Nurse leaders’ perspective on heat-related challenges and work-organizational interventions in inpatient care settings in Germany: A qualitative descriptive study

Background

In Germany, rising heat-related mortality and hospital admissions are posing significant challenges to healthcare systems. Nurses working in inpatient care facilities are particularly vulnerable because of heat stress.

Objective

This qualitative descriptive study explores the impact of heat waves on nurses and their work environment in inpatient care facilities. It examines existing interventions to mitigate heat stress and identify areas for improvement. The study was conducted using semi-structured interviews with nurse leaders from inpatient care facilities, including hospitals and long-term care facilities in Saxony, Germany.

Methods

Forty-eight nurse leaders from varied roles and facilities were interviewed (September 2022–June 2023). Qualitative analysis identified key themes around heat stress, impacts, and adaptations.

Results

The majority of hospital nurse leaders and all long-term care facility nurse leaders reported significant challenges because of high outdoor temperatures. Heat stress negatively affects nurses’ physical health, cognitive function, and overall work performance while also impacting patient care and medication management. Facilities reported implementing 38 different interventions, with organizational and personal-level adaptations being more common than technical interventions. However, adaptation efforts remain fragmented.

Conclusion

The study highlights the urgent need for structured heat adaptation in inpatient care, providing rationale for healthcare institutions to prioritize protections for nurses, patients, and residents amid rising temperatures. Future research should assess the effectiveness of current interventions, identify new solutions, and explore systemic barriers to successful implementation. To inform future policy and practice, the findings underscore the importance of formalizing heat action plans and integrating climate resilience into institutional strategies across the healthcare sector.