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Discursive practice – lean thinking, nurses’ responsibilities and the cost to care

journal contribution
posted on 26.03.2019, 00:00 authored by Clare HarveyClare Harvey, C Baret, C Rochefort, A Meyer, D Ausserhofer, R Ciutene, M Schubert
Purpose – The purpose of this paper is to explore the literature regarding work intensification that is being experienced by nurses, to examine the effects this is having on their capacity to complete care. The authors contend that nurses’ inability to provide all the care patients require, has negative implications on their professional responsibility. Design/methodology/approach – The authors used institutional ethnography to review the discourse in the literature. This approach supports inquiry through the review of text in order to uncover activities that remain institutionally accepted but unquestioned and hidden. Findings – What the authors found was that the quality and risk management forms an important part of lean thinking, with the organisational culture influencing outcomes; however, the professional cost to nurses has not been fully explored. Research limitations/implications – The text uncovered inconsistency between what organisations accepted as successful cost savings, and what nurses were experiencing in their attempts to achieve the care in the face of reduced time and human resources. Nurses’ attempts at completing care were done at the risk of their own professional accountability. Practical implications – Nurses are working in lean and stressful environments and are struggling to complete care within reduced resource allocations. This leads to care rationing, which negatively impacts on nurses’ professional practice, and quality of care provision.

Funding

Category 2 - Other Public Sector Grants Category

History

Volume

32

Issue

6

Start Page

762

End Page

778

Number of Pages

17

Publisher

Emerald Publishing, UK

Peer Reviewed

Yes

Open Access

No

Acceptance Date

14/08/2018

External Author Affiliations

University of Basel, Switzerland; Kaunas University of Technology, Lithuania; State College of Health Professions “Claudiana”, Italy; Eastern Institute of Technology, New Zealand; Aix-Marseille University, France; University of Sherbrooke, , Charles-LeMoyne Hospital, University Hospital Center of Sherbrooke (CHUS), Canada;

Era Eligible

Yes

Journal

Journal of Health Organization and Management