Psychological Safety of Critical Care Nurses in Finland

Psychological safety promotes open communication and collaboration by allowing individuals to speak without fear, a need emphasised by global nursing shortages. Despite its importance, research is fragmented, highlighting the need for context-specific tools.

The aim of this study was to describe Finnish critical care nurses' perceptions of psychological safety.

A descriptive cross-sectional survey was conducted among nurses working in adult intensive care and high-dependency units in one university hospital in Finland. The Observational Measure for Psychological Safety in Healthcare Teams was first translated and validated, as it had not previously been used in Finland. Content and construct validity, along with reliability, were assessed using expert evaluation of content validity index, principal component analysis and Cronbach's alpha. Descriptive statistics examined nurses' perceptions of their psychological safety, and the multiple linear regression analysis was applied to assess the relationship between demographic characteristics and nurses' psychological safety.

Altogether, 102 registered nurses participated in the survey. Item-level content validity index values were between 0.8 and 1.0, indicating acceptable validity. Principal component analysis showed two clear logical components: Colleagues and Team Leader with the mean scores of 5.52 (SD 1.06) and 5.81 (SD 1.17), respectively. Age was related to psychological safety in relation to team leader (p = 0.027). The model did not reveal any other statistically significant associations.

Nurses reported high psychological safety, reflected in positive interpersonal dynamics. Nurses who rate their psychological safety as high often see themselves as competent and do not fear being viewed as unqualified. Given the demands of intensive care, critical care nurses may inherently perceive higher psychological safety.

Identifying factors associated with psychological safety could facilitate the creation of a psychologically safe nursing environment. Strengthening intensive care and high-dependency unit nurses' psychological safety could be a valuable strategy in addressing the global nursing shortage.