Understanding how nurses ration care

Journal of Health Organization and Management
Clare HarveyMaria Pearson

Abstract

Purpose The purpose of this paper is to explore how nurses make decisions to ration care or leave it undone within a clinical environment that is controlled by systems level cost containment. The authors wanted to find out what professional, personal and organisational factors contribute to that decision-making process. This work follows previous international research that explored missed nursing care using Kalisch and Williams' MISSCARE survey. Design/methodology/approach The authors drew on the care elements used by Kalisch and Williams, asking nurses to tell us how they decided what care to leave out, the conduits for which could include delaying care during a shift, delegating care to another health professional on the same shift, handing care over to staff on the next shift or leaving care undone. Findings The findings suggest that nurses do not readily consider their accountability when deciding what care to leave or delay, instead their priorities focus on the patient and the organisation, the outcomes for which are frequently achieved by completing work after a shift. Originality/value The actions of nurses implicitly rationing care is largely hidden from view, the consequences for which potentially have far reaching e...Continue Reading

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Citations

Jul 25, 2019·Nursing Philosophy : an International Journal for Healthcare Professionals·Tanya LangtreeNarelle Biedermann
Apr 8, 2020·Journal of Nursing Management·Clare HarveyEileen Willis

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