Nurses' Experiences in Maintaining Patient Safety During High Workload Conditions in Public Hospitals
Keywords:
Nurses, Patient safety, Workload, Missed nursing care, PhenomenologyAbstract
Purpose - This study explored nurses' experiences of maintaining patient safety during high workload conditions in a public hospital, focusing on risk recognition, care prioritization, teamwork, adaptation, and organizational support.
Methodology - A qualitative descriptive phenomenological design involved 15 registered nurses from adult inpatient units in a Type B regional public hospital in Central Java, Indonesia. Data were collected from January to March 2026 through semi-structured interviews, six non-participant observation sessions, and document review. Colaizzi's method guided analysis, supported by NVivo 14.
Findings - Five themes emerged: simultaneous and unpredictable demands, dynamic prioritization of safety-critical care, teamwork and communication as a safety buffer, hidden personal costs of maintaining safe care, and dependence on organizational resources. Nurses maintained safety by repeatedly reassessing risks, reorganizing tasks, sharing responsibilities, and protecting time-critical care.
Implications - Hospitals should strengthen staffing flexibility, workload escalation procedures, structured handovers, leadership support, teamwork, and monitoring of delayed or unfinished nursing care.
Originality - The study identifies adaptive prioritization as a key process linking workload with patient safety and integrates the Job Demands-Resources perspective with the Missed Nursing Care Model.
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