Introduction: Nurse managers are the first healthcare professionals to observe safety-related incidents. In addition to their observational role, they are responsible for directing and implementing patient safety policies and procedures. Therefore, an in-depth exploration of their perspectives and lived experiences is necessary. Aims: To investigate the opinions and experiences of nurse managers regarding patient safety. Design: An explorative qualitative design was employed. Methods: The study was conducted between June 2022 and January 2023 at a university hospital in Turkey. A total of 14 nurse managers participated in semi-structured interviews. Data were analysed using thematic analysis. The study adhered to the COREQ checklist. Results: The opinions and experiences of nurse managers regarding patient safety were gathered under total of 21 codes and six sub-themes were identified and organised under four main themes: Perceptions of Patient Safety, Factors Influencing Patient Safety, Strategies to Enhance Patient Safety, and Patient Safety Incidents. Conclusion: The findings indicate that nurse managers encounter several challenges in ensuring and sustaining patient safety. Their insights reveal contributing factors to negative patient safety events and propose actionable precautions. Participants emphasised that managerial appointments often overlook merit, despite the necessity for experienced, well-trained, and competent nurse leaders. Implications for Nursing Practice and Policy: This study highlights the need to empower nurse managers and ensure their professional autonomy in the context of patient safety. It also reveals the importance of appointing qualified, experienced nurse leaders to improve safety outcomes. These findings may inform institutional strategies and policy reforms aimed at delivering high-quality, safe, and cost-effective care.