Through a Filter of Empathy and Understanding: Patients' Experiences of Missed Nursing Care

AIM: To explore how patients experience, interpret, and respond to missed nursing care during hospitalization in a Danish hospital context. DESIGN: A qualitative design was employed. METHODS: Individual semi-structured interviews were conducted with fifteen patients who had been admitted to medical or surgical wards at a Danish university hospital. Data were analysed using reflexive thematic analysis. FINDINGS: The overarching theme, 'Nursing care experienced through a filter of empathy and understanding', captured how patients perceived omissions and delays as understandable responses to systemic pressures rather than neglect. Although they experienced missed nursing care, patients rationalized these omissions as inevitable, adapting to organizational constraints with empathy toward nurses, awareness of workload pressures, and a wish not to be a burden. Three subthemes illustrated this process: 'Not wanting to be a burden: negotiating physical needs', 'Moderating expectations: the subtle importance of psychosocial care' and 'Waiting patiently: a sense of shared responsibility for timely care'. CONCLUSION: Patients' empathy and adaptation sometimes obscured unmet needs and contributed to the normalization of missed nursing care. Missed nursing care thus emerged as a relational, co-constructed phenomenon shaped by both system pressures and patients' efforts to avoid burdening nursing staff. IMPLICATIONS: Reducing missed nursing care requires action beyond staffing, addressing relational and cultural dimensions across clinical, organizational and policy levels through proactive, person-centered approaches. IMPACT: By foregrounding patients' perspectives, this study reframes missed nursing care as co-constructed by both system constraints and patient adaptations, offering new insight to guide policy, leadership, and practice efforts toward more responsive and person-centered nursing care. REPORTING METHOD: Reporting followed the consolidated criteria for reporting qualitative research. PATIENT OR PUBLIC CONTRIBUTION: Patients contributed as interview participants but were not involved in the design, conduct, or reporting of the study.