Abstract
BACKGROUND: The integration of sustainability into nursing practice is critical for addressing the environmental challenges posed by healthcare systems. Nurses, as frontline healthcare providers, are uniquely positioned to lead sustainability initiatives, though collaboration with other healthcare professionals is essential. However, nurses' engagement in sustainability behaviors is influenced by a complex interplay of attitudes, practices, barriers, and facilitators, which are not fully understood. This study aimed to explore nurses' attitudes, practices, and barriers and facilitators toward sustainability behaviors in clinical settings. METHODS: The study employed a descriptive qualitative design. Data were collected through semi-structured interviews designed to explore participants' experiences in depth with 15 purposively sampled licensed staff nurses. The sample size was determined by data saturation. Thematic analysis was used to analyze the data. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. RESULTS: Nurses viewed sustainability as an ethical responsibility linked to waste reduction and resource conservation, yet sustainability was often deprioritized due to immediate patient care demands. Sustainability behaviors included waste management and energy conservation, but inconsistent institutional policies and limited formal training posed significant challenges. Key barriers included organizational challenges, competing priorities, and lack of motivation, while facilitators such as leadership support, education, training, and teamwork emerged as critical enablers of sustainable practices. CONCLUSION: The study highlights the complex interplay between individual attitudes, institutional barriers, and enabling factors influencing sustainability in nursing. Nurses demonstrate an ethical inclination toward sustainability, but systemic challenges hinder their engagement. Leadership support, targeted training, and organizational policies are critical for fostering sustainable practices in clinical settings. IMPLICATIONS FOR PRACTICE: Addressing identified barriers and leveraging facilitators can enhance sustainability behaviors among nurses. Tailored interventions, such as sustainability-focused education, leadership engagement, and policy reforms, are essential to empower nurses as leaders in environmental stewardship. Recognizing and supporting nurses' roles as environmental advocates is crucial for advancing sustainability in healthcare. CLINICAL TRIAL NUMBER: Not applicable.