Experience of Registered Nurses with Missed Nursing Care in Acute Psychiatric Settings: A Descriptive Qualitative Study.

Abstract

This qualitative study explores the experiences of psychiatric nurses with missed nursing care in an acute inpatient setting. Missed care, defined as any aspect of required care that is omitted or delayed, poses significant risks to patient safety and care quality yet remains under-researched in psychiatric contexts. Using semi-structured interviews with eight nurses from a Slovak psychiatric clinic and reflexive thematic analysis, the study identified key systemic and organizational barriers contributing to missed care. Findings revealed that nurses frequently lack time, resources, and support to provide therapeutic communication, emotional support, and comprehensive patient assessments. These omissions were not due to negligence but to chronic workforce shortages, limited material conditions, and insufficient managerial support. Nurses expressed feelings of moral distress and professional frustration, highlighting a disconnect between institutional expectations and their capacity to deliver holistic, person-centred care. The study underscores the need to recognize relational and psychosocial aspects of psychiatric nursing as essential, not optional. Implications for practice include investing in workforce capacity, improving communication systems, enhancing psychiatric-specific education, and fostering supportive leadership. By addressing these systemic issues, psychiatric services can move closer to delivering safe, recovery-oriented care that values both patients' needs and nurses' professional integrity.