Table 2 Summary of themes and sub-themes from transcribed data

1. Psychological well-being of nurses

Experience of positive emotions

“When you know that the patient was nearly gone and you have a successful resuscitation, you feel happy…” (P4)

“…we actually did well, and he came back to life… and we were all happy because we were not willing for him to go…” (P5)

Experience of negative emotions

“…when it happens that we have to resuscitate the patient and we lose them, we feel down, and the day goes bad” (P7)

“When I resuscitate the patients, and they don’t make it, it affects me psychologically” (P11)

2. Environmental factors affecting the quality of CPR care

Time of CPR initiation

“…immediately you notice that a patient has a cardiac arrest, you have to act within the first minute. If you spend more than a minute in initiating resuscitation, it can affect your result” (P 4)

“Time is important. The more you delay, the more the patient goes, so time is crucial…” (P 9)

Availability and appropriateness of equipment and medications

“Availability of equipment, especially, ambu-bag…sometimes, you realise that you look for the ambu-bag and you don’t get the correct size for the patient” (P 4)

“…our emergency drugs and equipment are not arranged at a place where you can easily get access to them…”(P 8)

Workplace ergonomics

“…we don’t have the usual stretcher at the triage … I think using the low patient bed wasn’t appropriate “(P 1)

“I think we don’t usually consider much of the safety protocols as and when the person is in arrest. Our focus is basically on bringing the person up and restoring the cardiac movement” (P 6)

Institutional regulations

“…there are some institutional policies that restrict nurses from giving certain medications. For instance, nurses are not allowed to give adrenaline… This can make the work challenging when doctors aren’t available (P8)

3. Nurses’ perceptions of care on resuscitation

The attitude of condemnation and prejudice from nurses

“…due to the wrong perception that when patients are old, you won’t get any positive outcome, some nurses do not put in their best” (P 1)

“…some of us have done CPR so many times, and none of the patients survived… It is likely we don’t even bother ourselves to start CPR for the patient who has an arrest” (P 8)

Apathy and skills deficiencies

“…sometimes apathy and lack of skills make some nurses helpless…” (P 3)

“Sometimes, some nurses have little knowledge about emergency care…(P 11)

“You realise that those who do understand the concept of resuscitation, when it happens, they are eager to be involved, but those who don’t understand …” (P 6)

4. Self-reported behavioural competence during resuscitation

Knowledge and skills of CPR

“…lack of knowledge or ignorance about the resuscitation process makes some nurses tend to ignore the whole process” (P 6)

“…genuinely, some of them do not know about resuscitation. Probably, they have just joined the unit, and it is not a frequent thing they have been doing ” (P 4).

Confidence in initiating CPR

“…the way they respond to the command to do resuscitation in an urgent manner affects the outcome of whatever that is being done.” (P 1)

“Sometimes, we are reluctant to go and give chest compression. Nobody is actually willing to start it, and some of the time they don’t even know how to do it, and some will say it is for the doctors” (P 5)

Need for effort maximisation during CPR

“Our mindset is that CPR wouldn’t yield any results, so we don’t put in much effort.” (P 8)

“…we don’t put in much effort…the efforts that go into it is minimal. Sometimes while performing CPR, most nurses do not monitor, and that amounts to blind procedure.” (P 10)