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Nurses' views on workload, care rationing and work environments.

Clare Harvey1, Shona Thompson2, Edmond Otis2

  • 1School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton Campus, Townsville, Qld, Australia.

Journal of Nursing Management
|April 8, 2020
PubMed
Summary
This summary is machine-generated.

Nurses face difficult choices about patient care due to institutional pressures, leading to emotional exhaustion and compromised professional values. This study explores the psychological impact of missed nursing care under workload demands.

Keywords:
implicit care rationingmissed nursing carerationed nursing carework intensification

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Area of Science:

  • Nursing
  • Healthcare Management
  • Organizational Psychology

Background:

  • Increasing research highlights the prevalence of missed nursing care and care rationing.
  • Awareness is growing regarding the impact of these practices on nurses' coping abilities and well-being.

Purpose of the Study:

  • To examine nurses' experiences with institutionally enforced choices regarding undone patient care.
  • To explore how missed care is reconciled with nurses' professionalism and compassion using cognitive dissonance theory.

Main Methods:

  • In-depth interviews (video and telephone) were conducted with four experienced nurses.
  • Nurses described their decision-making processes for prioritizing patient care under workload pressures.

Main Results:

  • Thematic analysis revealed four key themes: compromising care, incongruity between professional standards and organizational resources, emotional exhaustion, and depersonalization.
  • Nurses' professional values are perceived as lost in the pursuit of financial targets.

Conclusions:

  • Nurses experience ethical and psychological dilemmas due to work intensification and financial targets.
  • Financial pressures negatively impact nurses' emotional and clinical well-being, creating cognitive dissonance.