Patients’ expectations of nursing staff in both medical treatment and surgical wards

Introduction

Modern healthcare poses numerous challenges for medical personnel, arising in part from increasing specialization of services and growing patient awareness and expectations. Patients are placed at the center of the healthcare system, and their needs and expectations are considered one of the key criteria for assessing the quality of medical services. Nurses, who are the largest professional group within the healthcare system, play a particularly important role in meeting these needs. They are expected to possess not only high substantive competence but also strong interpersonal skills [1-7]. Patients’ expectations of nurses concern both hard skills (e.g., professionalism, precision in actions) and personality traits and relational qualities, such as empathy, politeness, availability and the ability to communicate effectively. Meeting these expectations is essential for building trust, improving the patient’s care experience, and increasing overall satisfaction with hospitalization [3, 4, 8-15]. These expectations often vary depending on the hospital ward. In medical treatment (non-surgical) wards, where long-term hospitalization and medical treatment prevail, the patients primarily expect presence, emotional support, empathetic communication, and health education. In contrast, the patients in surgical wards, who undergo surgical treatment and intensive perioperative care, place greater emphasis on technical competence, operational efficiency, and clarity and accuracy of conveyed information [4, 8, 9, 16-19]. Despite these differences, several universal areas of patients’ expectations can be identified, such as kindness, empathy, prompt responses to reported needs, availability and respect for privacy and personal dignity [3, 5, 6, 10-12, 19, 20]. Understanding and identifying patient’s expectations towards nursing staff is a crucial element of strategies aimed at improving healthcare quality. Research shows that patients evaluate the quality of care not only through the lens of professional qualifications but also based on nurses’ ability to build relationships founded on trust, respect, and emotional support [2-4, 6, 7, 15, 18-21]. In an era marked by a shortage of nursing personnel and dynamic changes within the healthcare system, analyzing these expectations can serve as a vital tool for supporting workforce management and care planning processes.
The objective of this study was to investigate and compare patients’ expectations from nursing staff in medical treatment and surgical wards. The research aimed to determine which attributes – both technical and interpersonal – patients value most in nursing care, and to explore how these expectations differ depending on the ward type. Particular attention was paid to identifying the three most desirable nursing qualities from the patients’ perspective, as well as differences in expectations related to practical support and emotional care during hospitalization. The study provides empirical evidence on the most valued aspects of nursing care, offering a clearer understanding of what patients consider essential in their interactions with nursing personnel. These findings may serve as a basis for improving the quality of nursing care by reinforcing areas that patients find most meaningful – such as clinical competence, responsiveness, communication, and emotional support. By distinguishing the specific needs of patients in different hospital settings, the results may inform targeted strategies in nurse education and clinical practice. For instance, medical wards may benefit from enhanced focus on patient education and relationship continuity, while surgical wards could prioritize rapid response, effective information sharing, and postoperative support. Practical application of these results may contribute to more personalized and patient-centered care, increased satisfaction, and stronger trust between patients and nursing staff. This, in turn, may improve the overall effectiveness and perceived quality of hospital care.

Material and methods

The study was conducted following the approval of the Jagiellonian University Medical College Bioethics Committee in Kraków (opinion no. 118.0043.1.26.2025 dated January 27, 2025). The research was carried out in one of the hospitals in Kraków between February 11 and March 6, 2025. The target population comprised adult inpatients hospitalized in internal medicine and surgical wards. The demographic structure of the study group was naturally determined by the current inpatient population in the aforementioned departments, reflecting variability in age, sex, and type of ward where hospitalization took place. Eligibility criteria included: being 18 years of age or older, having an active patient status in one of the designated wards, providing informed and voluntary consent to participate in the study, sufficient cognitive function to complete the questionnaire reliably, and a stable health condition. Exclusion criteria were lack of patient status in the target wards, refusal or inability to provide informed consent, or the presence of significant cognitive impairment preventing reliable participation. The applied research method was a diagnostic survey using a proprietary questionnaire – the “Tool for Assessing and Determining Nursing Expectations” – developed specifically for the purpose of this study. The tool was designed to assess and compare patients’ expectations regarding nursing care across different types of hospital wards. The questionnaire consisted of four sections: 1) sociodemographic data (gender, age, type of ward); 2) perception of nursing care, assessed using 20 statements rated on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree); 3) expectations regarding nursing care, where patients rated the importance of the same 20 attributes on a 5-point scale (1 = not important, 5 = very important), and 4) selection of up to three of the most important nursing characteristics from a predefined list – with space provided for open-ended comments and suggestions. The development of the questionnaire was grounded in a review of relevant literature and informal consultations with clinical nursing experts. A preliminary pilot study was conducted among 10 patients (excluded from the final sample) to assess clarity, comprehensibility, and face validity of the instrument. The questionnaire was administered in paper form. Patients completed it independently in the inpatient rooms of the hospital wards in which they were hospitalized. In cases where the patient’s physical condition precluded self-completion – such as postoperative states or upper limb injuries – members of the research team provided assistance by reading questions aloud and recording responses, while maintaining neutrality and avoiding influence on the answers. All patients who undertook to complete the questionnaire returned it fully and correctly completed, resulting in a 100% response rate among those who agreed to participate. All completed questionnaires were included in the final analysis; no forms were excluded due to incompleteness or errors. Notably, the questionnaire was more willingly completed by patients in internal medicine wards, while lower participation was observed among surgical patients, likely due to their postoperative condition and decreased well-being at the time of the study. Given that the distribution of variables deviated from normality (as verified by the Kolmogorov-Smirnov test and Q-Q plot analysis), non-parametric statistical procedures were employed. The Mann-Whitney U test and Kruskal-Wallis test were used to compare differences between groups. Spearman’s rank correlation coefficient was used to assess relationships between ordinal variables. Categorical variables were analyzed using the c2 test (with Yates’s continuity correction where applicable), Fisher’s exact test, and the Fisher-Freeman-Halton test. A significance level of p < 0.05 was adopted. All statistical analyses were performed using IBM SPSS Statistics version 22.

Results

The study group consisted of 160 individuals, of whom the majority were women (67.5%, n = 108), while men accounted for 32.5% (n = 52). No respondents identified with a different gender. Regarding age, the largest group consisted of patients over 60 years of age (35.0%, n = 56). Nearly a quarter of respondents belonged to the 31-45 age group (26.3%, n = 42) or the 46-60 group (25.6%, n = 41). Medical treatment ward patients made up 61.3% (n = 98) of the sample, while surgical ward patients accounted for 38.8% (n = 62). No significant differences were found between male and female respondents regarding their statements about nursing staff. However, patients’ statements about nursing staff did vary significantly by age. Older patients agreed more readily with most of the statements regarding nursing staff. A correlation was found between patient age and positive evaluations of the nursing staff: the older the patient, the more positive the evaluation (Table 1). Patients’ perceptions also differed by ward type: the medical treatment ward patients rated the courtesy and kindness of the nursing staff higher (p = 0.0062), as well as the provision of sufficient health-related information (p = 0.0002) and other aspects of care (Table 2). Men rated the kindness and courtesy of nursing staff higher (p = 0.0262), while women gave higher ratings to professional conduct (p = 0.0375). The patients’ opinions about nursing staff did not significantly depend on age, nor were there statistically significant correlations between age and these opinions. The patients’ opinions also did not significantly vary based on the place of hospitalization. However, for the surgical ward patients, nurse’s kindness and courtesy held more importance (p = 0.0120). The data analysis allows for the identification of key traits valued by the patients, depending on the type of care – medical treatment or surgical. Regardless of therapeutic context, the most highly rated trait across both groups was the nurse’s knowledge and competence. This was indicated by 55.1% of respondents in the medical treatment ward and as many as 59.7% in the surgical ward, highlighting the universal importance of expertise and professional competence as a foundation for patient’s trust in nursing staff. Among the surgical ward patients, courtesy and kindness also emerged as particularly important, reported by 54.8% of respondents, compared to 34.7% of medical treatment ward patients. This may reflect a stronger need for emotional comfort in situations involving greater stress and direct medical intervention, such as surgery. Differences were also observed in the value placed on professionalism, which was more frequently appreciated in the context of medical (long-term) nursing care (32.7%) than in surgical care (24.2%). This may stem from the long-term and continuous nature of medical care, where patients place greater value on consistency, reliability, and high professional standards that foster trust and a sense of security. In contrast, a prompt response to patients’ needs received a higher percentage in the surgical group (29.0% vs. 26.5%), which can be interpreted as a sign of increased patients’ expectations regarding the constant readiness of medical staff to undertake quick and effective interventions in situations requiring immediate action. A significant difference was also observed in the assessment of an individualized approach to the patient, which was indicated by 23.5% of respondents in the medical treatment wards, compared to only 12.9% in the surgical care wards. Similarly, patience and understanding were more often indicated in the context of the medical treatment wards (21.4%) than in the surgical care wards (14.5%). These qualities may be particularly important in situations requiring a long-term therapeutic relationship and support in the treatment of chronic conditions. Some characteristics, such as availability and helpfulness, empathy and emotional support, respect for the patient, or clear explanation of the health condition and treatment, were indicated with similar frequency in both groups, suggesting their general importance in medical communication. However, it is worth noting that certain aspects – such as good work organization or respecting the patient’s privacy – were virtually absent in the responses of the surgical ward patients (0% of indications), whereas in the medical treatment wards they were noticeable (5.1% and 3.1%, respectively). This may indicate a different focus of attention of patients, where within the surgical care, the priority becomes the outcome of the procedure and how it is performed, rather than organizational or environmental factors. Importantly, the ability to listen was mentioned by 2% of the patients receiving nursing care in the medical treatment, while it was not mentioned at all among the patients receiving care in the surgical wards. This may suggest that in surgical settings, the nurse-patient relationship is primarily based on the implementation of medical procedures, with limited opportunities for a dialogue and emotional expression by the patient. In contrast, the medical treatment places greater emphasis on communication and emotional support, where active listening plays a key role (Table 3).

Discussion

The findings of this study provide comprehensive insight into hospitalized patients’ expectations of nursing staff, emphasizing both technical competence and interpersonal qualities. These results reaffirm the dual nature of nursing care as both a clinical and relational discipline, aligning with previous studies that highlight the simultaneous importance of professional proficiency and emotional responsiveness [3, 4, 6, 7, 18]. Our data show that high knowledge and competence are consistently prioritized by patients across both medical and surgical wards (55.1% and 59.7%, respectively), confirming that technical skill is a foundational expectation irrespective of clinical context. However, the type of ward significantly influenced the structure and prioritization of expectations. In the medical treatment wards, patients expressed a greater need for relational and communicative aspects of care, including empathy, patience, emotional support, and clear health education. This aligns with the findings of Dziubaszewska-Rabiasz et al. [4] and Rørtveit et al. [9], which suggest that in chronic or long-term treatment settings, interpersonal interactions and trust-building become central to patients’ perception of care quality. Conversely, patients in surgical wards, often experiencing acute interventions and shorter hospitalizations, emphasized responsiveness, efficiency, and emotional reassurance. These patients placed significantly higher importance on courtesy and kindness (54.8%) and quick response to needs (29.0%) compared to medical ward patients. The literature confirms this shift in expectations, with Sierpińska and Dzirba [11] reporting that over 80% of surgical patients highly valued the swiftness of nursing responses in ensuring procedural safety and comfort. An important additional finding concerns age-related variations in expectations, which were statistically significant across multiple domains. Older patients were more likely to positively evaluate nursing behaviors such as politeness (p = 0.0207), information provision (p = 0.0001), and availability (p = 0.0002), indicating that age may influence not only satisfaction but also the intensity of certain care expectations [7]. Furthermore, patients from medical wards more frequently indicated the importance of help in understanding the treatment plan (p = 0.0006) and work organization (p = 0.0025), possibly reflecting their prolonged exposure to nursing routines and need for structured communication. Meanwhile, some aspects – such as listening skills and privacy protection – were noticeably absent or underrepresented in the responses of surgical patients, suggesting that contextual clinical priorities may eclipse certain relational expectations in acute care scenarios. Finally, the high importance attributed to the educational and informational role of nurses (65% of all patients) underscores the necessity of strengthening communication competencies in clinical training. This is in line with contemporary literature which highlights health education as a growing component of patient-centered nursing care [16, 17]. Collectively, these results indicate that while core expectations – such as competence and empathy – are universal, the hierarchy of patient needs is significantly modulated by ward type, patient age, and clinical context. This highlights the need for flexible and context-sensitive approaches in nursing management and education.

Conclusions

Patients in both medical and surgical wards place high value on professional competence, politeness, and interpersonal sensitivity in nursing staff. These elements are perceived as foundational to safe and trustworthy care, regardless of clinical context.
Ward type significantly influences the structure of patient expectations. Medical treatment patients prioritize emotional support, clear communication, and accessibility, while surgical patients emphasize swift responses and emotional support reassurance during perioperative care.
The educational function of nurses is recognized as essential. A significant proportion of patients expect nurses to provide clear, understandable information regarding their health status and treatment plan, highlighting the need to enhance informational and communicative competencies in nursing practice.
Demographic factors, particularly age, affect patients’ evaluations and expectations. Older patients tend to express higher satisfaction and value relational aspects of care more intensely, suggesting that age-sensitive communication strategies may enhance care effectiveness.
Personalized nursing care requires adaptation to diverse expectations. Integrating ward-specific and patient-specific expectations into staff training, performance evaluation, and quality improvement strategies can contribute to more responsive, effective, and patient-centered care delivery.
Institutional policies should promote context-sensitive education and organizational support for nursing staff, ensuring that both technical proficiency and interpersonal competencies are systematically developed and maintained according to the evolving expectations of diverse patient groups.

Disclosures

This research received no external funding.
Institutional review board statement: 118.0043.1.26.2025 (dated 27.01.2025).
The authors declare no conflict of interest.

References