Abstract
In South Africa’s primary healthcare (PHC) system, professional nurses play a vital role in
frontline service delivery. However, growing patient dissatisfaction, particularly complaints
about negative staff attitudes, has become a concern for care quality and staff well-being.
While patient complaints are valuable tools for monitoring service delivery, their potential
impact on nurse job satisfaction remains underexplored, especially in resource-constrained
settings. This study investigates how patient complaints about perceived negative staff
attitudes influence the job satisfaction of professional nurses in PHC facilities within the
Ehlanzeni District, Mpumalanga.
A qualitative, explorative, and descriptive design was employed. Eleven professional nurses
from three purposively selected PHC clinics participated in semi-structured interviews. Data
were analysed using thematic content analysis following Giorgi’s phenomenological approach,
with support from ATLAS.ti Desktop Version 8.3 software. The study was guided by the Job
Demands–Resources (JD-R) model to explore emotional and systemic dynamics influencing
job satisfaction. Five major themes and sub-themes emerged: Theme 1: perceived staff
attitudes and patient complaints. Theme 2: work environment stressors; Theme 2, sub-theme
1: High patient-to-nurse ratio; Theme 2, sub-theme 2: Long waiting times due to understaffing;
Theme 2, sub-theme 3: Lack of basic resources; Theme 2, sub-theme 4: External interference
from management and community leaders. Theme 3: emotional impact on nurses; Theme 3
Sub-theme 1: Feelings of frustration, helplessness, and burnout; Theme 3, Sub-theme 2: Loss
of job satisfaction and professional Confidence; Theme 3 Sub-theme 3: Emotional toll from
patient complaints and systemic challenges. Theme 4: concerned communication challenges;
Theme 4 sub-theme 1: Lack of clear explanations leading to misunderstandings. Theme 5:
recommended strategies for improvement; Theme 5, sub-theme 1: Increasing staff levels and
reducing patient loads; Theme 5, sub-theme 2: Regular training on communication, conflict
resolution, and stress management. Nurses expressed that complaints often stemmed from
systemic deficiencies such as staff shortages, long waiting times, and miscommunication.
Complaints were frequently internalised, resulting in emotional exhaustion, professional
demoralisation, and reduced job satisfaction. Patient complaints in PHC settings, though often
reflective of broader health system challenges, are experienced by nurses as personal
criticism, with significant emotional and professional consequences. Interventions such as
improved communication training, structured complaint-handling mechanisms, psychological
support systems, and increased staffing are essential for protecting nurses’ well-being and
enhancing patient care quality. These findings hold critical implications for PHC strengthening
and National Health Insurance (NHI) implementation in South Africa.