Providing culturally sensitive disaster nursing is essential to enhance survivors’ resilience, especially in Pacific Rim island countries, which are home to 80% of the disaster victims of the world. Until now, most studies have focused on immigrant culture or language, and few have explored the idea of disaster nursing adjusted to the affected area’s culture.

The study explores public health nurses’ (PHNs) tacit knowledge regarding culturally sensitive disaster nursing focusing on the Pacific Rim island countries. This first report is the result of the study that clarified how Japanese PHNs, as relief nurses, considered the local culture to provide care to survivors in Japan.

Study participants were nine PHNs from seven prefectures, who provided care to survivors of natural disasters that occurred in 2011–2017 in Japan. Semi-structured interviews were conducted with questions such as, “Which culture did you consider while providing care to survivors in each disaster phase?” Data were analyzed qualitatively and inductively and were sorted according to the four disaster phases. The study was approved by the ethical committee at the National Institution of Public Health.

In the acute phase, PHNs utilized close relationships between local residents and health care providers to collect information. They balanced local habits and the prevention of secondary health damage in the subacute phase; for example, balancing sanitation habits and prevention of contaminations. Additionally, they, as strangers to the community, played a role in alleviating tensions between residents under stress. During the recovery phase, they strengthened survivors’ attachment to the area.

PHNs dispatched from the outside of the affected areas must be culturally malleable to adjust their practice to the local context. Being strangers in an affected area can be advantageous if they utilize their position effectively.