Table 1.

Examples of how individuals define safe care and feeling safe

In the words of participants: what safe care and feeling safe is about & should be…
Elusive, hard to describe… I do believe I get safe care [at study site] except for the odd little thing. I know I have safe care – I do. I feel it. I don't know what to say about that. I'd like to know they got safe care, I assume they do. It's just something I take for granted.
Mobility & fall prevention… Providing things when you need to move about safely – like giving you a walker if you need to walk somewhere or wheelchair and they make sure it fits my body comfortably so I can get around better. They take me to the bathroom if I need it and stand by so I don't get up and fall. They make sure you're sitting down safely before they leave the room and…or in bed or whatever. I do feel safe here. I guess because I can get around. To make sure, if they're so sick they don't know what they're doing, for themselves, that they're not going to be able to fall or fall out of bed or if they are trying to get out of bed then, that's when they're going to get out of bed anyway because you can't be everywhere at once. If you can't keep them in the bed at all then you take all precautions that that one's not making the decision on their own to get out of bed. And also if they needed to be strapped in then they are, it's for their protection and the staff protection to do it. I think when you're unsteady on your feet you kind of need that extra little hand to help you.
Rushing feels unsafe… [Anything that made you feel unsafe] Just the rush. It's like I've [staff] got to get this job done because I've got another really important job I've got to get to. I'm in a hurry. [worry miss something] I do. We have to streamline everything.
Away from stress of roommate… Away from a tyrant [roommate].
Infection control… You want to make sure that you're not going to give any germs if you have them to somebody else. There could be times when they [staff] should wear a mask too maybe.
Teaching (or not)… What the nurses teach us. How to sit down, how to get up, always back up to a chair till you feel it at the back of your legs and then you can sit down. If somebody doesn't know what they're doing…they can tell you if you don't do this something like this might happen. [Would teaching on medication make you feel safer] Yes, I think it would. Yes – they [patients] will know what is required of them to make sure that they're safety is looked after. Make sure that they can. Yes, that's for sure. Especially the physio part. No, I've been in hospitals enough to know what goes on.
Everyone follows safety standard… The hospital treating you was ensuring your safety by having the best trained or qualified people to look after you, to ensure that they wash their hands, to ensure that they're kept up on the latest methods, to ensure that other hospital staff such as, cleaners, food, volunteers, all maintain that safety standard too and that cleanliness factor of cleaning their hands before they come in. [Unsafe] The non‐caring nurses that administered it [treatment at another site], that didn't follow protocol, I'd call that unsafe care. Very scary.
Environment… That if they're mopping the floor they put the signs out and they warn you. Or if they're making your bed, they make sure they haven't got it up too high that you can't get into it. That they have the furniture arranged so that you're not going to fall over it. Stuff is placed so you can get at it. I'm in a safe and clean environment which means a lot to me. [Unsafe] These floors are very slippery. I have to wear my slippers all the time. But they force me to wear my slippers anyways. It's your environment, anything on the floor, like if I look around and say see something on the floor and anything's not going to fall off. Your total environment, just that, something's not going to be some kind of a little accident happening or something. Watching your cords. I think that's the big one there, the clean [hospital]. The only that comes to my mind is the smaller area, make sure it's not cluttered to that if an emergency comes up that you have to remove the person from the room, that you can get the bed out safely. [clean environment part of safe care] Definitely. Yes. I like things being clean. I can't stand anything dirty. When I see things dusty it makes me feel like I'm not breathing well.
Providers’ responsibility… A nurse's responsibility to make sure that her patients are getting better. The responsibility seems to stem back to the nurses…proper care from them. That they do their part. Teamwork. Safe care is you're in the hospital, and you've got the nurses and the medical people looking after you, I figure that's safe care. That they're doing what they should do to help me. I'm in the hands of them.
Not threatened… I don't feel threatened by anything.
Medication administration… Your medications should be looked at but I don't know maybe they do look, the nurse who brings it to you. Getting the right drugs, the nurse checking that the drugs are the ones you're supposed to get, washing her hands before she gives them to you.
Insightful, reliable & attentive staff… Being there when you need them. I feel that they should be here, like if you ring the buzzer and you're in a lot of pain and you know that you're afraid to get up to do things on your own, that's my only concern, that they would come and do it, for you, help you. Be prompt, and that if you need them, to get here as soon as possible. I don't think you should leave the patient alone so much. I know they've cut back but. But these horror stories about retirement homes and…terrible. Just awful and they're right here in our own community. They assessed each person whether they were nervous or they were apprehensive or they were relaxed. I think they should look in on you more often than they do. They do have a bell if you need it but you have to remember that there's a bell there or you have to be awake enough to know “yes” you've got to press the bell. That's where the problem is. And sometimes…you can't see how sick I am, I can't see how sick you are. I don't know how you feel, you don't know how I feel. That's hard. They're there when you want them—I think that's the bottom line. Being able to have somebody respond when you ring your bell quickly.
Effective communication… Yes. Exactly. He [anaesthesiologist] was very reassuring, every time I saw him, he would touch me on the shoulder – “you ok now, it's just me,” you know and I had my eyes shut and he said, “it's just me again and I'm going to be…” and “just me.” So, he made me feel relaxed. Even the surgeon who I'd not met, he was very good as well. He introduced himself, he asked me if I had any questions. And he explained the procedure all over again, told me what we were going to do, told me that I was to participate, and that was fine [she chuckles] – I said am I going to be out for this and he said no. And I said well that's good. And both the anesthesiologist and the doctor said that they wanted me to participate, and I felt good about that [having awareness]. [feeling unsafe] Yes, when the fire alarm went off. The first time it happened, they did say we'll close the door. But last night, nothing happened, it just kept on and on – soon the buzzers stopped and don't know if it was a fire or, somebody broke in or…nobody came in the room even. People that you could ask questions.
Fair, honest, nice… Well, you don't hear guns going off or fire trucks pulling up. I don't know, just everything is fair and honest and nice, so you feel safe. Not going to come in and steal your stuff or anything.
Being mistreated… [safe care] Like being mistreated, you mean?
Alerting staff… Not doing what you shouldn't do by yourself without letting, you should always let the nurses let them know if you are going to be doing something, if it's something you shouldn't be doing by yourself. Unless you've already agreed, ok, it's fine I can do this by myself. But I like the idea there's bells all over. If you do get into something you can call for a nurse.
Everyone's role… Everyone, everyone being aware.
Multifaceted… I think there would be maybe two or three different scenarios that should come into play. Make sure that the room is not cluttered, and stuff like that. The medication should be, definitely looked at properly. And also whether that patient is demanding because they are hurting in pain so much that they're becoming an annoying, so therefore it works on one's nerves, so you have to keep in mind this is not that person's right make‐up. There's safety for all, not only for the patient but for the nurse, the doctor, the staff person.
Common sense… [Not getting safe care] Sometimes I think common sense has been cancelled.
Small town‐feel… I feel extremely secure here. Extremely secure. I guess I'm looking at I live in a small town, I don't live in [name of large city] anymore. But you see forced entrances into hospitals, and whatnot. We don't think about that here.
Caring… They [staff at study site] don't let you go off on your own, walking around the hospital if you're not able to do it and they're here looking after you 24 hours a day. And they're always on call. [family member adds] In the real sense of the word, rather than just making a buck. The nurses themselves, they do all they can to help you. They do their best.
Reinforcement and reminders… They provide well, like for you to call for help if you need it and they tell you if you need anything at all call me, every night. So much reinforcement [pre‐procedure of what will happen]. Somebody in a wheelchair will try and stand up, they say “oh no, you have to sit down” and that's just a constant thing, they do that all the time. And just the way they set people in a wheelchair for an example. You know, “be careful, we have to do this, we have do that” and then they always put brakes on when they stop and stuff like that. Being a non‐professional may do it sometimes and not others, where they are constant with it.
Being aware… It's like anywhere else, you've [patient] got to keep your eyes open and your ears.
Rights… I know we [patients] have rights. If they think they aren't being looked after safely I believe there's someone that they should be able to go to or report to or discuss it with, certainly.