Aug 2026· Turkish journal of health science and life· Vol 9, pp. 55-66· 0 citations· 14 references
TL;DR
Light is shed on the multidimensional nature of the barriers faced by nurses and, with its solution-oriented perspective, is expected to contribute to both health policy and nursing education.
Abstract
This study aimed to examine the barriers that nurses encounter in fulfilling their professional roles and to explore solution-oriented suggestions through a phenomenological approach. Nursing is a discipline that encompasses multifaceted professional roles such as caregiver, educator, advocate, researcher, manager, and decision-maker. However, performing these roles effectively can be challenging for nurses due to various barriers arising at individual, institutional, and societal levels. The research was conducted with 18 participants, including nursing students and faculty members from a foundation university. Data were collected through semi-structured in-depth individual interviews and analyzed using thematic analysis. The findings were categorized under five main themes: individual-level barriers (e.g., lack of motivation, low self-confidence, language barriers), institutional-level barriers (e.g., excessive workload, staff shortages, lack of merit-based management), societal-level barriers (e.g., stereotypes, low professional prestige), role-specific implementation difficulties, and participant-suggested solutions. Participants emphasized the need for enhanced educational opportunities, stronger managerial support, increased public awareness, and institutional encouragement for professional development to improve the implementation of nursing roles. This study sheds light on the multidimensional nature of the barriers faced by nurses and, with its solution-oriented perspective, is expected to contribute to both health policy and nursing education.
INTRODUCTION
Specialization in nursing is essential to enhance effectiveness, quality, and accessibility of healthcare. Barriers to implementing advanced practice nurses and specialist nurses have been widely reported to limit advanced practice roles in many countries. Identifying these barriers and promoting integration of the role requires an understanding of stakeholders' perspectives. The current study aimed to explore barriers to implementing specialist and advanced specialist nursing roles in Jordan from the perspective of nursing regulators, nursing leaders, and nursing educators.
METHODS
A qualitative descriptive design was used to collect data from a purposive sample of 23 nursing stakeholders from the private and public sectors. Data were collected through in-depth semi-structured interviews using an interview guide developed specifically for this study. Sample adequacy was guided by data saturation. Inductive thematic analysis following Braun and Clarke's 6-step approach was used.
RESULTS
Based on the participants' narratives, findings were classified into four main themes and six sub-themes: (1) Policy and Regulatory Constraints, with two sub-themes: Scope of Practice limitations and Role Ambiguity, (2) Knowledge and Skill Gaps with two sub-themes: Incompetent Graduates and the Nature of Educational Programs, (3) Organizational and Administrative Obstacles with two sub-themes: Inefficient Management Structures and Burdens, and (4) the Reluctance to Implement. In addition, participants proposed recommendations and approaches such as clarifying scope of practice, defining roles, curricular reforms, and creating a supportive organization to facilitate effective role implementation.
CONCLUSION
This study demonstrates that implementation of specialist and advanced specialist roles in Jordan is constrained by educational, regulatory organizational structure gaps, and absence of coordinated policy alignment across all levels. Establishing a collaborative implementation model supported by effective policies is crucial to assist healthcare institutions in overcoming obstacles and barriers and to support the specialized roles in Jordan.
M. Gharaibeh, Rabia S. Allari, Safa A Al-Ashram et al.· Journal of Nursing Scholarsh...· 0 citations
The number of children with medical complexity has been increasing annually, resulting in a growing demand for appropriate support from nurses in school settings. However, the lack of standardized criteria and clearly defined job descriptions presents a significant challenge in securing and retaining personnel. This study aimed to clarify the current status of school nurses, their perceptions of professional roles, and barriers to effective care. A paper-based questionnaire survey was conducted, followed by semistructured interviews with school nurses in City A, Japan. Responses were obtained from 34 participants (response rate: 71%). Witnessing students' growth and ensuring their safety were identified as key sources of professional fulfillment and motivation. In contrast, many participants described themselves as "extra workers," reflecting low self-esteem and role ambiguity. These findings indicate that school nurses experience considerable anxiety and role-related challenges, highlighting the need for guideline development, systematic support, and structured training programs.
Tomoyo Yamashita, Hiroshi Inada, Takako Konda et al.· Journal of School Nursing· 0 citations
Introduction Community health nursing (CHN) is central to primary healthcare delivery, but undergraduate nursing students may encounter educational, organizational, resource-related, and sociocultural barriers that affect their readiness for community-based practice. This study aimed to identify and quantify perceived barriers to CHN practice among nursing students in Saudi Arabia and to examine their relationships with self-reported educational preparedness and organizational support. Methods A quantitative cross-sectional survey was conducted among nursing students enrolled in Saudi universities. A structured online questionnaire assessed perceived CHN practice barriers, educational preparedness, and organizational support. The instruments underwent cultural adaptation, forward-backward translation, expert-panel content validation, pilot testing, and internal-consistency assessment. Descriptive statistics, non-parametric tests, correlation analyses, and exploratory multiple linear regression were used. Results A total of 139 nursing students completed the survey. Participants reported minor-to-moderate overall barriers (M = 2.69, SD = 0.96). Resource barriers were rated highest, with shortage of equipment (M = 2.93, SD = 1.38) and lack of educational materials (M = 2.86, SD = 1.32) identified as the most salient challenges. Educational preparedness (M = 3.25, SD = 0.98) and organizational support (M = 3.46, SD = 1.03) were rated moderately positive. Small-to-moderate positive correlations were observed between barriers and educational preparedness (r = 0.269, p = 0.001) and between barriers and organizational support (r = 0.242, p = 0.004); these findings were interpreted cautiously as potentially reflecting awareness effects, conceptual overlap, or shared-method variance. The multivariable regression model was not statistically significant and explained a small proportion of variance (R2 = 0.089, p = 0.052). Discussion Nursing students in Saudi Arabia perceived meaningful, though not severe, barriers to effective CHN practice, with resource limitations and skills gaps as primary concerns. The findings support strengthened curriculum-practice integration, expanded simulation and community-immersion experiences, improved placement resources, and targeted faculty development aligned with healthcare transformation priorities.
Background: Nursing is a cornerstone of the healthcare system, providing essential services that contribute to patient recovery, health promotion, and community well-being. The perceptions held by nursing students are crucial, as they shape their academic engagement, professional identity, job satisfaction, and even their decision to remain in the field after graduation. A negative perception may result in low morale, reduced performance, or intentions to leave the profession. Conversely, a positive outlook may foster passion, resilience, and a commitment to lifelong service in healthcare. Hence, the aim of this study is to identify perception of nursing students towards nursing profession in nursing students of Nepal police hospital school of health sciences.
Methods: A quantitative descriptive cross-sectional study design was adopted for this study in Nepal Police Hospital School of Health Sciences, Maharajgunj, Kathmandu from 2025 to August 2025. A total of 120 students participated in the study as that is the maximum sample size available at the school of nursing. A self-structured questionnaire was used to collect the data which the researcher had already used.
Results: The findings revealed that slightly more than half of the participants (51.7%) had a positive perception of nursing, whereas 48.3% expressed a negative perception.
Conclusion: The perception towards nursing profession was moderately positive, the findings highlight the need to improve recognition, appreciation, and working conditions for nurses in Nepal to strengthen professional satisfaction and retention.
Nirmala Rayamajhi, Sagun Lohala, Nishma Mahotra· Nepal Journal of Public Heal...· 0 citations
Aim: This study aimed to explore the experiences of nurses who left the profession within the first two years of completing their undergraduate nursing education, identify the factors contributing to early-career attrition, and examine proposed solutions to address this issue.Material and Methods: A phenomenological qualitative research design was employed. The study included 15 nurses who had left the nursing profession within two years following graduation. Participants were selected through purposive and snowball sampling methods. Data were collected through semi-structured individual interviews and analyzed using Colaizzi’s phenomenological analysis method. The research process was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.Results: The findings indicated that early-career attrition resulted from interacting factors at the individual, institutional, and systemic levels. At the individual level, burnout, anxiety, sleep disturbances, and emotional strain were prominent. Institutional factors included insufficient managerial support, unfair workload distribution, lack of resources, and exposure to workplace violence. At the systemic level, low salaries, insecure employment conditions, and the declining societal value of the nursing profession contributed to early departure. Additionally, the mismatch between expectations developed in nursing education and the realities of clinical practice weakened professional identity and increased the tendency to leave the profession. Participants particularly emphasized the absence of supportive leadership, fair shift scheduling, and mentoring systems.Conclusions: Improving the retention of newly graduated nurses requires coordinated interventions in education, health policy, and clinical management. Strengthening practice-oriented education, ensuring fair remuneration and safe working conditions, and promoting supportive leadership and mentorship are essential to enhancing professional commitment and supporting the sustainability of healthcare systems.Implication for nursing management: This study provides evidence-based findings on nursing management practices to support newly graduated nurses.
Miray Aksu, Belgin Varol· Global Nursing Insights· 0 citations
BackgroundIntegrity is a foundational value in nursing, essential for ethical practice, professional accountability, and maintaining patient trust. Growing evidence of dishonest behaviors in academic and clinical settings highlights the complexity of practice, where boundaries between honesty and dishonesty are not always clear-cut. Despite this, limited research has explored how senior nursing leaders conceptualize integrity and dishonesty across the academic-clinical continuum.AimThis study aimed to explore senior nursing leaders' perceptions of integrity and dishonesty, the underlying factors contributing to unethical behaviors, and potential strategies for addressing these challenges in educational and clinical contexts.DesignA qualitative study was conducted. Data was collected through semi-structured, in-depth interviews and analyzed using thematic analysis to identify patterns and themes.ParticipantsThe study included ten senior nursing leaders from academia, hospitals, and the Ministry of Health. All participants held managerial roles and had experience in nursing education or training, allowing for perspectives across the educational-clinical continuum.Ethical considerationsEthical approval was obtained from the institutional review board. Informed consent was secured from all participants, and principles of confidentiality, anonymity, and voluntary participation were strictly maintained.FindingsThree themes emerged: (1) integrity and dishonesty were perceived as existing along a continuum rather than as dichotomous constructs, with patient safety serving as a key moral boundary; (2) dishonest behaviors were shaped by a combination of individual, cultural, and systemic factors, including organizational pressures and inconsistent enforcement; and (3) leadership practices, particularly education, role modeling, and case-by-case management, were viewed as central to promoting integrity.ConclusionsIntegrity in nursing is not solely an individual attribute but is co-constructed within organizational and educational systems. Promoting ethical practice therefore requires integrated approaches that combine education, supportive organizational cultures, and clear policies, while acknowledging the complexity and ambiguity inherent in real-world clinical practice.
Efrat Danino, Elena Maoz· Nursing Ethics· 0 citations
