Perspectives of nursing executives regarding ethical-economic issues

The authors grapple with the very real issue of how to allocate scarce health care resources while trying to hold down costs, especially in the face of changing federal and managed care reimbursement realities. Nurse executives (NEs) were surveyed in an attempt to discover their perspectives on a number of related ethical-economic issues. The NEs' responses to the entire "ethical-economic" survey were contrasted with answers offered to the same tool earlier by staff RNs. Among the questions raised was the impact of cost controls on staffing patterns. Not surprisingly, the staff nurses reported perceiving that budget cuts had a greater negative impact on staff positions and the quality of patient care than the nurse executives reported. Both groups were in favor of taxpayers covering a greater part of the cost of medically indigent care. When asked if they would be willing to pay higher taxes themselves, slightly less than half of the nurse executives answered in the affirmative while only 17% of the staff nurses indicated a similar willingness.