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Objectives: To describe the constraints and challenges face by the nurses in provision of care at Accident and
Orthopedic Service (AOS), National Hospital of Sri Lanka (NHSL).
Methods: Nurses currently working in AOS included for the sample (n=223). Pre-tested self-administered
questionnaire was used to collect data related to personal characteristics and perceived challenges of nurses. Data
analysis was done using SPSS statistical software and descriptive statistics were used to analyze data
Results: The response rate was 77.2% (n= 163), majority (90%) was female. High percentage (70%) of the nurses
experience work related stress and majority (80%) has job satisfaction and positive level of autonomy (60%) in their
nursing practice. However, majority (85%) of nurses experienced time pressure to complete tasks and high
percentage (80%) of nurses felt that dealing with patients with substance abused, aggressive behavior, patients and
family members with unrealistic expectations as challenges during their practice. Almost half (50%) of the muses
felt increased number of patients and dealing with patients with critical conditions as challenging conditions in their
working area. And also most of them (75%) felt increased number of working hours, excessive number of night
shifts and work over load as challenges during their clinical practice.
Conclusions: Nurses at AOS perceived many challenges during their practice. Most common factors that
contributed were dealing with substance abused or aggressive patients and family members, unrealistic expectations
