The ripple effect: irregular salary payments, job satisfaction, and patient safety among nurses in Cameroon

Irregular financial remuneration, including salary and non-salary payments like overtime and incentives, poses a significant and persistent challenge within Cameroon’s healthcare sector, adversely affecting the well-being of nurses and the quality of patient care. This qualitative study explores how these financial irregularities influence job satisfaction and perceived patient safety from the unique perspectives of hospital-based nurses. Employing a qualitative descriptive design, we conducted semi-structured interviews with 40 nurses from public hospitals across Cameroon. Participants were purposively selected to ensure diverse experiences with financial irregularities across urban, regional, and rural settings. Data were analyzed using Braun and Clarke’s six-phase thematic analysis framework, utilizing an inductive coding process to allow themes to emerge directly from the participants’ narratives. Data saturation was achieved after 35 interviews, with an additional five interviews conducted to confirm consistency. Findings revealed three overarching themes: (1) Impact of irregular salary payments on job satisfaction; (2) Effects of financial stress on patient care; and (3) Coping mechanisms and resilience demonstrated by nurses. Specifically, irregular payments consistently generated high levels of financial stress, emotional exhaustion, and demotivation. Participants frequently reported experiencing burnout and reduced job commitment, which they directly associated with compromised patient care, including delayed treatments and limited nurse-patient interaction. The results indicate that financial instability profoundly undermines nurses’ ability to maintain professional standards and poses tangible risks to patient safety. Irregular financial remuneration negatively impacts both job satisfaction and the quality of patient care in Cameroonian hospital settings. Addressing this critical issue through timely disbursement of all owed funds and supportive policy reforms is essential for fostering a motivated, resilient nursing workforce and ensuring the delivery of safe, high-quality care. Future qualitative research should build on the identified coping mechanisms to explore effective support interventions and policy strategies that foster long-term resilience within the nursing workforce.