ASSESSMENT OF CHALLENGES FACED BY NURSING PROFESSIONALS WORKING IN TERTIARY CARE HOSPITALS IN KARACHI, PAKISTAN

Abstract

Background: Nurses constitute a major component of the health workforce, and unfavorable working conditions may affect staff well-being, retention, and patient care. This study assessed occupational and organizational challenges among nursing professionals working in selected tertiary-care hospitals in Karachi, Pakistan.

Methods: A descriptive cross-sectional study was conducted in one public and one private tertiary-care hospital in Karachi from January 1 to June 30, 2026. A purposive sample of 237 registered nurses with at least six months of continuous work experience participated. Data were collected using a structured self-administered questionnaire covering workload and staffing, workplace safety and environment, professional recognition and compensation, and physical and mental health. The questionnaire was reviewed by five experts for content validity. Data were analyzed using SPSS version 26.0 with descriptive statistics and tests of association.

Results: Of 237 nurses, 51.9% were male, 46.8% were aged 31–40 years, and 64.1% held a Post RN BSN qualification. Most participants (80.2%) worked rotational shifts. Workload challenges were prominent: 76.4% reported an inaccurate patient-to-nurse ratio, 81.0% reported frequently performing non-nursing tasks, 89.0% reported missing breaks or meals because of workload, and 71.7% reported insufficient time to provide quality care. Verbal abuse was reported by 79.7% and physical violence by 62.0%. Only 32.9% reported that a strict violence-reporting protocol was available and acted upon. Regarding compensation, 58.2% were dissatisfied with salary and 85.2% reported no health insurance or other benefits. Emotional exhaustion occurring often or always was reported by 42.6%, while sleep disorders occurring often or always were reported by 48.5%. Missing breaks/meals because of workload was significantly associated with age (p<0.001), gender (p<0.001), qualification (p<0.001), and years of experience (p=0.011), but not marital status (p=0.077 using Pearson chi-square; exact testing also remained non-significant).

Conclusion: Nurses in the participating tertiary-care hospitals experienced substantial workload, staffing, workplace violence, compensation, and well-being challenges. Organizational responses should focus on adequate staffing, workload distribution, violence prevention and reporting, professional support, fair compensation and benefits, and protection of nurses’ health and work-life balance.