resilient in the face of crises. Implications for Policy and Practice The study findings highlight the necessity of clearly and formally defining individual and professional competencies in disaster leadership. Individual skills such as calmness, quick and accurate decision-making, and foresight, along with professional knowledge and experience, should be integrated into national and international disaster management plans as fundamental criteria for leader selection. Leaders regularly monitoring and evaluating team members’ performance will enable merit- and skill-based task allocation. This approach will enhance fairness and efficiency within teams, thereby improving the effectiveness of response processes. Considering that effective leadership fosters calmness, trust, and solidarity within the team, mechanisms to objectively assess leader performance in disaster response teams should be designed. Regular feedback from teams should be used as guidance for leaders’ development; flexibility in decision-making and delegation of authority should be supported. Furthermore, access to simulation- and technology-based applications should be provided to improve leadership skills, along with technical knowledge about geographic, climatic, and transportation conditions specific to disaster regions. Programs aimed at increasing collaboration should include content sensitive to public communication, local culture, and social dynamics. Accessible support systems for stress management and post-trauma recovery should be established; practices that encourage knowledge sharing among experienced leaders and strengthen team solidarity should be widely implemented. Limitations Since this research was conducted only with nurses working in the 15th UMKE Region, it may not fully reflect the experiences of personnel in other regions and regional conditions. Given Turkey’s geographical, socio-cultural, and climatic diversity that can influence disaster experiences, the generalizability of the findings is limited. Interviews conducted in controlled environments based on participant self-reporting may not fully reveal real reactions in the field. Additionally, conducting the study solely with nurses has limited the complete representation of the multidisciplinary nature of disaster leadership. Future research is recommended to plan field-based, mixed-method approaches involving different regions and professional groups. Conclusion This study, based on the experiences of UMKE nurses, revealed that disaster leadership is a multidimensional structure not limited to technical skills but integrated with personal traits, ethical values, and organizational competencies. Leaders’ individual qualities, such as composure, foresight, stress management, and fair approach, alongside organizational competencies like planning, inter-institutional coordination, and motivation provision, are critical for effective field operations. The findings show that nonverbal communication (eye contact, body language, and posture) is an important tool in reinforcing leadership authority and strengthening team cohesion. Furthermore, effective leadership was found to enhance team performance by fostering a culture of trust, collaboration, and solidarity, whereas ineffective leadership led to motivation loss, role ambiguity, and coordination problems. Additionally, the necessity of holistic approaches incorporating individual, team-based, and psychological support elements to strengthen leadership was emphasized. Declarations Funding None. Author Contribution Study design: NKK, BB, GTE, SS; data collection: SS; data analysis: NKK, BB, GTE, SS; study supervision: NKK, BB, GTE; manuscript writing: NKK, BB, GTE, SS; critical revisions for important intellectual content: NKK, BB, GTE. Data Availability Data can be accessed upon request from the authors. References United Nations Office for Disaster Risk Reduction. 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Leadership in disaster management: Theory versus reality. J Clin Health Sci. 2020;5(1):4-11. doi: 10.24191/jchs.v5i1.9818 Xue CL, Shu YS, Hayter M, Lee A. Experiences of nurses involved in natural disaster relief: A meta-synthesis of qualitative literature. J Clin Nurs. 2020;29(23-24):4514-4531. doi: 10.1111/jocn.15485 Uhr C. Leadership ideals as barriers for efficient collaboration during emergencies and disasters. J Contingencies Crisis Manag. 2017;25(4):301-312. doi: 10.1111/1468-5973.12157 Grossman VA. Leadership essentials during a disaster. J Radiol Nurs. 2020;39(3):156. doi: 10.1016/j.jradnu.2020.04.006 Acil Sağlık Hizmetleri Genel Müdürlüğü. Afet ve Acil Durum Yönetimi Daire Başkanlığı: Ulusal Medikal Kurtarma Ekibi Birimi (UMKE). Accessed August 20, 2025. https://ashgmafetacildb.saglik.gov.tr/TR-80255/ulusal-medikal-kurtarma-ekibi-birimi-umke.html Neubauer BE, Witkop CT, Varpio L. How phenomenology can help us learn from the experiences of others. Perspect Med Educ. 2019;8(2):90-97. doi: 10.1007/s40037-019-0509-2 Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist. Int J Qual Health Care. 2007;19(6):349-357. doi: 10.1093/intqhc/mzm042 Daher W. Saturation in qualitative educational technology research. Educ Sci. 2023;13(2):98. doi: 10.3390/educsci13020098 Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: A systematic review. Soc Sci Med. 2022;292:114523. doi: 10.1016/j.socscimed.2021.114523 Morrow R, Rodriguez A, King N. Colaizzi’s descriptive phenomenological method. Psychologist. 2015;28(8):643-644. Tracy SJ. Qualitative quality: Eight “big-tent” criteria for excellent qualitative research. Qual Inq. 2010;16(10):837-851. doi: 10.1177/1077800410383121 Nashwan AJ, Joy GV. The 2024 Declaration of Helsinki revision: Relevance to nursing research. J Adv Nurs. 2025;81(1). doi: 10.1111/jan.70082 Batı Ş, Çelikkalp Ü. Nurses’ preparedness for disasters: Perceptions and levels of psychological resilience. Int Nurs Rev. 2025;72(1):e13093. doi: 10.1111/inr.13093 Asgari F, Panahi L, Pouy S. COVID-19: What should we do in future crises? The leadership role of nurses: A scoping review. Eurasian J Emerg Med. 2021;20(4):211-218. Mert IS, Koksal K. Unveiling the heart of disaster nursing: Motivations, challenges, lessons from 2023 Turkey earthquakes. Int Nurs Rev. 2025;72(2):e13023. doi: 10.1111/inr.13023 Deng J, Kou X, Ma H, Niu A, Luo Y. Core competencies of nursing personnel in emergency rescue teams: A qualitative study. BMJ Open. 2024;14(4):e077821. doi: 10.1136/bmjopen-2023-077821 Härgestam M, Hultin M, Brulin C, Jacobsson M. Trauma team leaders’ nonverbal communication: Video registration during training. Scand J Trauma Resusc Emerg Med. 2016;24(1):37. doi: 10.1186/s13049-016-0221-9 Purnomo E, Hamid AYS, Gayatri D, Setiawan A. Nurse leadership in disaster management in West Sulawesi: A qualitative study. Health Emerg Disasters Q. 2025;10(3):227-236. doi: 10.32598/hdq.10.3.375.2 Sihvola S, Kvist T, Nurmeksela A. Nurse leaders' resilience during COVID-19: A scoping review. J Nurs Manag. 2022;30(6):1869-1880. doi: 10.1111/jonm.13640 Goniewicz M, et al. Resilience in emergency medicine during COVID-19: Staff expectations and preparedness. J Pers Med. 2023;13(11):1545. doi: 10.3390/jpm13111545 Alonazi WB. Building learning organizational culture during COVID-19: A national study. BMC Health Serv Res. 2021;21(1):422. doi: 10.1186/s12913-021-06436-2 Farokhzadian J, Shahrbabaki PM, Farahmandnia H, Taskiran Eskici G, Soltani Goki F. Nurses’ challenges for disaster response: A qualitative study. BMC Emerg Med. 2024;24(1):1. doi: 10.1186/s12873-023-00921-8 Thrwi AM, Al Hazmi AM, Kalfout AM, Kariri HM, Aldabyan TY, Alsalah ZH. Nursing leadership in disaster preparedness and response. Int J Community Med Public Health. 2024;11(8):3261-3265. doi: 10.18203/2394-6040.ijcmph20241989 Cheng C, Bartram T, Karimi L, Leggat SG. Transformational leadership and social support mitigate stress on nurses’ burnout. J Adv Nurs. 2023;79(3):1012-1024. doi: 10.1111/jan.15601 Veenema TG, Griffin A, Gable AR, et al. Nurses as leaders in disaster preparedness: A call to action. J Nurs Scholarsh. 2017;49(6):632-640. doi: 10.1111/jnu.12326 Ličen S, Prosen M. Disaster nursing competencies in global conflicts and climate crises. Int Nurs Rev. 2025;72:e70052. doi: 10.1111/inr.70052 Geng C, Luo Y, Pei X, Chen X. Simulation in disaster nursing education: A scoping review. Nurse Educ Today. 2021;107:105119. doi: 10.1016/j.nedt.2021.105119 Lee YM, Park SY, Lim JY. Disaster preparedness and cultural competence among emergency nurses. BMC Nurs. 2023;22(1):450. doi: 10.1186/s12912-023-01576-w Cariaso-Sugay J, Hultgren M, Browder BA, Chen JL. Nurse leaders' knowledge and confidence managing disasters in acute care. Nurs Adm Q. 2021;45(2):142-151. doi: 10.1097/NAQ.0000000000000441 Mani ZA, Innab A, Taleb F. Assessing frontline competency gap: Emergency care perceptions among nurses in Yemen. Int Nurs Rev. 2025;72(2):e13047. doi: 10.1111/inr.13047 Said NB, Chiang VC. Knowledge, skill competencies, and psychological preparedness of nurses for disasters: A systematic review. Int Emerg Nurs. 2020;48:100806. doi: 10.1016/j.ienj.2019.100806 Additional Declarations No competing interests reported. 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05:34:01","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":15513,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryTableS1.docx","url":"https://assets-eu.researchsquare.com/files/rs-7496702/v1/413db4be6ad7688a03e835dd.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Understanding Disaster Leadership: A Qualitative Study from the Perspective of UMKE Nurses","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDisasters are sudden, destructive events that disrupt lives, public health, and healthcare continuity. Factors such as climate change, uncontrolled urbanization, mass migration, and weak infrastructure increase their frequency and complexity.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e These crises go beyond physical damage, involving multiple stakeholders and uncertainty, and demand not only technical and logistical resources but also strong communication, coordination, strategic thinking, and rapid decision-making skills.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e In particular, for healthcare professionals working on the front lines during disasters, leadership skills play a critical role in both effectively managing the crisis and enhancing community resilience. The preparedness, flexibility, and sustainability of health systems in emergencies largely depend on these professionals\u0026rsquo; leadership capacities.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eDisaster environments are complex settings where decisions are made under pressure, resources are limited, and multidisciplinary teams work together. Under such circumstances, effective leadership is crucial not only for operational success but also for maintaining team morale, sustaining trust, and ensuring the continuity of services.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e During crises, leaders are not only decision-makers but also sources of morale and motivation, conflict managers, and information coordinators.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e Therefore, leadership is not merely a managerial position but also a professional competency.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e Indeed, poor leadership in disaster settings can lead to several problems, including task conflicts, disruptions in information flow, psychological burnout, and mistrust within the team,\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e whereas effective leadership yields positive outcomes such as maintaining morale, coordinating the team, managing resources, and fostering public trust.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e Nurses, by serving on the front lines in disasters, assume leadership roles both in terms of clinical expertise and crisis management.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e However, information in the literature regarding these leadership roles is limited and mostly theoretical.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e Leadership in disasters requires functioning under distinctive conditions involving uncertainty, time pressure, and resource constraints. Examining leadership behaviors within their context is critically important for understanding the actual dynamics in the field.\u003c/p\u003e\u003cp\u003eThe National Medical Rescue Team (UMKE), which plays a critical role in Turkey\u0026rsquo;s disaster response capacity, not only provides clinical care but is also a healthcare force that actively assumes field leadership.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e UMKE nurses fulfill multidimensional leadership roles in disaster settings, such as decision-making, team management, and psychosocial support. However, these leadership roles are often not systematically defined, supported, or formally recognized. The limited number of qualitative field studies in the literature addressing the disaster leadership experiences of UMKE nurses restricts knowledge production and policy development processes in this area. This study examined in depth the disaster leadership experiences of nurses working in Turkey\u0026rsquo;s 15th UMKE Region, revealing that leadership is not merely an administrative duty but a complex process that involves strategic decision-making, team coordination, and ethical responsibility in crises. The findings obtained are expected to contribute to educational, managerial, and structural improvements aimed at strengthening nurse leadership in disasters.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eDesign\u003c/h2\u003e\u003cp\u003eThis study adopted a phenomenological approach, which aims to explore and make sense of a phenomenon from the perspective of the individuals who experience it.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e The research aimed to examine in depth the disaster leadership experiences of UMKE nurses. The reporting of the study was based on the \u0026ldquo;Consolidated Criteria for Reporting Qualitative Research (COREQ)\u0026rdquo; guidelines.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eResearch Team and Reflexivity\u003c/h3\u003e\n\u003cp\u003eThe research team consists of academics specializing in disaster studies and UMKE personnel with field and leadership experience. Two researchers (NKK, GTE) specializing in nursing management contributed to the in-depth analysis of the managerial, organizational, and leadership dimensions of disaster leadership experiences. In addition, an expert (BB) with disaster-related studies and previous experience as a UMKE volunteer strengthened the coherence between practice and theory. The field leadership experience of the UMKE Regional Coordinator (SS) brought strong practical perspectives to the study. This interdisciplinary and field-based expertise significantly contributed to the development of reflexivity during the processes of data collection, analysis, and interpretation.\u003c/p\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eThe study population consists of UMKE nurses working within Turkey\u0026rsquo;s 15th UMKE Region (Trabzon, Rize, Artvin, Giresun, G\u0026uuml;m\u0026uuml;şhane). These provinces were included in the research scope because one of the researchers is the coordinator of the 15th UMKE Region, which facilitated access and coordination. UMKE teams, operating in Turkey through 30 Regional Coordinators covering all 81 provinces, are composed of volunteer healthcare workers who serve within the scope of emergency and disaster management. In the 15th UMKE Region, 134 nurses serve as volunteers. Participants were selected using the criterion sampling technique, one of the purposive sampling methods. The inclusion criteria for this study were (1) being a nurse; (2) having served actively within UMKE for at least three years; (3) having field experience (experience in disaster response); (4) having no barriers to communication; and (5) volunteering to participate in the study. In qualitative research, information saturation is deemed reached when the data obtained begins to repeat.\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e The sample size was determined when interview data began to repeat or no new information emerged, with the stopping method applied after three interviews yielded no new codes;\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e a total of 24 UMKE nurse interviews were completed.\u003c/p\u003e\n\u003ch3\u003eData Collection Tools\u003c/h3\u003e\n\u003cp\u003eFor data collection, a Demographic Information Form and a Semi-Structured Interview Form, developed by the researchers in line with the literature, were used. The Information Form consists of five questions covering demographic data such as participants\u0026rsquo; age, gender, education level, years of professional experience, and duration of UMKE experience.\u003c/p\u003e\u003cp\u003eWhen preparing the semi-structured interview form, the researchers (NKK, BB) independently reviewed the literature to create a pool of questions.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e Based on this pool, an initial draft focusing on disaster nursing and leadership was prepared, and the 8-question form was submitted to three experts with studies in disaster nursing and leadership. Based on feedback from the experts, the questions were reviewed for scope, clarity, and comprehensibility, and the final version was determined.\u003c/p\u003e\u003cp\u003eThe resulting semi-structured interview form consists of a total of 6 questions that explore UMKE nurses\u0026rsquo; disaster leadership experiences, difficulties encountered in disaster response, perceptions of leadership roles, and suggestions for improvement (See Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eInterview Questions Regarding UMKE Nurses\u0026rsquo; Disaster Leadership Experiences\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"1\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. How do you define the concept of leadership during a disaster? What words or examples come to mind when you think about leadership?\u003c/p\u003e\u003cp\u003e2. As a UMKE nurse, how do you evaluate the leadership roles you have taken on during disasters? What are the most challenging situations you face while fulfilling your disaster leadership role? If you think of a specific disaster you worked on, how did you demonstrate your leadership roles during that process?\u003c/p\u003e\u003cp\u003e3. What are the most important qualities an effective leader should have in disaster situations?\u003c/p\u003e\u003cp\u003e4. Have you experienced any situations in disasters where you thought there was a lack of leadership? How did these deficiencies affect the disaster response?\u003c/p\u003e\u003cp\u003e5. What can be done to improve the leadership roles of UMKE nurses in disasters? What kind of training, support, or resources do you think are needed?\u003c/p\u003e\u003cp\u003e6. Do you have any additional thoughts or personal experiences related to your leadership that you would like to share?\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eIn this study, the fourth author (SS), who is the coordinator of Turkey\u0026rsquo;s 15th UMKE Region, identified UMKE nurses who met the inclusion criteria. SS contacted the nurses directly, providing detailed information about the study\u0026rsquo;s purpose, scope, and methodology, and explained that the research would be conducted in accordance with ethical principles. Care was taken to ensure sample diversity in participant selection, aiming to include nurses with varied characteristics regarding gender, education level (associate, bachelor\u0026rsquo;s, postgraduate), and UMKE experience (3\u0026ndash;19 years). The goal was to obtain diverse perspectives on disaster leadership experiences. Participants were selected on a voluntary basis, and face-to-face interviews were conducted in a quiet room within the clinic where both the participants and the researcher were present, after obtaining their consent. During the interviews, the researcher kept reflective field notes alongside observational records to enhance the contextual interpretation of the findings. This process strengthened the comprehensiveness and reliability of the data.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eSince this study focuses on the disaster leadership experiences of UMKE nurses, Colaizzi\u0026rsquo;s seven-step content analysis method was used for data analysis.\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e In the first step, audio recordings were numbered (UH1, UH2...), and all data were anonymized and transcribed. Then, the transcripts were independently read multiple times by two researchers (NKK, BB) to become familiar with the texts. In the second step, the researchers independently identified meaningful segments directly related to the research questions among the statements of UMKE nurses. In the third step, 55 short codes representing the core meanings of UMKE nurses\u0026rsquo; experiences were created from the identified meaningful statements. In the fourth step, codes were grouped based on content similarities, resulting in seven sub-themes and three main themes. In the fifth, relationships between themes were analyzed to holistically define the phenomenon of disaster leadership. In the sixth step, themes were presented to five UMKE nurses to gather feedback and evaluate whether the themes reflected their experiences. In the final step, the main and sub-themes were supported by direct quotes from nurses, providing detailed findings. While nurses\u0026rsquo; personal contexts varied, common points regarding disaster leadership experiences were identified. Each interview lasted between 30 and 45 minutes, depending on the participant\u0026rsquo;s engagement.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eRigor\u003c/h3\u003e\n\u003cp\u003eThis study considered Tracy\u0026rsquo;s (2010) eight criteria to ensure rigor in qualitative research.\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e (1) Firstly, the study topic was deemed a worthy one, having the potential to fill a critical gap in healthcare by examining the leadership experiences of UMKE nurses working in disaster settings. (2) Rich rigor was ensured through purposive sampling, interview questions developed based on the literature, data analysis using Colaizzi\u0026rsquo;s method, and participant verification. (3) The research team, with expertise in disaster nursing and management, embraced the reflexivity process, enhancing sincerity and transparency throughout the research process. (4) Credibility was supported by participant verification, researcher diversity, and detailed descriptions. (5) Findings were linked to the literature, aiming for resonance with the experiences of UMKE nurses. (6) The study makes a significant contribution by offering educational, support, and policy recommendations for leadership development. (7) Ethical standards were upheld based on voluntariness, informed consent, and confidentiality. (8) Meaningful coherence was achieved among methodology, analysis, and findings, maintaining consistency between research questions, methods, and interpretations.\u003c/p\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003e The study was conducted with Bayburt University Non-Interventional Clinical Research Ethics Committee approval (Number: E-47535748-050.99-247862, Date: 16.01.2025). Prior to data collection, verbal and written consents were obtained from all nurses voluntarily participating in the study. Audio recordings of the interviews were securely stored on an encrypted computer accessible only to the researchers. To ensure the confidentiality of nurses\u0026rsquo; identities, codes (e.g., UH1) were used instead of personal information. Throughout the study, the ethical principles of the Declaration of Helsinki were rigorously adhered to.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eNurses\u0026rsquo; socio-demographic characteristics\u003c/h2\u003e\u003cp\u003eThe mean age of the 24 nurses participating in the study was 35.45 years (min\u0026ndash;max: 29\u0026ndash;59 years). The majority of them were male (54%) and held a bachelor\u0026rsquo;s degree (58.3%). Their professional experience averaged 13.25 years (min\u0026ndash;max: 4\u0026ndash;29 years), and their UMKE experience averaged 7.60 years (min\u0026ndash;max: 3\u0026ndash;19 years) (See Supplementary file: Table \u003cspan refid=\"MOESM1\" class=\"InternalRef\"\u003eS1\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eIdentified themes and subthemes\u003c/h2\u003e\u003cp\u003eIn line with the study\u0026rsquo;s objectives, three themes emerged from the perspectives of UMKE nurses: (a) competencies in disaster leadership, (b) outcomes of disaster leadership, and (c) strengthening disaster leadership (See Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe codes of the UMKE nurses\u0026rsquo; statements\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThemes\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSubthemes\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCodes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ecompetencies in Disaster Leadership\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndividual competencies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCalmness, decisiveness, ability to cope with stress during crises, foresight to anticipate dangers, psychological resilience, ego control and delegation of leadership when necessary, sense of responsibility, being a role model, postponing emotional trauma, effective use of body language\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTeam competencies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDisaster experience and field expertise, strengthening leadership skills through training and drills, professional knowledge and technical proficiency, continuous learning and development, effective organization, planning and task delegation, recognizing and utilizing team members\u0026rsquo; talents efficiently, maintaining discipline and authority, effective communication skills, ensuring inter-organizational coordination, fostering team cohesion and motivation, making fair task assignments, maintaining professionalism\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eOutcomes of Disaster Leadership\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEffective Leadership Outcomes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMaintaining calmness at the scene, reducing inter- or multidisciplinary conflicts, creating an environment of trust and solidarity, boosting morale and motivation, fostering an atmosphere open to feedback and learning, recognizing and effectively utilizing team members\u0026rsquo; talents, and ensuring psychological comfort\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIneffective Leadership Outcomes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDecline in team morale and motivation, disruptions in work and coordination problems, repetitive tasks and inefficiency, breakdowns in communication and team cohesion, conflicts over roles and authority among disaster response teams\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eStrengthening Disaster Leadership\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndividual and Technical Empowerment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eParticipating in continuous education and development activities, gaining experience through hands-on learning methods, strengthening quick and accurate decision-making and problem-solving competencies, engaging in all stages of organizational processes to gain mastery over the process, acquiring knowledge about the characteristics of the disaster area, keeping equipment and method knowledge up to date by following technological developments, benefiting from mentorship and guidance support, determining individuals\u0026rsquo; leadership styles\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTeam- and Community-Based Empowerment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIncreasing effective communication to ensure team cohesion and trust, clarifying roles and task distribution, establishing training and feedback mechanisms, enhancing social awareness and participation, showing sensitivity to cultural and local characteristics, establishing effective communication and cooperation with the public, spreading disaster volunteering.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePsychological Empowerment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIncreasing the team\u0026rsquo;s psychological resilience, enhancing emotion regulation, being sensitive to the psychological needs of disaster victims and the community, utilizing the knowledge and experience of experienced personnel, establishing psychological support and motivation systems\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eTrail of Codes and Representative Quotations from Interviews with UMKE Nurses\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThemes\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSubthemes\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eExamples of Quotes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e\u003cp\u003eDisaster Leadership Experiences from the Perspective of UMKE Nurses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e1. Competencies in Disaster Leadership\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIndividual competencies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUH3: During a disaster, a leader is someone who can remain calm, think in a planned and multifaceted way, generate ideas, and manage and guide their staff effectively. A leader evaluates risk factors and accurately identifies needs.\u003c/p\u003e\u003cp\u003eUH6: Leadership is not only about giving instructions; it requires being a person who supports the team both physically and psychologically, steps to the front line when necessary, and remains calm in times of crisis. A leader must suppress their own stress and lighten the team\u0026rsquo;s burden. The leader is responsible not only for task distribution but also for maintaining morale and motivation.\u003c/p\u003e\u003cp\u003eUH24: Ensuring trust and motivation within the team is one of the leader\u0026rsquo;s most important duties.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eTeam competencies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUH9: In a disaster setting, having thorough knowledge of the equipment and using technology effectively strengthens leadership.\u003c/p\u003e\u003cp\u003eUH13: A leader possesses knowledge and skills in on-site incident management.\u003c/p\u003e\u003cp\u003eUH15: In leadership, experience and ability take precedence. Leaders should be chosen from UMKE\u0026rsquo;s experienced and active personnel. Being able to maintain stable leadership and ensure continuity in assignments is very important for team motivation and discipline. Training alone is not sufficient for leadership; practical experience is essential.\u003c/p\u003e\u003cp\u003eUH20: In a disaster setting, leadership directs the team with accurate information and algorithms, assigns tasks, and manages the process.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e2. Outcomes of Disaster Leadership\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEffective Leadership Outcomes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUH1: An effective leader should have disaster experience and learn from the lessons of those experiences. They should be able to use body language well, remain calm, and make quick decisions.\u003c/p\u003e\u003cp\u003eUH7: An effective leader should possess diligence and a sense of responsibility, psychological resilience, communication skills, ego control (and be able to hand over leadership if necessary), crisis management skills, and the ability to make quick decisions. They should also set an example\u0026mdash;not only giving directions but also demonstrating tasks in practice.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIneffective Leadership Outcomes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUH9: If a leader does not know their team members well and cannot allocate tasks fairly, it can lead to serious unrest and a lack of coordination within the team.\u003c/p\u003e\u003cp\u003eUH15: Incompetent leaders cannot establish authority in the disaster area and cause a loss of trust within the team.\u003c/p\u003e\u003cp\u003eUH20: Leaders lacking training and preparedness display indecisive and disorganized management during a crisis.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e3. Strengthening Disaster Leadership\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIndividual and Technical Empowerment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUH6: To be effective in disaster zones, a leader should learn the characteristics of all regions, including technical knowledge about geography, climate, weather conditions, and transportation options.\u003c/p\u003e\u003cp\u003eUH13: A leader should prepare not only to manage their own organization but also to oversee and coordinate all supporting groups.\u003c/p\u003e\u003cp\u003eUH18: Individual empowerment comes through inclusive, dynamic, and continuously updated training. In particular, simulation-based training improves the ability to make quick and accurate decisions in chaotic environments. Incorporating technological advancements into equipment and gaining hands-on experience in using all available tools can significantly enhance disaster leadership effectiveness.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eTeam- and Community-Based Empowerment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUH7: A good leader should know the individuals in their team and provide support in areas where it is needed.\u003c/p\u003e\u003cp\u003eUH11: They should be well-acquainted with the knowledge and skills of the organization team, provide skills training when necessary, and serve as a role model.\u003c/p\u003e\u003cp\u003eUH23: They should develop their rhetorical skills in order to guide the community and utilize them effectively during disasters. They should engage with communities that have regional differences and be familiar with these differences.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePsychological Empowerment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUH8: A leader should consider not only their own psychology but also that of the team, the community, and the disaster victims. Therefore, they should possess knowledge and certifications that enable them to provide support to personnel and the public in acute psychological situations.\u003c/p\u003e\u003cp\u003eUH10: Leaders\u0026rsquo; abilities to cope with stress, pressure, loss, and uncertainty should be developed. For this purpose, training on psychological first aid, post-traumatic stress management, self-care, and emotional resilience should be provided. Psychological support should be offered to leaders after disasters, and rotation, leave, and support mechanisms should be established to prevent burnout.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003eParticipants; P.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eTheme 1. Competencies in Disaster Leadership\u003c/h2\u003e\u003cp\u003eThis theme was addressed within the scope of professional and disaster competencies at both the individual and team levels.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eSubtheme 1.1. Individual competencies\u003c/h2\u003e\u003cp\u003eUMKE nurses possessed various characteristics regarding individual competencies in disaster leadership. Participants emphasized the importance of remaining calm during crises, demonstrating decisiveness, and managing stress effectively. They also stated that they could anticipate dangers, and had psychological resilience, and flexibility to delegate leadership when necessary. Most nurses expressed that they act with a sense of responsibility, value being role models, and can postpone dealing with emotional trauma if needed. Additionally, UMKE nurses highlighted the importance of effectively using body language in disaster settings for leadership purposes (See Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eSubtheme 1.2. Team competencies\u003c/h2\u003e\u003cp\u003eUMKE nurses were aware of their professional and disaster competencies in disaster leadership. Some nurses noted that disaster experience and field mastery were important for leadership, while others stated that these competencies develop through training and drills. Additionally, most nurses expressed feelings responsible for maintaining professional knowledge, technical proficiency, and for continuous learning and development. The nurses emphasized their competence in effective organization, planning, and task distribution, and highlighted that recognizing and utilizing team members\u0026rsquo; talents efficiently is critical in disaster management. Furthermore, they reported feeling responsible for maintaining discipline and authority, developing effective communication skills, coordinating inter-institutionally, and supporting team cohesion and motivation. Some nurses also stated that being fair in task distribution and maintaining professionalism in all situations are important attitudes in disaster leadership (See Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003eTheme 2. Outcomes of Disaster Leadership\u003c/h2\u003e\u003cp\u003eThis theme focuses on the outcomes of disaster leadership and is examined under two subheadings: effective and ineffective leadership outcomes.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003eSubtheme 2.1. Effective Leadership Outcomes\u003c/h2\u003e\u003cp\u003eThe majority of UMKE nurses indicated that effective leadership in disaster settings yields several positive outcomes. They believed effective leadership contributes to maintaining calm at the stage, reducing conflicts at interdisciplinary and multidisciplinary levels, and establishing an environment of trust and solidarity within the team. They listed improved morale and motivation, having an environment open to feedback and learning, the recognition and effective utilization of team members\u0026rsquo; talents, and the provision of psychological relief as other important outcomes of effective leadership (See Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\u003ch2\u003eSubtheme 2.2. Ineffective Leadership Outcomes\u003c/h2\u003e\u003cp\u003eAccording to the nurses, ineffective leadership in disaster settings leads to negative outcomes, loss of morale and motivation within the team, disruptions in work, and coordination problems. Additionally, repetitive tasks and inefficiency, breakdowns in communication and team cohesion, as well as conflicts over duties and authority among disaster response teams, were reported as significant negative consequences of ineffective leadership (See Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\u003ch2\u003eTheme 3. Strengthening Disaster Leadership\u003c/h2\u003e\u003cp\u003eThis theme expresses a holistic approach to strengthening disaster leadership. Success in disaster leadership involves not only developing individual and technical competencies but also team- and community-based empowerment as well as psychological support elements. This theme is addressed under three subheadings: (i) Individual and Technical Empowerment, (ii) Team- and Community-Based Empowerment, and (iii) Psychological Empowerment.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\u003ch2\u003eSubtheme 3.1. Individual and Technical Empowerment\u003c/h2\u003e\u003cp\u003eUMKE nurses emphasized the importance of participating in disaster leadership in training programs and sustaining professional development through in-service training, certification programs, and postgraduate education. They also stated that experience gained through drills, simulations, and field assignments plays a critical role in leadership success, and that nurse leaders need to enhance their ability to make quick and accurate decisions. Mastery of all organizational phases and effective learning and use of equipment and technological tools used in disasters were noted to support leadership success. UMKE nurses mentioned that having technical knowledge about disaster area characteristics, such as geography, climate, and transportation, and keeping equipment and methodology knowledge up to date by following technological developments increases leader effectiveness. They believed that developing analytical thinking, time management, and problem-solving skills, along with benefiting from mentoring and guidance support, positively influences leadership performance (See Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\u003ch2\u003eSubtheme 3.2. Team- and Community-Based Empowerment\u003c/h2\u003e\u003cp\u003eThe majority of UMKE nurses emphasized the importance of team- and community-focused empowerment strategies in disaster leadership. They noted that team cohesion and trust should be supported by effective communication, fairness, motivation, and social activities. Additionally, the importance of organizing roles and task distribution within the team based on merit and hierarchy and reinforcing this through drills was highlighted. Nurses expressed the need for training and feedback mechanisms to develop team skills and address deficiencies. The necessity of education, awareness-raising, and volunteer support to increase community awareness and participation was emphasized. They reported that leaders should be responsive to social characteristics such as local culture, customs, traditions, and language, and take regional conditions into account. Effective communication and collaboration with the public and strengthening coordination with local governments, non-governmental organizations, and volunteers were listed as further critical factors (See Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cdiv id=\"Sec23\" class=\"Section3\"\u003e\u003ch2\u003eSubtheme 3.3. Psychological Empowerment\u003c/h2\u003e\u003cp\u003eThe majority of UMKE nurses stated that supporting personal psychological health in disaster leadership is critical for leadership success. They emphasized that leaders and team members should receive training on trauma management, coping with stress, and burnout prevention. Expanding psychosocial support training and responsiveness to disaster victims\u0026rsquo; psychological needs were also highlighted. Nurses reported that knowledge sharing by experienced personnel, intra-team support mechanisms, and motivational approaches are effective in enhancing leadership performance (See Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec25\" class=\"Section2\"\u003e\u003ch2\u003eCompetencies in Disaster Leadership\u003c/h2\u003e\u003cp\u003eIn this study, participants emphasized that individual competencies\u0026mdash;such as calmness, foresight, and flexibility\u0026mdash;demonstrated by leaders in crisis conditions play a critical role in disaster management. These competencies are also recognized in the literature as essential components of effective disaster leadership.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e Deng et al. (2024) found that foresight and risk assessment skills enhance intervention effectiveness.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e A notable finding of this study is the identification of \"delegation flexibility\" as a leadership behavior that strengthens team cohesion in crisis environments\u0026mdash;a unique contribution to the limited literature on situational leadership approaches.\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eParticipants regarded effective organization, comprehensive planning, and justice-based task distribution as priority leadership elements in disaster leadership. Previous studies also emphasize that leaders should efficiently manage resources and clearly define tasks through personnel guidance, communication, and coordination skills.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e However, those studies do not provide a concrete framework for the principles underlying task distribution. In this study, basing task distribution on the principle of justice adds an ethical dimension to disaster leadership, thereby making a unique contribution to literature. Furthermore, participants noted that leaders have multifaceted responsibilities such as inter-organizational coordination, balancing discipline and authority, team motivation, and the use of body language. H\u0026auml;rgestam et al. (2016) also demonstrated that body language in trauma teams enhances team trust and strengthens coordination.\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e These findings reveal that disaster leadership is not limited to operational tasks\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e but requires an ethical, multifaceted, and relationship-oriented approach.\u003c/p\u003e\u003cdiv id=\"Sec26\" class=\"Section3\"\u003e\u003ch2\u003eOutcomes of Disaster Leadership\u003c/h2\u003e\u003cp\u003eOur findings show that effective leadership supports team performance by strengthening trust and solidarity in the field. This aligns with studies reporting that leadership reduces anxiety, helps cope with uncertainty, accelerates decision-making processes, and supports maintaining task performance.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e Additionally, leadership approaches that encourage feedback, support learning, and plan tasks according to abilities were identified as key components of effective leadership in this study. Previous research also emphasizes that open feedback and a strong learning culture increase information sharing in emergencies and disasters, supporting continuous improvement.\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e Furthermore, distributing tasks based on team members\u0026rsquo; strengths optimizes resource use and speeds up interventions.\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e In this context, leaders need to develop flexible decision-making skills in disaster environments, adapt to rapidly changing conditions, and establish mechanisms that sustain learning and feedback within the team.\u003c/p\u003e\u003cp\u003eAccording to the participants, ineffective disaster leadership is associated with negative consequences such as loss of morale in the field, communication problems, role ambiguity, task repetitions, delays in interventions, and conflicts between teams. Lack of clear and directive communication disrupts team cohesion in the disaster area and undermines the sense of trust.\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e When the chain of command is not clearly defined, authority conflicts arise among disaster response teams, impairing operational efficiency.\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e Additionally, insufficient leadership support raises burnout levels among team members working under disaster conditions and negatively affects task performance.\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e These findings reveal the impacts of leadership deficiencies on three main levels: managerial (role and task confusion, decision-making problems), communication (lack of communication, loss of trust), and psychosocial (burnout, decreased motivation). In this context, integrating transformational, agile, supportive, and ethical leadership models into disaster management processes emerges as a strategic necessity that can enhance both operational success and team resilience.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec27\" class=\"Section3\"\u003e\u003ch2\u003eStrengthening Disaster Leadership\u003c/h2\u003e\u003cp\u003eThe findings indicate that strengthening disaster leadership requires addressing technical, team/community-based, and psychological dimensions together. This multidimensional approach necessitates the integrated development of technical, communicational, and psychosocial skills.\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eRegarding technical empowerment, participants emphasized the importance of theoretical and practical training, certification programs, and field-based experiences. This finding aligns with studies showing that simulation-based training increases nurses\u0026rsquo; disaster preparedness levels and leadership capacities.\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e,\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e Moreover, the literature highlights the importance of considering not only technical skills but also cognitive and emotional skills (such as decision-making, ethical sensitivity, and cultural competence) in disaster leadership processes.\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e Regarding team and community-based empowerment, literature shows that leaders\u0026rsquo; inclusive communication styles enhance team solidarity and promote collaboration.\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e,\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e In our study, taking into account local cultural values and establishing effective communication with the public were also found to be critical for leadership success. However, structural and cultural challenges such as differences in local government capacities, resource shortages, centralized decision-making, and trust deficits linked to past negative experiences may arise when implementing such a holistic approach in the field.\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e Regarding psychological empowerment, participants emphasized the need to develop leaders\u0026rsquo; and team members\u0026rsquo; skills in trauma management, coping with stress, and preventing burnout. Mani et al. (2025) also highlight the importance of targeted training programs in trauma management and psychological first aid to strengthen emergency care competencies.\u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e Furthermore, previous studies report that psychological resilience training improves performance under disaster conditions\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e and that structured debriefing and mentoring processes support post-disaster recovery.\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e In light of these findings, success in disaster leadership requires enhancing technical competencies, strengthening team- and community-based communication and collaboration mechanisms, and activating psychological support processes. Improvements in these areas will enable both leaders and teams to be more effective and resilient in the face of crises.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec28\" class=\"Section2\"\u003e\u003ch2\u003eImplications for Policy and Practice\u003c/h2\u003e\u003cp\u003eThe study findings highlight the necessity of clearly and formally defining individual and professional competencies in disaster leadership. Individual skills such as calmness, quick and accurate decision-making, and foresight, along with professional knowledge and experience, should be integrated into national and international disaster management plans as fundamental criteria for leader selection. Leaders regularly monitoring and evaluating team members\u0026rsquo; performance will enable merit- and skill-based task allocation. This approach will enhance fairness and efficiency within teams, thereby improving the effectiveness of response processes. Considering that effective leadership fosters calmness, trust, and solidarity within the team, mechanisms to objectively assess leader performance in disaster response teams should be designed. Regular feedback from teams should be used as guidance for leaders\u0026rsquo; development; flexibility in decision-making and delegation of authority should be supported. Furthermore, access to simulation- and technology-based applications should be provided to improve leadership skills, along with technical knowledge about geographic, climatic, and transportation conditions specific to disaster regions. Programs aimed at increasing collaboration should include content sensitive to public communication, local culture, and social dynamics. Accessible support systems for stress management and post-trauma recovery should be established; practices that encourage knowledge sharing among experienced leaders and strengthen team solidarity should be widely implemented.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec29\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eSince this research was conducted only with nurses working in the 15th UMKE Region, it may not fully reflect the experiences of personnel in other regions and regional conditions. Given Turkey\u0026rsquo;s geographical, socio-cultural, and climatic diversity that can influence disaster experiences, the generalizability of the findings is limited. Interviews conducted in controlled environments based on participant self-reporting may not fully reveal real reactions in the field. Additionally, conducting the study solely with nurses has limited the complete representation of the multidisciplinary nature of disaster leadership. Future research is recommended to plan field-based, mixed-method approaches involving different regions and professional groups.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study, based on the experiences of UMKE nurses, revealed that disaster leadership is a multidimensional structure not limited to technical skills but integrated with personal traits, ethical values, and organizational competencies. Leaders\u0026rsquo; individual qualities, such as composure, foresight, stress management, and fair approach, alongside organizational competencies like planning, inter-institutional coordination, and motivation provision, are critical for effective field operations. The findings show that nonverbal communication (eye contact, body language, and posture) is an important tool in reinforcing leadership authority and strengthening team cohesion. Furthermore, effective leadership was found to enhance team performance by fostering a culture of trust, collaboration, and solidarity, whereas ineffective leadership led to motivation loss, role ambiguity, and coordination problems. Additionally, the necessity of holistic approaches incorporating individual, team-based, and psychological support elements to strengthen leadership was emphasized.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eNone.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eStudy design: NKK, BB, GTE, SS; data collection: SS; data analysis: NKK, BB, GTE, SS; study supervision: NKK, BB, GTE; manuscript writing: NKK, BB, GTE, SS; critical revisions for important intellectual content: NKK, BB, GTE.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData can be accessed upon request from the authors.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eUnited Nations Office for Disaster Risk Reduction. \u003cem\u003eForensic insights for future resilience, learning from past disasters.\u003c/em\u003eGeneva, Switzerland: UNDRR; 2024. 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Qualitative quality: Eight \u0026ldquo;big-tent\u0026rdquo; criteria for excellent qualitative research. \u003cem\u003eQual Inq.\u003c/em\u003e 2010;16(10):837-851. doi: 10.1177/1077800410383121\u003c/li\u003e\n \u003cli\u003eNashwan AJ, Joy GV. The 2024 Declaration of Helsinki revision: Relevance to nursing research. \u003cem\u003eJ Adv Nurs.\u003c/em\u003e 2025;81(1). doi: 10.1111/jan.70082\u003c/li\u003e\n \u003cli\u003eBatı Ş, \u0026Ccedil;elikkalp \u0026Uuml;. Nurses\u0026rsquo; preparedness for disasters: Perceptions and levels of psychological resilience. \u003cem\u003eInt Nurs Rev.\u003c/em\u003e2025;72(1):e13093. doi: 10.1111/inr.13093\u003c/li\u003e\n \u003cli\u003eAsgari F, Panahi L, Pouy S. COVID-19: What should we do in future crises? The leadership role of nurses: A scoping review. \u003cem\u003eEurasian J Emerg Med.\u003c/em\u003e 2021;20(4):211-218.\u003c/li\u003e\n \u003cli\u003eMert IS, Koksal K. Unveiling the heart of disaster nursing: Motivations, challenges, lessons from 2023 Turkey earthquakes. \u003cem\u003eInt Nurs Rev.\u003c/em\u003e 2025;72(2):e13023. doi: 10.1111/inr.13023\u003c/li\u003e\n \u003cli\u003eDeng J, Kou X, Ma H, Niu A, Luo Y. Core competencies of nursing personnel in emergency rescue teams: A qualitative study. \u003cem\u003eBMJ Open.\u003c/em\u003e 2024;14(4):e077821. doi: 10.1136/bmjopen-2023-077821\u003c/li\u003e\n \u003cli\u003eH\u0026auml;rgestam M, Hultin M, Brulin C, Jacobsson M. Trauma team leaders\u0026rsquo; nonverbal communication: Video registration during training. \u003cem\u003eScand J Trauma Resusc Emerg Med.\u003c/em\u003e 2016;24(1):37. doi: 10.1186/s13049-016-0221-9\u003c/li\u003e\n \u003cli\u003ePurnomo E, Hamid AYS, Gayatri D, Setiawan A. Nurse leadership in disaster management in West Sulawesi: A qualitative study. \u003cem\u003eHealth Emerg Disasters Q.\u003c/em\u003e 2025;10(3):227-236. doi: 10.32598/hdq.10.3.375.2\u003c/li\u003e\n \u003cli\u003eSihvola S, Kvist T, Nurmeksela A. Nurse leaders\u0026apos; resilience during COVID-19: A scoping review. \u003cem\u003eJ Nurs Manag.\u003c/em\u003e2022;30(6):1869-1880. doi: 10.1111/jonm.13640\u003c/li\u003e\n \u003cli\u003eGoniewicz M, et al. Resilience in emergency medicine during COVID-19: Staff expectations and preparedness. \u003cem\u003eJ Pers Med.\u003c/em\u003e 2023;13(11):1545. doi: 10.3390/jpm13111545\u003c/li\u003e\n \u003cli\u003eAlonazi WB. Building learning organizational culture during COVID-19: A national study. \u003cem\u003eBMC Health Serv Res.\u003c/em\u003e2021;21(1):422. doi: 10.1186/s12913-021-06436-2\u003c/li\u003e\n \u003cli\u003eFarokhzadian J, Shahrbabaki PM, Farahmandnia H, Taskiran Eskici G, Soltani Goki F. Nurses\u0026rsquo; challenges for disaster response: A qualitative study. \u003cem\u003eBMC Emerg Med.\u003c/em\u003e 2024;24(1):1. doi: 10.1186/s12873-023-00921-8\u003c/li\u003e\n \u003cli\u003eThrwi AM, Al Hazmi AM, Kalfout AM, Kariri HM, Aldabyan TY, Alsalah ZH. Nursing leadership in disaster preparedness and response. \u003cem\u003eInt J Community Med Public Health.\u003c/em\u003e 2024;11(8):3261-3265. doi: 10.18203/2394-6040.ijcmph20241989\u003c/li\u003e\n \u003cli\u003eCheng C, Bartram T, Karimi L, Leggat SG. Transformational leadership and social support mitigate stress on nurses\u0026rsquo; burnout. \u003cem\u003eJ Adv Nurs.\u003c/em\u003e 2023;79(3):1012-1024. doi: 10.1111/jan.15601\u003c/li\u003e\n \u003cli\u003eVeenema TG, Griffin A, Gable AR, et al. Nurses as leaders in disaster preparedness: A call to action. \u003cem\u003eJ Nurs Scholarsh.\u003c/em\u003e2017;49(6):632-640. doi: 10.1111/jnu.12326\u003c/li\u003e\n \u003cli\u003eLičen S, Prosen M. Disaster nursing competencies in global conflicts and climate crises. \u003cem\u003eInt Nurs Rev.\u003c/em\u003e 2025;72:e70052. doi: 10.1111/inr.70052\u003c/li\u003e\n \u003cli\u003eGeng C, Luo Y, Pei X, Chen X. Simulation in disaster nursing education: A scoping review. \u003cem\u003eNurse Educ Today.\u003c/em\u003e2021;107:105119. doi: 10.1016/j.nedt.2021.105119\u003c/li\u003e\n \u003cli\u003eLee YM, Park SY, Lim JY. Disaster preparedness and cultural competence among emergency nurses. \u003cem\u003eBMC Nurs.\u003c/em\u003e2023;22(1):450. doi: 10.1186/s12912-023-01576-w\u003c/li\u003e\n \u003cli\u003eCariaso-Sugay J, Hultgren M, Browder BA, Chen JL. Nurse leaders\u0026apos; knowledge and confidence managing disasters in acute care. \u003cem\u003eNurs Adm Q.\u003c/em\u003e 2021;45(2):142-151. doi: 10.1097/NAQ.0000000000000441\u003c/li\u003e\n \u003cli\u003eMani ZA, Innab A, Taleb F. Assessing frontline competency gap: Emergency care perceptions among nurses in Yemen. \u003cem\u003eInt Nurs Rev.\u003c/em\u003e 2025;72(2):e13047. doi: 10.1111/inr.13047\u003c/li\u003e\n \u003cli\u003eSaid NB, Chiang VC. Knowledge, skill competencies, and psychological preparedness of nurses for disasters: A systematic review. \u003cem\u003eInt Emerg Nurs.\u003c/em\u003e 2020;48:100806. doi: 10.1016/j.ienj.2019.100806\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Disasters, disaster nursing, leadership, qualitative research, emergency preparedness","lastPublishedDoi":"10.21203/rs.3.rs-7496702/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7496702/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction:\u003c/strong\u003e Disaster environments demand rapid decision-making, interprofessional coordination, and adaptive leadership skills, particularly from frontline healthcare workers, including nurses. In Turkey, the National Medical Rescue Team (UMKE) nurses play a crucial leadership role during disasters, yet their leadership experiences remain underexplored in the literature. This study aims to explore UMKE nurses’ perspectives on disaster leadership to inform strategies for capacity building.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This descriptive qualitative study employed a phenomenological approach to explore UMKE nurses’ experiences in Turkey’s 15\u003csup\u003eth\u003c/sup\u003e regional unit. Data were collected via face-to-face, semi-structured interviews with 24 nurses selected through criterion sampling and analyzed using Colaizzi’s seven-step content analysis method. Methodological rigor was ensured through member checking, research triangulation, and adherence to the COREQ guidelines.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Three major themes and seven subthemes were identified: (1) Leadership Competencies, including personal (resilience, decisiveness, emotional control) and professional-disaster competencies (coordination, communication, task delegation); (2) Consequences of Leadership, highlighting both positive (morale, trust, effectiveness) and adverse outcomes (conflict, inefficiency, role ambiguity); and (3) Strengthening Disaster Leadership, which emphasized the need for individual/technical development, team and community-based strategies, and psychological support systems.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eUMKE nurses perceive disaster leadership as a multifaceted role that extends beyond clinical competence to encompass ethical responsibility, emotional resilience, and adaptive team coordination. Strengthening disaster leadership requires structured training, psychosocial support, and inclusive policy frameworks that recognize and develop nurses’ leadership capacities in high-pressure environments. The findings offer critical insights for disaster preparedness planning, nurse education, and leadership development initiatives in emergency health systems.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePolicy and Practice Implications: \u003c/strong\u003eFormally defining individual and professional competencies in disaster leadership and making them the main criteria in leader selection and appointments; establishing merit- and talent-based, performance-driven dynamic task allocation systems in team management; and regularly evaluating leader performance through team feedback to strengthen delegation and flexibility mechanisms stand out as priority policy steps that will enhance the effectiveness of disaster leadership.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u003c/strong\u003e Not applicable.\u003c/p\u003e","manuscriptTitle":"Understanding Disaster Leadership: A Qualitative Study from the Perspective of UMKE Nurses","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-16 05:33:57","doi":"10.21203/rs.3.rs-7496702/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-08T08:03:03+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-01T17:50:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"62826194039894739363750299436630137559","date":"2026-04-29T17:00:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"45715138110366946699638826023763949404","date":"2026-04-28T17:12:06+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-13T11:25:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-09T01:56:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"218260492708547858064106553076361817034","date":"2025-10-04T12:01:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"230594197818378590522765706085638991327","date":"2025-10-03T17:04:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"67148668574457818558541329847051107333","date":"2025-10-03T15:48:00+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-03T10:36:20+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-10T04:40:47+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-06T04:56:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-06T04:55:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-08-30T17:10:50+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3ff51723-005e-4927-bf75-26c93a40ad2c","owner":[],"postedDate":"October 16th, 2025","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-08T08:03:03+00:00","index":91,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-01T17:50:01+00:00","index":90,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-10-16T05:33:57+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-16 05:33:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7496702","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7496702","identity":"rs-7496702","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}