We are not in the same boat: a qualitative exploration of Turkish emergency department nurses’ climate-related health experiences

Objective: This study explores Turkish emergency nurses' experiences with climate-related health issues. Guided by Nightingale's Environmental Theory, it highlights nurses' frontline roles in recognising and managing environmental factors that influence patient outcomes during climate-related crises, with implications for public health systems and nursing policy. Methods: This research is a qualitative descriptive study using reflexive thematic analysis. Data were collected from 23 emergency department nurses using purposive and snowball sampling methods. Semi-structured interviews were conducted using an interview guide developed in consultation with experts. Thematic analysis was carried out based on Braun and Clarke's reflexive approach. Results: Most participants were women with 5 years or more of emergency department experience. The majority reported no formal training on climate change. Three main themes were developed: (1) Defining the storm - nurses described climate change as a disruption of natural patterns, observing increases in heat-related illnesses, respiratory exacerbations and vector-borne diseases; (2) Navigating the storm - nurses managed crises through symptomatic care and self-acquired knowledge in the absence of formal protocols or training and (3) We are not in the same boat - nurses identified resource shortages, socio-economic disparities and infrastructural vulnerabilities that disproportionately affected low-income patients. Conclusion: Emergency nurses are increasingly confronted with climate-related health challenges, yet lack adequate training and institutional support. These findings underscore the need for national-level reforms in nursing curricula, institutional preparedness and public health policy to strengthen climate resilience in emergency healthcare.