Action Model for Unforeseen Inadequacy in Nurse Qualifications and Staffing: A Descriptive Study of the Experiences...

This study aimed to explore the experiences of nurses and nurse managers when using the Unforeseen Situations of Staffing and Qualifications action Model (USSQM) and to describe their views on the further development needs of the USSQM.

A descriptive qualitative study was employed. Nineteen (n = 19) nurses and nurse managers from one department of a University Hospital in Finland were selected for semistructured focus-group interviews by purposive sampling. Data were collected from January to October 2025; the interview guide focused on participant's experiences of the use of USSQM. Data were analyzed using inductive content analysis.

The analysis of the results revealed six themes: (1) Integration of the USSQM into clinical routine, (2) Providing decision-making support and practice clarity, (3) Strengthening the fundamentals of the USSQM, (4) Safeguarding nurse well-being and ethics, (5) Fostering communication and cooperation, (6) Utilization of digital solutions. Nurses and nurse managers described that USSQM was mainly used to assess workload status and manage patient flow. Participants described experiencing a tension between their strong professional ethics and the fundamental objectives of the USSQM. Consequently, they expressed that it was challenging to follow the reorganization and prioritization guidelines dictated by the model.

The participants described the USSQM as a practical and usable action model for daily practice. However, future refinement of the USSQM must focus on integrating objective workload indicators to reduce subjectivity and utilizing digital solutions for automated data retrieval. Additionally, adequate information and support from organizational leadership should be ensured during the implementation process to facilitate the comprehensive use of the USSQM.

Nurse managers especially experienced that USSQM gave them support in decision-making; therefore, nurse managers play an essential role in ensuring the implementation of the USSQM in the units. They serve as role models and support nurses in decision-making when tasks need to be reorganized or prioritized during periods of high workload.