The Silent Struggle: Nursing Students' Experiences related to barriers to speaking up for Patient Safety: a qualitative study

Background Patient safety is a significant concern in healthcare settings, and speaking up for patient safety is essential for promoting quality of care and preventing harm. However, nurses, including nursing students, may face barriers to speaking up, which can hinder their ability to report safety concerns.In this study, we explored the nursing students’ experiences related to the barriers to speaking up for patient safety. Methods The study was conducted using a qualitative research design. Data were collected by conducting semi-structured interviews with 19 final-year nursing students from April 2023 and June 2023 in Iran. Data were analyzed by conventional content analysis until data saturation was achieved. Results This study has revealed the formation of three distinct themes, namely negative organizational culture,inadequate preparation for speaking up for patients' safety and inconsistencies between learning through theories and learning through practice. These themes are comprised into eight subthemes. The main themes of the study showed the significant barriers to speaking up about patients’ safety. These barriers can lead to critical issues being overlooked, potentially harming patients. When healthcare staff feel unable to speak up, errors and unsafe practices may remain unreported. Conclusion Research findings revealed barriers to speaking up in organizational settings, including fear of retaliation, lack of confidence, and perceived futility. These barriers often prevent employees from voicing their concerns or suggestions. By understanding the underlying barriers to speaking up for patient safety, healthcare professionals can develop strategies to promote a culture of safety. They can also empower nursing students to become effective advocates for patient safety. This includes providing training on effective communication and assertiveness skills, encouraging a culture of open dialogue, and building trusting relationships between students and healthcare providers.