Missed nursing care (MNC), the omission or delay of required nursing activities,is closely linked to patient safety, strained work environments and nurse burnout. Although contributing factors such as staffing shortages, workload pressures and teamwork deficits are well established, emerging research shows that MNC also involves intentional prioritization by nurses under constrained conditions. However, less is known about how nurses experience and manage these competing demands in everyday practice, particularly in surgical inpatient settings. This study explores nurses' experiences of MNC and the strategies they employ to maintain and improve nursing care. A qualitative descriptive design was used, based on focus group interviews. Six focus groups were conducted with a convenience sample of 20 nurses from three inpatient wards at one surgical clinic. Transcribed data were analyzed using thematic analysis. Three themes were identified: “ Caught in a tug of war ”, “ Bridging the gap ” and “ Active patients with a seat at the table ”, along with seven sub-themes describing nurses' experiences of MNC and their strategies to reduce it. These strategies involved drawing on clinical experience, providing patient education and helping patients to actively participate in their care. Leadership also emerged as essential, particularly in prioritizing and allocating resources to patients with the greatest care needs to ensure equitable and effective care delivery. This study identified key strategies to reduce MNC and its implications for patient safety and the work environment. Addressing MNC requires adequate staffing, effective teamwork, supportive leadership and active patient involvement. • Nurses experience missed nursing care due to time pressure and competing demands. • Education and effective use of clinical experience are key strategies to reduce missed nursing care. • Active patient participation can support the completion of essential nursing care. • Leadership and resource prioritization are critical for equitable care delivery.

Beyond protocol versus judgment: A qualitative study of nurses' prioritization and integration strategies.

The integrative nursing framework may enhance both nurses' well-being and patient care. The EU-funded Integrative Nursing Education Series (INES) project developed educational materials to strengthen nursing curricula. A University College in Denmark studied a six-week, 10 ECTS-credits elective integrative nursing course. Students' learning experiences were explored using a mixed-methods design. The course was structured around ten selected learning outcomes and included lectures, workshops, self-care exercises, and study-activities led by students. Quantitative data was collected through a brief questionnaire and a rubrics tool. Qualitative data were obtained via semi-structured interviews and analyzed using inductive content analysis. Of the 39 enrolled students, 33 completed the questionnaire. A high understanding of integrative nursing was reported by 26 students (79%), and in six out of ten learning outcomes a minimum of 23 students achieved a competent level. Only four students rated themselves as having competence levels lower than expected. Interviews with 12 students revealed increased awareness of patient perspectives, improved communication skills, and a broader understanding of nursing practice. Students valued attention to self-care in education and highlighted the relevance of non-pharmacological interventions in nursing. Key facilitators included experiential learning and a supportive environment; barriers included time constraints, biomedical dominance, and limited institutional support. Integrative nursing education can broaden students' understanding of patient care and potential for well-being. Findings suggest further integrating of self-care practices into nursing education yet recognizing institutional responsibility for nurses' well-being. Students value a person-centered approach while recognizing systemic barriers limiting the application of integrative nursing in clinical practice. Based on relevant learning outcomes, students validated the content of the integrative nursing course. The course supports sustainable healthcare and highlights self-care as a key component of professional identity. Future steps include addressing the theory-practice gap and scaling the course to other institutions.

Indonesian immigrant nurses' stress, distress, and coping: A qualitative study.

Paediatric palliative care (PPC) is a relatively new field in many countries, including Denmark, where regional home-based PPC teams were established between 2015 and 2016. While research on PPC is growing, the lived experiences of nurses providing care in the family home remain underexplored. Understanding how nurses experience this form of care is essential for developing practices that support both families and professionals in this demanding field. This study asks what it is like for nurses to accompany children and families through illness, dying, and bereavement in the context of home-based PPC. A qualitative phenomenological-hermeneutical approach informed by Max van Manen guided the study. Ten nurses from the Danish regional PPC teams participated in individual phenomenological interviews. Analysis followed van Manen's holistic, selective, and detailed reflection, allowing meaning to emerge through attentive engagement with the lived experiences expressed in the interviews. The analysis brought forward three ways in which the experience showed itself: The experience of coming close by walking alongside families; The experience of letting care arise through presence rather than action; The experience of sensing what is at stake. Nurses' accounts show that home-based PPC unfolds through ways of being that move between doing and being present. Their care is shaped by the ability to come close as relationships develop, to remain with families when no further action is possible, and to sense what is lived but not spoken. These forms of attentiveness draw on professional experience as well as an openness to what the situation calls for, supporting families through illness, dying, and the time that follows.

Professional experiences and decisions to return to work among nurses about to retire: A descriptive qualitative study.

Evidence-based practice (EBP) is expected in nursing, and its implementation is still limited by workload, evidence access, and organizational culture. In Saudi settings, nurses report mixed readiness for EBP and recurring constraints related to resources, autonomy, and change processes in daily care. This exploratory study aimed to examine the perspectives of postgraduate nursing students (Master's and doctoral level) on barriers and facilitators to EBP in the Saudi healthcare context, using the Johns Hopkins Practice Evidence Translation (PET) model as the analytic framework. A framework-guided thematic analysis of recorded focus group transcripts used deductive coding to PET domains (Practice, Evidence, Translation) with dual coding across two purposively sampled focus groups: Master's-level nursing students (FG1; n = 5) and doctoral-level nursing students (FG2; n = 5), yielding N = 10 participants. In Practice participants framed EBP as "not personal preference," integrating research evidence, clinical experience, and patient preferences, and described adapting tools and protocols locally. Key practice barriers include bedside resistance when EBP steps were viewed as extra work and hierarchical norms that constrained nursing autonomy. In Evidence, participants reported variable EBP education and research literacy and inconsistent organizational access to journals and databases. In Translation, facilitators included leadership support and capacity-building, while barriers included multi-level resistance and slow approval processes. PET mapping highlights priorities to protect time for EBP work, build research skills, ensure reliable evidence access, and streamline translation pathways.

Medication errors represent a major patient safety concern, with pediatric populations particularly vulnerable due to complex dosing requirements and developmental factors. Although the prevalence and causes of medication errors are widely documented, limited attention has been given to the emotional, ethical, and moral consequences for pediatric nurses, especially within non-Western healthcare contexts. This study aimed to explore how Jordanian pediatric nurses experience, respond to, and learn from medication errors, with specific attention to emotional impact, moral distress, reporting behaviors, and institutional support. A qualitative descriptive design with a phenomenological design was employed. Semi-structured interviews were conducted with 21 pediatric nurses working in a public pediatric hospital and a university-affiliated teaching hospital in Jordan. Interviews were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke's thematic analysis. Five themes were identified: lingering emotional fallout marked by guilt and anxiety; blame-oriented cultures and lack of institutional support; growth through increased vigilance and peer solidarity; fear-driven silence related to reporting; and moral injury involving identity rupture, silent suffering, and moral repair. Medication errors were experienced as enduring emotional and moral events rather than isolated technical incidents. Trauma-informed leadership, just culture implementation, structured emotional debriefing, and peer support are essential for promoting learning, reporting, and moral recovery.

Oncology nurses play a key role in addressing sexual health challenges arising from gynaecological cancer. This study aimed to explore oncology nurses' perceptions and experiences regarding the assessment of sexual problems in women diagnosed with gynaecological cancer. The study was conducted with 12 nurses working in a medical oncology clinic of a research hospital, using a qualitative design with a phenomenological approach. Data were collected through face-to-face semistructured interviews and analysed using the Colaizzi method. Two main categories were derived from the collected data: patient-nurse communication about sexual experiences and barriers faced by nurses in assessing sexual issues. These themes included six subthemes. Nurses reported difficulties initiating conversations about sexuality, feeling inadequate and uncomfortable discussing the topic, and viewed workload as a barrier to providing sexual counselling. This study highlights the obstacles nurses face in integrating sexual health into holistic cancer care.

To explore newly-graduated registered nurses' professional needs and how these needs are supported by mentors in clinical practice, at two Swedish hospital care units. Previous studies show that newly-graduated registered nurses face challenges on initially starting to provide hospital care, thus needing organisational support. Experienced nurses and mentors are commonly described in the literature as facilitating this support and need to be investigated further; however, where this appears in a hospital setting. A qualitative study using focused ethnography was conducted between May 2024 and March 2025. Data was generated from 9 different fieldwork sessions (68 h) for mentoring that included newly-graduated registered nurses and mentors from two different care units at hospitals within one regional healthcare authority in Sweden. Data was collected by means of participant observations, shadowing, ethnographic interviews, and the use of ethnographic analysis. One main theme was identified: I'm in freefall and in need of practical, social and emotional support when navigating my new role, as well as two subthemes: (1) I am a new nurse and in need of help in comprehending and performing nursing, and (2) I am undergoing a learning process in need of a trust-based relationship. Each theme includes three subthemes. Newly-graduated registered nurses need consistent practical, social, and emotional support in their day-to-day work through trust-based relationships with mentors. This is a relationship crucial for their learning process, and which helps them bridge the gap between understanding and practicing nursing. Structured mentorship can improve the learning environment of newly-graduated registered nurses and constitute a sustainable working environment for them. Decision-makers and managers can use this knowledge to implement mentoring programmes that are of interest when it comes to retaining both new and experienced nurses and providing qualitative and safe care. This study conforms to the reporting of the COREQ guidelines and checklist. No patient or public contributions.

Evidence-based practice competence among nurses in acute and critical care settings: a national cross-sectional study in Spain - The #Evidencer Project.

This mixed-method systematic review synthesised quantitative and qualitative empirical evidence on how cognitive dissonance triggered by care experiences and circumstances affects nurses' well-being, professional behaviour, patient care and on the coping strategies nurses use to manage these experiences. Following Joanna Briggs Institute guidance, a convergent integrated synthesis approach combined qualitative and quantitative findings. Sixteen studies were included following a comprehensive search across five databases in August 2024. Sixteen studies were included: 12 qualitative, two quantitative and two mixed-methods. Four key themes were identified: (i) dissonance is triggered by conflicting demands, (ii) dissonance discomfort may generate lasting distress, (iii) dissonance influences nursing practice and quality of care and (iv) dissonance reduction efforts varied. Overall, the evidence base was limited in scope and predominantly qualitative, with included studies generally showing moderate to high methodological quality. Cognitive dissonance is a common but under-recognised challenge in nursing. It arises when actions conflict with professional standards or when nurses are prevented from providing necessary care. If unresolved, it harms nurses' psychological well-being, causing stress, emotional strain and reduced job satisfaction. It may also reduce the quality of care in nursing practice. There is a need for validated measurement tools, longitudinal research exploring long-term impacts and targeted interventions to support nurses. This review is the first to systematically synthesise qualitative and quantitative evidence on cognitive dissonance in nursing. It addresses an important gap by bringing together findings on how dissonance arises in clinical settings, how nurses experience and manage it and its effects on practice and patient care. It also contributes to our understanding of coping strategies nurses use to cope with cognitive dissonance. The findings will support future research, education and interventions aimed at improving care quality and nurse well-being. No patient or public involvement.

ObjectivesThe COVID-19 pandemic had significant physical and psychosocial impacts on nurses. While the initial phases of the pandemic presented considerable challenges, these appear to have diminished over time. This study aimed to explore the lived experiences of Iranian nurses working in clinical settings during the post-pandemic period of COVID-19.DesignThis is a qualitative study conducted using the conventional content analysis approach proposed by Granheim and Lundman (2004).SettingThis study was conducted at secondary care hospitals in northwest Iran that served as referral centres for multiple provinces during the COVID-19 pandemic.ParticipantsA total of 18 nurses with at least 1 year of clinical experience in COVID-19 wards were recruited using purposive sampling. Participants were diverse in terms of gender, age and educational background. Nurses temporarily transferred from other wards were excluded.Results‘Return to Normalcy’ emerged as the overarching theme, encompassing five main categories: Expansion of Knowledge, Changing Attitudes Toward the Disease, Improved Disease Management, Changing Nature of the Disease and Expansion of Facilities.ConclusionsThe findings suggest that, like other crises, the COVID-19 pandemic represents a temporary disruption. However, certain factors can expedite the transition back to normalcy. These include enhanced awareness of the disease, effective crisis management and improved access to diagnostic, therapeutic and protective resources.

Compassionate Care Experiences of Nurses in Acute Psychiatric Settings: A Qualitative Study.

ABSTRACT Purpose Community health nurses (CHN) are vital in delivering primary and preventive care, particularly in underserved and rural areas. Their job satisfaction remains a key determinant for workforce retention, quality of care, and professional well-being. Therefore, this review examines the factors influencing the job satisfaction of community health nurses. Design Mixed-method systematic review. Methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-2020) guidelines. A comprehensive search was conducted across three major databases, including CINAHL, Medline and PROQUEST, between 2019 and December 2025. Two authors independently conducted quality appraisal and data extraction. Data were synthesized using a convergent synthesis approach. Findings Thirteen studies were included, revealing four themes: Organizational and Work Environment, Financial and Mentorship Support, Role, Recognition and Professional Development, and Workload and System Constraints. These interconnected factors shape job satisfaction among community health nurses, with inadequate organizational support, limited growth opportunities, and heavy workloads linked to greater dissatisfaction. Conclusions The findings highlight the importance of creating supportive work environments, ensuring equitable compensation, and offering continuous professional development to enhance job satisfaction among community health nurses. Addressing these factors is critical for improving nurse retention and sustaining high-quality community-based care. Clinical Relevance This review sheds light on the experiences of community health nurses working in both community and home settings. With an increasing number of these nurses leaving the profession and challenges in recruiting for community roles, the findings offer crucial insights for managers and leaders to devise strategies aimed at enhancing nurse satisfaction, boosting retention, and minimizing burnout.

Differentiating the importance of workplace barriers for ICU nurse well-being and patient safety using AHP and FAHP methods.

Pre-registration nursing students' experiences with debriefing in simulation: A scoping review.

ABSTRACT Background Stroke rehabilitation requires a multidisciplinary approach, in which nurses contribute to the continuity and coordination of care. While their role is integral within the rehabilitation team, the experiential and contextual dimensions of nursing practice in stroke rehabilitation remain insufficiently explored. Objective This study aimed to explore the lived experiences of nurses in stroke rehabilitation and to identify factors influencing their roles and working conditions. Methods A qualitative study with a phenomenological orientation was conducted in two rehabilitation hospitals. Data were collected through face-to-face semi-structured interviews with 14 nurses. Data collection continued until sufficient depth and richness of the data were achieved. Interviews were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis supported by MAXQDA Analytics Pro 2024. Results Three main themes were identified: (1) the integrative role, (2) everyday challenges, and (3) working conditions. Nursing practice was experienced as requiring continuous vigilance, emotional regulation, and ongoing negotiation between patient needs, safety, and organizational constraints. Conclusions This study reconceptualizes nursing roles in stroke rehabilitation as integrative practices rather than task-based functions. The findings highlight the need for organizational strategies that better support nurses in managing complex clinical and emotional demands, which may enhance nurses’ well-being and improve the quality of rehabilitation care.

Transitioning from student to professional nurse is stressful, with nearly 18% of newly licensed nurses leaving within the first year. Clinical education models may influence competence, confidence, satisfaction, and retention. This study examined the effect of instructor-led versus preceptor-led clinical education on newly graduated RNs (NGRNs) transition outcomes. A retrospective quasiexperimental pilot study compared first-year NGRNs who completed either an instructor-led or preceptor-led experience. Thirty-three baccalaureate nursing graduates completed the Casey-Fink Graduate Nurse Experience Survey at 1 and 6 months postemployment, measuring communication, leadership, patient safety, stress, and satisfaction. During the first month of practice, instructor-led participants reported higher confidence in communication and delegation, while preceptor-led participants reported higher early job satisfaction. Differences diminished between groups by 6 months. Both models improved competence, confidence, and integration into practice. Structured clinical education supports successful NGRN transitions and highlights the value of intentional academic-practice partnerships in preparing competent, satisfied nurses and promoting retention.

Online screening tools are recommended in well-child visits to support early detection and standardized assessment, while also facilitating meaningful dialogue and collaboration with parents. However, little is known about how public health nurses experience and handle these tools in practice. The aim of this study was to explore public health nurses' experiences with, and handling of, online screening tools in their work practices in well-child clinics and school health services. We used observations and semi-structured interviews to capture public health nurses' experiences and practices after integration of online screening tools. Public health nurses were observed during well-child visits, and when possible, also before and after visits to provide a broader understanding of their practice. In total, eight public health nurses were observed in connection to well-child visits with families of children aged 0-7 years. Interviews were conducted over an extended time-period, with a total of 13 public health nurses participating individually or in groups. Data was analyzed using reflexive thematic analysis of verbatim transcripts and field notes. The findings from this study illustrate how public health nurses experienced tension between structural requirements and relational values when online screening tools were implemented into their practice. The relationship with families was considered the cornerstone of their work, shaping trust, continuity, and holistic understanding. While the tools offered opportunities for structured assessment and dialogue, they also introduced uncertainty about interpretation, follow-up, and professional responsibility, often diverting time and attention away from nurturing relationships. The experienced tension between standardized procedures and relational care reflected a deeper struggle to balance professional obligations with the relational connection that public health nurses regarded as foundational to their role. These dynamics are explored through three themes: When the Structures Comes Between Us, When We Get Trapped Within the Structures, and When the Structures Supports Our Practice. To realize the potential benefits of online screening tools, integration must safeguard both structural requirements and relational needs, ensuring that structures do not come at the expense of trust, relationship, and presence. Not applicable.