“I Wish Waste Bins Would Sound an Alarm”: A Qualitative Study of Head Nurses’ Experiences and Perspectives on Sustainability in Healthcare

Background: Healthcare professionals, including nurses and head nurses, play a key role in integrating sustainable practices into healthcare delivery. Despite their central role in shaping the clinical work environment, head nurses' experiences and perspectives on sustainability have received limited attention.
Aim: This study explored head nurses’ experiences and perspectives on integrating sustainability into nursing practice, with a focus on successes, facilitators, barriers, and recommendations for improvement.
Methods: A descriptive qualitative design was employed in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Between September and October 2025, semi-structured, in-depth interviews were conducted with 14 head nurses working in medical–surgical, intensive care, emergency, perioperative, and pediatric units. Data were analyzed using content analysis guided by the ecological–economic–sociocultural dimensions framework.
Results: Three main categories emerged: ecological issues, economic aspects, and sociocultural interactions. The ecological category encompassed waste management and energy and water conservation. The economic category focused on resource management and budgetary considerations. The sociocultural category highlighted team dynamics during orientation and socialization, as well as strategies for promoting equity and equality in care. Reported successes included effective waste segregation, efficient resource utilization, conservation of energy and water, equitable care, and supportive orientation practices. Reported challenges included competing priorities, inconsistent policies, limited staff engagement, and organizational barriers. Key facilitators included leadership support, interdepartmental collaboration, technology, and education.
Conclusion: The findings highlight the pivotal role of head nurses in advancing sustainability through resource stewardship, equitable care, and staff engagement. Sustainable nursing practices may be strengthened by recognizing successful initiatives, addressing barriers through targeted education and standardized protocols, and establishing effective mechanisms for responding to staff feedback.

Keywords: Ecological, economic, head nurse, healthcare, social, sustainable development