سامانه همایش های دانشگاه آزاد اسلامی واحد نجف آباد

صفحه اصلی / اولین همایش بین المللی تحول خدمات سلامت: تلفیق مراقبت، درمان، بازتوانی و امیدبخشی

Sustaining Nursing Care Under Clinical Constraints: Iranian Nurses’ Experiences of Professional Agency and Workforce Pressures

نویسندگان :

Somaye Moayedi¹ Jamileh Farokhzadian² Sirous Pourkhajoei³ Neda Asadi⁴

1- دانشگاه علوم پزشکی کرمان 2- دانشگاه علوم پزشکی کرمان 3- دانشگاه علوم پزشکی کرمان 4- دانشگاه علوم پزشکی کرمان

کلمات کلیدی :

Nursing workforce،Health human resources،Resource constraints،Professional agency،Working conditions،Qualitative research

چکیده :

Sustaining Nursing Care Under Clinical Constraints: Iranian Nurses’ Experiences of Professional Agency and Workforce Pressures Introduction Healthcare systems increasingly require nurses to maintain high-quality and ethically appropriate care in settings characterized by workforce shortages, workload pressures, and limited clinical resources. However, less is known about how nurses navigate these constraints in everyday practice. Objective This study aimed to explore Iranian nurses’ experiences of sustaining care under clinical and organizational constraints, with particular attention to professional agency and workforce-related pressures. Methods A qualitative descriptive design using conventional qualitative content analysis was employed. Nineteen nurses were purposively recruited from educational hospitals affiliated with Kerman University of Medical Sciences in southeastern Iran, and semi-structured interviews were conducted and audio-recorded. Data were transcribed verbatim and analyzed through identification, condensation, coding, and categorization of meaning units until no new codes, subcategories, or categories emerged. Results Four themes and twelve subthemes emerged.“Professional commitment and ethical responsibility under constraints” described nurses’ professional conscience, compassion, and responsibility toward patients and the care system. “Professional agency and value creation under resource constraints” reflected nurses’ use of clinical judgment, patient education, teamwork, creativity, and resource-conscious practices.“Ethical struggles within constrained working conditions” captured tensions between ideal and possible care, emotional burden associated with unmet care needs, and powerlessness .“Workforce pressures and efforts to sustain professional identity” reflected lack of recognition, workload and fatigue, declining motivation, and nurses’ efforts to advocate for improved staffing, policies, and practice conditions. Conclusions Nurses actively use professional knowledge, creativity, teamwork, and advocacy to compensate for resource limitations; however, reliance on individual commitment cannot substitute for supportive workforce structures. Strengthening the nursing workforce therefore requires adequate staffing and resources alongside professional recognition, supportive management, participation in decision-making, and organizational mechanisms that enable nurses to contribute their experiential knowledge to care and health system improvement. Keywords Nursing workforce; Health human resources; Resource constraints; Professional agency; Working conditions; Qualitative research.