Background: Measurements of nursing workload often fail to reflect the complexity of nursing work. Nurses' perceived workload is shaped by many factors, including patient characteristics, personal, social, organizational, and environmental factors. There is a demonstrated interest in developing more comprehensive nurse workload measurement strategies, but little research has employed qualitative methods to investigate the beliefs and experiences of frontline staff. The purpose of this study was to explore inpatient nurses' perceptions of their workload and the factors that impact their percieved workload levels.

Methods: This was qualitative study using focus groups. Participants were recruited from the cardiac floors of an urban, academic medical center. A total of 17 nurses participated, including nurses from bedside, charge, educator, and nurse manager roles. Focus group transcripts were analyzed by a team of qualitative investigators using conventional content analysis.

Results: Inpatient nurses' perceived workload is shaped by their work volume, work attributes, and their ability to complete required tasks while providing meaningful, impactful care. The volume of nursing work is comprised of patient-focused, unit-focused, and institutional-focused tasks. Important work attributes include its perceived urgency, difficulty, alignment to the nurse and unit, interference, unpredictability, and individual nursing burden. Overall, participants expressed deep concern over high workloads that compromise holistic nursing care.

Conclusion: Strategies to more comprehensively measure nurses' perceived workload should account for the breadth and complexity of nursing work. Nurses should advocate for workload measurement systems that more closely reflect their subjective work experiences.

Clinical trial registration number: Not applicable.