Nursing care is derived from the philosophies of holism and humanism ( Frisch & Rabinowitsch, 2019 ). Holism is one of the features that are well connected to holistic nursing care as it attests to the importance of the whole sum rather than the sum of its parts, which includes the whole being, body, and soul. McMillan et al. (2018) describe the vitality of a whole being or system as performing well if all parts of the system are not impaired or disturbed. In other words, one part is unable to function without the whole; therefore, providing the care needed by an individual is substantial. It is revealed that sick people die because of a nurse’s incompetence and carelessness, whereby the aging group needs critical care. Furthermore, deaths among children under 5 years of age are linked to nurses’ carelessness ( Kirwan et al., 2013 ).

Nursing attitude continues to be a major health problem in developing countries, especially as nurses’ behavior has a great influence on patient recovery. Nurses are the largest group of healthcare professionals who are the most interactive with patients ( Wake, 2022 ). Patient safety is an important aspect of healthcare delivery and is critical to healthcare assessment ( Yin et al., 2023 ). One of the primary burdens faced by nurses in Cameroon is the high patient load. The nurse-to-patient ratio is often inadequate, leading to overworked nurses who must manage multiple patients simultaneously. WHO recommended that the nurse-to-population ratio be 1:500, but in many parts of Cameroon, this ratio is far exceeded ( WHO, 2023 ). Also, Nurses frequently have to work in environments with insufficient medical supplies, outdated equipment, and poor sanitary conditions due to a lack of essential resources ( Moyimane et al., 2017 ).

Poor nursing care in many situations comes as a result of different challenges faced. In countries with low development skills, nurses face a greater challenge as a result of inadequate equipment, thereby exposing patients to more harm, and patients find it difficult to come to the hospital ( Moyimane et al., 2017 ). Possible reasons for the poor behavior of nurses in patient care is due to high workload and stress, lack of resources and limited support from their colleagues, poor communication, lack of respect from the patient, organization culture, nurses having personal issues with patients, lack good education and training of the concept of patient care ( Molina-Mula & Gallo-Estrada, 2020 ). Previous studies have shown that healthcare by nurses has been faced with challenges such as caring problems, inadequate nurses’ ability, poor management, and lack of adequate infrastructure, payment models, coordination and lack of job satisfaction in healthcare ( van Weel et al., 2019 ).

Patients still suffer from a lack of adequate nursing care. Even with the part nurses play in healthcare delivery, there are still various challenges that affect their ability to provide optimal care. This is probably because of the high patient load, limited resources, inadequate training opportunities, and emotional and psychological stress. A considerable knowledge gap exists in the understanding of the specific challenges faced by nurses in Cameroon and their impact on patient care. Also, there is extensive information available on nursing care in other regions, but similar information is lacking in the Buea health area. Hence, there’s a need to assess behaviors and factors that influence nurses’ attitudes towards patient care in the Buea Regional Hospital.

This study was meant to determine nurses’ attitudes toward patient care at Buea Regional Hospital of the Southwest Region of Cameroon. Generally, the attitude of nurses toward patient care was good, as it was seen in the politeness of nurses 57 (71.8%) when talking to their patients. It has been previously reported that a good nurse-patient relationship enhances patient stay and recovery in any hospital in the world ( Molina-Mula & Gallo-Estrada, 2020 ). Most patients will always feel welcomed, and recovery will always take a shorter time once they have a good relationship with the nurses. It can also help in drug compliance and receptiveness. The high level of patient satisfaction linked to polite care highlights the importance of soft skills training in nursing education and continuing professional development programs.

A majority of the study participants (60.3%) attested that nurses at the Buea Regional Hospital worked in teams. McEwan et al. (2017) in a systematic review and meta-analysis of controlled interventions based on the effectiveness of teamwork training on teamwork behaviors and team performance, revealed that effective teamwork and performance will improve behavior and effectiveness in service provision. Patients at the Buea Regional Hospital revealed that nurses work hand-in-hand with other healthcare providers to provide quality services. This finding was also in line with a study carried out by Zajac et al. (2021) , who showed the importance of teamwork with other healthcare practitioners in service provision. Therefore, incorporating teamwork curricula in healthcare training institutions can reinforce the importance of professional attitude, teamwork, and communication in nursing practice.

A majority of the study population, 52 (66.7%), reported that they felt safe while being treated in the hospital, and the nurses were kindhearted, 52 (66.7%). This finding was in line with studies carried out by Dikmen et al. (2018) and Ayhan et al. (2015) . In their findings, they revealed that nurses’ care and treatment towards a patient is based on kindheartedness, regardless of the patient’s sex or race. This was also the case at the Buea Regional Hospital. The sense of safety and kindheartedness reported by patients reinforces the role of emotional intelligence and empathy in nursing care.

When the participants were asked if patients were allowed to express themselves freely, a majority of the participants, 56 (71.8%), said patients were allowed to express themselves freely. This was contrary to the study carried out by Pereira et al. (2018) , who showed that a majority of the participants were not allowed to express themselves freely. This could be related to the nurse’s job description. Most patients have the habit of trying to tell the nurses what to do, whereas it is not their job to do so. This will likely cause the nurses to restrict the patients from freely expressing themselves during treatment. The freedom of expression among patients at the Regional Hospital Buea reflects positively on the institution’s commitment to patient-centered care. These policies are implemented to promote participatory healthcare, where patients’ voices are valued in decision-making. However, a need exists to clearly delineate patient-nurse boundaries, ensuring that patients feel heard without overstepping clinical roles.

This study was also meant to determine some factors that affect nurses’ attitudes at the Buea Regional Hospital. From statistical analysis, 47 (70.5%) of the study population responded that nurses had a high workload in the hospital. This was in line with a study carried out by Adriani et al. (2022) , who revealed that 76% of the study population had high workload at the hospital. The reported staff shortages necessitate urgent policy interventions to recruit and retain more nurses. Additionally, 45 (57.7%) of the study population revealed that nurses always complain to the patients that they are not well paid at the hospital. These challenges are not unique to Buea; rather, they reflect broader systemic problems in healthcare across many African settings and may even migrate to other countries to seek for better wages ( Adam et al., 2025 ). Chang et al. (2023) have also highlighted this concern, and this may affect nursing practice towards patient care and safety.

Interestingly, 46 (59.0%) of the study population reported that nurses work in favorable working conditions. This is contrary to a study carried out by Dikmen et al. (2018) and Ayhan et al. (2015) , who found working environments to be generally poor in similar settings. A favorable working condition may improve healthcare and practice, which may improve recovery time and compliance with medical healthcare procedures by patients. More so, the number of nurses per shift was small to carry out the task and the majority, 60 (65.4%). This is in line with the study carried out by McMillan et al. (2018) in similar settings. Limited nurses per shift will definitely influence nurses’ attitudes. The Buea Regional Hospital is known to host so many patients per day, and this could influence nurses’ attitudes towards holistic patient care.

The authors appreciate the support and cooperation of all the patients who participated in the study. We also appreciate Cornerstone University and Theological Seminary, Cameroon, for giving us the opportunity to carry out this project.

HFM conceived, designed, supervised the study and major contributions and performed statistical analysis and drafted the manuscript, and BAM participated in designing the project and carried out data collection in the field. WCA, HLP, VNN and LBA contributed to the revision of the manuscript. All authors read and approved the final manuscript.

All datasets generated and analyzed during the study are presented in the paper.