Attitudes of nurses towards patient care at a rural district hospital in the Kwazulunatal Province of South Africa

It is important for nurses to have positive attitudes towards patient care if good quality care is to be provided. This study explored nurses' attitudes towards providing care to patients in one rural district hospital in KwaZulu-Natal from the perspective of the nurses themselves, and from the patients' perspective. We conducted an explorative qualitative study. Thirteen focus group discussions were conducted with professional/enrolled nurses, enrolled nurse assistants and patients. Discussions were audio-recorded, transcribed and analysed using a thematic approach. While some nurses were passionate about nursing for altruistic reasons, many nurses said they actively disliked nursing. Reasons were staff shortages, high patient loads, absenteeism, and poor interpersonal communication. Both nurses and patients reported incidences of poor patient care and even willful neglect of patients' basic care. Nurses blamed sub-standard nursing care on the attitudes of patients or patients' relatives, as well as on lack of management support. Patients described both positive and negative experiences of nursing care received. Poor attitudes of nurses, resulting in poor patient care, could severely undermine the ability of the health system to provide quality care and improve outcomes for patients. It is recommended that all hospitals assess nurses' attitudes regularly to ensure that patient care is not compromised.