What Nurses Do During Time Scarcity-and Why.

Area of Science:

• Nursing
• Healthcare Management
• Patient Care

Background:

• Time scarcity is prevalent in nursing work environments.
• This scarcity necessitates clinical prioritization, also known as implicit rationing of care.
• Implicit rationing involves nurses deciding which patient care activities to complete and which to leave unfinished.

Purpose of the Study:

• To explore the phenomenon of implicit rationing in nursing.
• To identify mechanisms influencing clinical prioritization decisions.
• To determine the impact of implicit rationing on patient needs and suggest interventions for nurse leaders.

Main Methods:

• Literature review to identify mechanisms influencing implicit rationing.
• Analysis of the effects of these mechanisms on patient care.
• Identification of potential intervention points for nurse leaders.

Main Results:

• Five mechanisms influencing implicit rationing are supported in the literature.
• Implicit rationing leaves patients vulnerable to unmet needs in education, psychological support, care coordination, and discharge planning.
• Nurse leaders can intervene through redesigned care delivery, performance monitoring adjustments, and fostering supportive work cultures.

Conclusions:

• Addressing time scarcity and implicit rationing is crucial for patient safety and quality of care.
• Nurse leaders have a key role in mitigating the negative effects of implicit rationing.
• Interventions should focus on systemic changes in care delivery, performance metrics, and organizational culture.