Table 2: Themes, sub-themes, and participants’ statements about assertiveness barriers in collaboration implementation for the care of patient with ACS in emergency departments

Theme Sub-theme Participant’ statement/keyword
Difference of confidence between senior and junior nurses in caring for ACS patients Senior nurses note that the mistakes made were minimal “If there is a case of ACS, as far as I know, it is handled by senior nurses. Based on our experience, the senior has only a minimal error rate once ... (P4)
“Expertise maybe depends on the experience of handling ACS. Our nurses, ventilator and defibrillators are already here in 24 hours. It is important, we must know where we work. We learn to understand what is happening and must know the procedure to avoid mistakes.” (P8)
Junior nurses are less confident and more confused Generally, the junior activities include administering an intravenous infusion, providing something, just like that. Here, we need a fast response, 4 minutes or 5 minutes, junior nurses often get doubt and face obstacles to follow the speed.” (P4)
“I am still afraid and confused to do collaboration, because I just joined the ED.” (P9)
“If there are too many patients, usually for treating ACS patients, I consult with a more senior nurse. I help the patient as much as I can do such as apply an infusion therapy or ECG. Sometime I got less confident because I have little experience about the ECG procedure.” (P11)
“Even junior nurses held bachelor degree, they cannot be guaranteed in understanding ACS, this may happened because they were newbies as emergency nurses, so we as senior nurses should hold more roles and guide them.” (P15)