TY - JOUR
T1 - Resource allocation and rationing in nursing care
T2 - A discussion paper
AU - RANCARE Consortium COST
AU - Scott, P. Anne
AU - Harvey, Clare
AU - Felzmann, Heike
AU - Suhonen, Riitta
AU - Habermann, Monika
AU - Halvorsen, Kristin
AU - Christiansen, Karin
AU - Toffoli, Luisa
AU - Papastavrou, Evridiki
AU - Chryssoula, Lemonidou
AU - Walter, Sermeus
AU - Olga, Riklikiene
AU - Rengin, Acaroglu
AU - Darijana, Antonic
AU - Christophe, Baret
AU - Helga, Bragadottir
AU - Luk, Bruyneel
AU - Raul, Cordeiro
AU - Liana, Deklava
AU - Suzanne, Dhaini
AU - Sigal, Ezra
AU - Elena, Gurkova
AU - Patti, Hamilton
AU - Raphaela, Kane
AU - Marcia, Kirwan
AU - Mario, Amorim Lopes
AU - Christian, Rochefort
PY - 2019/8
Y1 - 2019/8
N2 - Driven by interests in workforce planning and patient safety, a growing body of literature has begun toidentify the reality and the prevalence of missed nursing care, also specified as care left undone, rationedcare or unfinished care. Empirical studies and conceptual considerations have focused on structural issuessuch as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspectsof unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covertrationing/missed care/care left undone – suggesting that nurses, in certain contexts, are actively engaged inrationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicitdecision-making frameworks within which to consider rationing of nursing care. In reality, the assumption ofpolicy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appearthat rationing/missed care/nursing care left undone is a direct response to overwhelming demands on thenursing resource in specific contexts. A discussion of resource allocation and rationing in nursing thereforeseems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resourceallocation and rationing as they relate to nursing care and the distribution of the nursing resource.
AB - Driven by interests in workforce planning and patient safety, a growing body of literature has begun toidentify the reality and the prevalence of missed nursing care, also specified as care left undone, rationedcare or unfinished care. Empirical studies and conceptual considerations have focused on structural issuessuch as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspectsof unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covertrationing/missed care/care left undone – suggesting that nurses, in certain contexts, are actively engaged inrationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicitdecision-making frameworks within which to consider rationing of nursing care. In reality, the assumption ofpolicy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appearthat rationing/missed care/nursing care left undone is a direct response to overwhelming demands on thenursing resource in specific contexts. A discussion of resource allocation and rationing in nursing thereforeseems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resourceallocation and rationing as they relate to nursing care and the distribution of the nursing resource.
KW - Care left undone
KW - missed nursing care
KW - nursing care
KW - rationing
KW - resource allocation
U2 - 10.1177/0969733018759831
DO - 10.1177/0969733018759831
M3 - Article
SN - 0969-7330
VL - 26
SP - 1528
EP - 1539
JO - Nursing Ethics
JF - Nursing Ethics
IS - 5
ER -