Determinants of nursing care rationing among nurses employed in surgical and conservative hospital wards

To identify factors associated with nursing care rationing among nurses employed in surgical and conservative hospital wards.

This cross-sectional study included 383 nurses employed in surgical (n = 161) and conservative (n = 222) hospital wards. Nursing care rationing was assessed using the Basel Extent of Rationing of Nursing Care-Revised (BERNCA-R), whereas life satisfaction and dispositional optimism were evaluated using the Satisfaction with Life Scale (SWLS) and the Life Orientation Test-Revised (LOT-R), respectively. Group differences were analysed using non-parametric tests, and factors associated with nursing care rationing were identified using univariate and multivariate linear regression analyses.

The mean nursing care rationing score in the whole group was 1.31 (SD = 0.90), whereas mean life satisfaction and dispositional optimism scores were 21.30 (SD = 6.57) and 14.85 (SD = 3.93), respectively. No significant differences between surgical and conservative ward nurses were observed in sociodemographic characteristics (all p > 0.05). Shift work was independently associated with higher levels of nursing care rationing in both surgical (β = 0.364; p = 0.022) and conservative wards (β = 0.290; p = 0.035). In conservative wards, completion of specialist courses was independently associated with lower levels of care rationing (β = -0.272; p = 0.039).

Organisational determinants appear to be more strongly associated with nursing care rationing than individual psychological resources. Shift work was the factor most strongly associated with missed nursing care irrespective of ward profile, whereas completion of specialist courses was associated with lower levels of care rationing in conservative wards.