Intensive care nurses in South Africa: Expectations and experiences in a public sector hospital

To explore the content, fulfilment and potential breach of nurses' psychological contracts and provide a nuanced understanding of the expectations and lived experiences of intensive care unit (ICU) nurses.

The challenges presented by the South African healthcare system have implications for the motivation and retention levels of ICU nurses. In an environment such as the ICU, personnel dynamics and nursing management's role are crucial to success.

A qualitative study of 44 ICU nurses from a South African tertiary hospital. Template analysis was used to identify themes. Manifest content analysis established the frequency of those themes.

Psychological content elements were predominantly relational in nature. Nurses' contracts were fulfilled by nursing managers, peers and patients. Examples of breach included unfairness, abuse of trust and public reprimands.

The nature of the work, the emphasis on professional and caring values, as well as the relational and intrinsic aspects associated with these, provide important indicators for the composition of nurses' psychological contracts.

Understanding ICU nurses' expectations can ensure that their psychological contracts remain positive and fulfilled. Practical suggestions include public and private appreciation, autonomy, and management visibility and discretion.