Medical–surgical nurse leaders' experiences with safety culture: An inductive qualitative descriptive study

AIM: The aim of this study is to describe safety culture as experienced by medical–surgical nurse leaders. BACKGROUND: Safety culture remains a barrier in safer patient care. Nurse leaders play an important role in creating and supporting a safety culture. METHODS: We used an inductive qualitative descriptive study using semistructured interviews, document review and observations in a Midwestern community hospital in the United States. RESULTS: Results of the study are as follows: making sure nurses are keeping patients safe, making sure nurses have nursing interventions in place, expecting nurses to stop unsafe acts or escalate when they feel uncomfortable, making sure nurses have what they need to provide safe care, organization prioritizes patient safety and making sure nurses are learning and growing emerged as themes describing safety culture. CONCLUSIONS: Nurse leaders made sure patients were safe by making sure everyone was doing their best to provide safe care. Insufficient time, too many priorities, insufficient resources, poor physician behaviours and lack of respect for their role emerged as barriers to leading a safety culture. IMPLICATIONS FOR NURSING MANAGEMENT: Organizations must remove barriers for nurse leaders to develop and lead a safety culture. Nurse leaders must learn to advocate successfully for safe nursing care and professional work environments.